Augmentative and Alternative Communication (AAC)

Augmentative and Alternative Communication (AAC)4es blog 16

“Not being able to speak is not the same as not having anything to say” – Rosemary Crossely

As the field of speech and language therapy has evolved along with other allied health disciplines and the improvement in functioning and access to technology, the field of Augmentative and Alternative Communication has rapidly expanded. Access to alternative communications is accepted as a right for children and adults who have difficulties communicate verbally. The government supports this by providing funding for assessment and implementation of AAC technologies.

With the inclusion of children with all different abilities into mainstream education and early childhood education and the increase in use of AAC, more and more ECEs are coming into contact with users of AAC and are often learning to use AAC alongside children and their whānau. Speech therapists know that without collaborating and providing adequate support to the child’s whānau and education team, there is a risk AAC becomes something that is only pulled out and used when the SLT is there but there are often time and resource barriers that need to be overcome.

So what is AAC? Who is it useful for? How can early educators provide a supportive environment for users of AAC? How can they create and maintain a culture of AAC use? What AAC can they implement in their centres universally or while waiting for assistance.

AAC is any non-speech communication system used by an individual who has communication difficulties and their communication partners. Generally it is divided into three categories.

  1. No tech – communication that uses the child’s body, which includes sounds, key word signs/Makaton, gestures, body language, facial expression.
  2. low tech – includes printed visuals and object symbols
  3. High tech – such as ipad apps or dedicated electronic devices and technical adaptions.

Some users require person assistance to use their systems, others are independent. It’s important to note that New Zealand Sign Language is not AAC. It is a language in it’s own right formed by the community that use it.

ECEs and school teachers play an important role in designing and supporting the use of AAC. They understand how children in their centre communicate and what they communicate about. They know the rigours that the system will need to cope with and can contribute to goal setting within the educational centre. If you don’t feel part of the process contact the child’s speech and language therapist and ask how you can help.

Supporting an AAC user learning and using their device requires educators to learn how to be good communication partners and to model and teach this to the user’s peers. What are some key strategies? Below are some top tips consider (although there are many more).

  1. Actively participate in goal setting, there could be some goals that are only relevant at an education centre or where the child has the most opportunity to use that particular word or phrase.
  2. Assume competence, if we believe a child has the potential to communicate we will behave in a way that gives opportunities
  3. Have a total communication mindset, use all the communication options that a child has.
  4. Ensure (if it is an external AAC) that it is near and that there is a simple way the child can indicate they need their AAC. If the child has written/visual information about their system ensure that they are assisted to give this to visitors or new teachers/children.
  5. Wait, wait, wait, give the user time to construct a message and do not feel you have to be the first one to talk.
  6. Avoid using hand over hand prompting or supporting a child’s hand unless you are specifically advised to do so.
  7. Model model model, use the AAC system and speech at the same time. We don’t expect children to be experts at spoken communication before they start using it and it’s the same with children using AAC. Model it at an individual level but also in small group or mat time activities.
  8. This brings me to tip number four ‘be meta’ overtly show when you are confused or looking for words, this could include scanning left to right with your finger, looking up for the word in a catalogue/dictionary. We do this with verbal language too ‘thingy with the red shirt on, ah Oliver’.
  9. Some people worry about children playing with their device, not using it properly. Encourage this, think of it as babble. How do we respond to babble, we copy it or we assign meaning to it, helping children to move to intentional communication.
  10. Allow peers to use the device with supervision. Typical children spend a lot of time interacting with their peers and we want to enable the same of children using AAC.

All of the above contribute to an environment that supports the use of AAC. What about children that don’t have specialists working with them yet? What are universal things you can implement to keep a culture of using AAC.

Visual time tables and routine schedules can benefit all children and support comprehension within daily routines. You can use photos of the centre or pictures from the internet or a system such as board maker. Visual timetables show the daily activities. Routine schedules outline visually the process of a particular routine such as going to the toilet, hand washing, lunch times, going outside. Many educators are learning and teaching sign language in their classrooms. Key signs can be used while talking to children to help them learn sign language vocabulary and support their understanding of the spoken word. Wear core vocab boards or key rings with visuals to support preschool rules or with depictions of feelings for helping managing children’s emotions.

By creating an environment where AAC is the norm rather than the exception, it makes it much easier to implement and use an individualised system and creates a naturally inclusive environment.


Guest Author: Alison Bruce, Speech and Language Therapist

Your Potential Speech and Language Therapy

Alison has spent the last year working in the child development service in Nelson. Prior to that she spent over six years working in a remote area of North West Australia as a generalist speech pathologist. Before moving to Australia Alison worked in both private and public services. This has given her a knowledge of a range of areas of speech and language therapy including early development of communication and early intervention.

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