Lauren S. Enders

The good news is this: A growing number of people with complex communication needs are getting access to AAC. Educators whose students had AAC only at circle and snack time are now using it more co…

In May this year David Niemeijer from AssistiveWare and I did a presentation at the AGOSCI Conference on the Do’s and Don’ts of Implementing Real Communication Through AAC. We created a…

“How was school?” (Good) “What did you do?” (Nothing) This scenario plays out in many cars and kitchens in the after school hours and it can be hard to know who is more frustrated: the kids for being asked or the parents for not getting satisfactory answers. And still, we repeat the process day after day. Of course, we want to know the fine details of what happened and how our children felt, but in some cases, we’d settle for ANY school-related conversation at all. I’ll be the first to admit that it took me way too long to get the hang of how to get information about my children’s school days, and it seemed like just when I did, pow! They were pre-teens and then teenagers. New rule book. Here are some ‘lessons learned’ along the way about those afterschool conversations and some suggestions for parents of the kids on your caseloads who use AAC. General Thoughts Remember, they can only tell you what they can tell you. Be thoughtful about how you ask. If they don’t have the means to answer a certain question, they can’t possibly respond and you’ll both be frustrated. Visual Schedule: If the child uses one for structuring daily activities, put an ‘afterschool conversation’ or ‘school talk’ activity into the routine for afternoon or evening. Setting an expectation for this kind of conversation and making it part of the routine helps to give the child a lot of practice. We tend to like things that we’re good at. Sometimes, kids resist these conversations because they are difficult. Do what you can to make it easier. Use visual supports. A visual representation of things to talk about or a copy of their daily schedule at school can help jog a tired child’s memory. Model. Tell a little about your day. Give it the sound and feel of what you hope to get eventually from the child (e.g., chronological order; something novel; one good thing). Rating scales work well for many children. You can see some that we use here (mouse over the bottom part to print, save, or download). Beginning Communicators Make sure that they have the appropriate vocabulary within their AAC systems. Use aided language input as you speak. Use visual supports, such as a replica of their school schedule or pictures of teachers and classmates, as you speak. Try asking forced choice questions (e.g., “Did you have art or music today?” “Did you see Lissa or Robert?”). It helps if you know the right answers so that you can model the correct response if the child gets it wrong. For very beginners, try questions of affirmation along with the appropriate visual support. E.g., show picture of teacher; “Ms.Humphrey. Did you see Ms. Humphrey?” show symbol for recess; “Recess. Did you have recess?” If the child doesn’t respond after a 10 second pause, model the correct answer and help the child do it, too. “Yes. Mrs. Humphrey. You saw. Ms. Humphrey.” “Art. You had art today.” If the children use AAC systems that are rich in core language, this is a good time to practice. It’s a little tricky, but with practice you can get into the habit of framing the question so that they always have a means of responding using core words. Later this week, we’ll post a PDF of suggestions for core language conversations. Try using a script that has predictability and structure. Plan a conversation that has 2 turns for each of you and develop a script with appropriate visual supports. For example: Forced choice Parent: “Who was your lunch buddy, ___ or ___ ?” Child: “___” (with AAC) Parent: “Was it fun or not fun?” Child: “Fun” (with AAC) Affirmation Parent: “Story Circle. Did you have Story Circle today?” Child: “Yes” (with AAC) Parent: “Special letter. Did you see the special letter?” Child: “Yes” (with AAC) Kids with Fairly Robust Language Skills Try comments rather than questions About something they did or handed in: “I bet your teacher noticed the practice you did with your math facts.” “I was thinking about you and your spelling quiz today.” About something you observed: “That looks like a lot of books to lug home.” “It looked like Maya had a birthday hat when she came out.” “You look pretty worn out.” “Mrs. Ward seemed to be rushed this morning.” Preview the conversation. Give them some time to prepare mentally. “Later on, I’d like to hear about....” “When you get a chance, fill me in on....” “After you change, let’s talk about...” “At snack, I want you to tell me 2 things about...” Use a visual schedule. For kids that do well with structure, put an ‘Afterschool Conversation’ in the schedule for the afternoon or evening. Keep the conversation short and easy at first, then build from there. Make a prediction. “I bet you were glad that ….” “Maybe you’ll have a sub tomorrow.” “I wonder if Mr. Marlow will do Recess Warriors this week.” Be wrong. Say something plausible that you know is likely to be incorrect. For some kids, nothing is more motivating than the chance to correct an adult. Ask specific questions. Here are some good suggestions from iMOM (and downloadable PDFs) After school conversations are about sharing things that happened in a different place and time. It’s a bit abstract and can be challenging. We don’t give our kids a lot of practice talking in the past tense, and it may not be very meaningful to them at first. Repetition is the key. Manage your expectations because this takes some time. But eventually, you’ll get beyond “Good” and “Nothing.”

Almost anyone who has done AAC trainings, consultations, and evaluations has spent at least part of their time educating others and busting myths about AAC principles, practices, and expected outco…

AAC) with students who have Complex Communication Needs (CCN)...A LOT of reasons. I've chosen the top six and created a flow chart.

How are AAC and Abuse connected? Read more and learn how to protect your students? 5 EASY Things you need to do NOW to prevent abuse in kids with Autism!

It's ridiculous if you think about it. In schools around the world, children with complex communication needs (CCN) are being asked to prove that they can

Research shows that children with communication challenges do best when introduced to augmentative and alternative communication as early as 12 months.

iOS 10, Apple’s new operating system, includes many changes and additions that improve accessibility. An overview can be found in our recent post. We can take this new functionality a step further and use the iPad or iPhone as an…Read more ››

Looking for a quick, easy-to-read resource to supplement your AAC trainings with colleagues and families? In today’s post we share a flipbook-style handout that might come in handy. It covers basic…

Looking for a clear way to introduce people to AAC? Check out the Explore AAC website developed by Prentke Romich and Saltillo. You can access the first learning module here. Browse the site for in…

That’s a question we hear from time to time, and it often stops us in our tracks. The good thing about this question is that is signals that the clinician recognizes a stumbling block and is search…

"I'm finally able to say what I need to say."

I come across a lot of parents of non-verbal or minimally verbal children now who are considering using Sign Language as their main form of AAC. I have a lot to tell these parents, more than I can tell them in a few sentences in a forum or a private message. I decided a blog post was the best place to talk about my personal experience with Sign Language, and why, after almost a year of signing, we decided to give it up for good. I hope that by telling you what Sign Language was to me, as a parent of a child with complex communication issues, I can help you to parse out what it will (or won't) be for you. At 16 months we brought Elanor to Early Intervention. She couldn't walk and she couldn't talk but somehow she still wasn't behind enough to get help. "You should try signing with her," they said, "teach her to sign 'more'." So I did, and I still consider that sweet little "more" sign to be her real first word. I remember sitting with her on the kitchen floor with a stack of teddy grahams asking "more cookie?" over and over again until I finally got my answer. It was an amazing moment for both of us, for which I am incredibly grateful. Who doesn't cherish their child's first word? I am grateful to signing for other reasons, as well. It was through signing that Elanor first asked us to watch Blue’s Clues. Her first “dog” and “cat” signs hinted at her intense love for animals. I’m glad to have had an opportunity to have my 19 month old ask me very earnestly for cookies at 7 o’clock in the morning. I know not everyone is so lucky. What we also gained from ASL was an early understanding of Elanor’s capability. Between 16 and 17 months Elanor picked up well over 100 signs. She showed me that she knew her colors and that she could make sentences. She could learn new words after only seeing them once in conversation. We learned that she was at least as capable of learning and communicating as an average neurotypical toddler. This knowledge is invaluable to the parent of a non-verbal child. Of course we are told to presume competence, but actually seeing that competence is what we long for more than anything. Signing gave us that. There were many things that signing couldn’t give us, though. This became more obvious as time went on. Elanor still cannot count in ASL. She cannot tell you her ABC'S, although I know she knows them. She may try to tell you she "wants" something, but she is unable to make the sign for "want." A stranger wouldn't understand her sign for "horse," or "orange", or "eat." A stranger (who knew how to sign...a rare stranger indeed) would not understand almost anything she signs. Her difficulty in signing was one of the first, most obvious indications that she had a problem planning movements in places other than her mouth. Now this difficulty is more obvious and as I sit watching her struggle, and ultimately fail, to put on her socks I know that the nuanced movement required to sign fluently will likely never be possible for her. And yet this was hardly the biggest problem we faced when it came to Sign Language. This may seem incredibly selfish, but I think as the parent of a special needs child I am entitled to be selfish sometimes. The biggest problem that I had with ASL was the pressure that it put on me. As I said earlier, in the four weeks between 16 and 17 months Elanor learned over 100 signs. Let's restate that. In the four weeks between 16 and 17 months I taught Elanor over 100 signs. Let's restate that one more time. In the four weeks between 16 and 17 months I learned considerably more than 100 signs. I had to. I was her only source of words. It was an incredibly stressful time for me. Most of the almost one full year we relied on signing was incredibly stressful for me. To put it in perspective, let's say that your child, for whatever reason, cannot speak English. You are told that the only way they will ever be able to communicate is in Italian. Okay great, teach them Italian then! Go! Wait? You don't know Italian? Okay, here's a list of videos and books that you can use. No classes though. No one to teach your child directly. Nope, this is all on you. Let's take this Italian analogy even further. Okay, so now spend day and night learning Italian in order to teach it to your child. Your child has picked up quite a bit of Italian from you at this point (good for you!) and you're out in the world, in public, say at a restaurant. The waiter asks your child what they want to eat and they answer in, you guessed it, Italian. Now you have to translate, and you will always have to translate. Anywhere you go, always. So you find that what you've done is taught your child a way to communicate with you and only you, and really, doesn't that kind of suck for both of you? Yes, yes it does. The communication device is different though. It speaks English. I may have to spend time learning where the words are, but I already know all the grammar, and Elanor and I can find the words together. Her little fingers, although shaky, have created motor plans for these buttons and even if her movements aren't perfect, she can easily get her point across. I am confident that she could ask a stranger for a cookie if she had to, and that the stranger would understand her. The difference is night and day. I will always be grateful for the many things Elanor was able to tell me when sign was her only means of communication, but I imagine that if she had used her device all along she would have been able to say many more things, and to many more people. In the end, Sign Language was good, but it was not good enough. When you, as the parent of a non-verbal, hearing child, are looking for a communication solution I urge you to look beyond ASL and consider what else it out there. Ultimately, it will be easier on everyone.

Looking for simple ways to explain what AAC is and what it might look like for people with different communication needs? In today’s post, we feature some short and simple videos created by CALL Sc…

Dear Parent of a Child with Speech Delays, Good morning/afternoon/evening. You may have clicked this link hopefully, seeing “speech delays” and wondering if I have some answer that will help your child. You might be here through a googling session, during naptime or late at night or at work because it’s just eating away at you and the-time-to-act-is-now and what-more-can-I-do to help my child communicate. You may have a kitchen drawer, or a shoebox, or a giant Ziploc bag full of tools: chewy tubes and bite blocks, z-vibes and jigglers, horns and whistles, and bubbles, oh my! (If you don’t know what I’m talking about, and you are the parent of a child with a minor speech issue, like a lisp or a funny /r/ sound . . . then this letter isn’t for you.) I am one of you, a tired parent of a child who was late (oh so very, very late, and she’s still taking her time, traveling the long, hilly, bumpy, exhausting road) to speech. Like me, you may have 20/20 hindsight, realizing that the feeding struggles that appeared early on should have hinted at the oral-motor weakness and disorganization that lay ahead. Or perhaps sounds and speech made appearances, only to fade away and leave you wondering if they ever really happened in the first place. You may look back on the times that people complimented your baby for being “so well-behaved and quiet!” with a combination of wistfulness (because back then you didn’t know) and angst (because back then, should you have known?). You may wonder if things would have been different if you had spent more time sitting face to face with your child and practicing sounds, should you have done more, do other parents do more, how-was-I-supposed-to-know-what-more-to-do. The truth is simple: there’s nothing (in the realm of normal parenting) that you could have done. And once you identified a speech delay and started with the exercises, the dramatic enunciations, the games . . . well, you were already going above and beyond what a “typical” parent has to do to help their “typical” child develop speech. Anyway, back to your speech delayed/apraxic/dyspraxic/nonverbal child. Your child may have some speech, just less than he should. Or perhaps she has a handful of sounds, but nothing intelligible to anyone (except for you, her parent, of course). Maybe your child is young enough and delayed enough that they don’t have much of anything (so well behaved and quiet, indeed). Maybe they are on the road to speech. Maybe they aren’t yet. Maybe they just aren’t, end of sentence. If, in your quest to help your child communicate, you haven’t yet tried something besides speech therapy (as in, therapy aimed at producing and refining oral speech), the time is now. Please, let the time be now. My daughter, Maya, is almost 5 years old. She can clearly speak approximately 15-20 words. With her talker (an iPad with a communication app) she can speak approximately 700 words, with thousands more available at the touch of a button if she needs them. With her voice, she can say "Mommy" and "Daddy". With her talker, she can tell me that today is Friday and she’s going to the therapy gym in the afternoon and she wants to ride on the big swing and the tire swing and do an art project. With her voice she can say “bus.” With her talker, she can tell me who she sat next to at school and what they talked about and what she wants to have for dinner and whether she’s feeling tired or happy or cranky. With her voice she tells me “no.” With her talker she tells me “No way, Jose.” With her talker, she tells jokes and is sassy and is proud, so proud, to tell us things and to connect with us. If she only had her speaking voice, I would barely know her. Maya & her talker (photo by Keith Wagstaff, TIME.com) As we have spent the past three months searching for an ideal kindergarten for Maya, we have seen many (many) schools and met with numerous doctors and therapists for evaluations. We have heard, over and over again, “I’ve never seen a preschooler use a communication device the way that she does.” I have seen (too many) K/1/2 classrooms populated by nonverbal kids where I am told that certain children "are learning to use communication boards" or "have just started learning how to use an iPad app to communicate" or "will soon be evaluated by the assistive technology team and will probably start using a communication device in the near future." This is not because these children needed to wait until K/1/2 to be ready to use a communication device. This is not because preschoolers aren’t capable. This is because most preschoolers (and pre-preschoolers, frankly) don’t have the access to the augmentative and alternative communication (AAC) that they need. And, not to put too much pressure on you (since I know that you have so much on your plate, and raising a child with special needs is overwhelming, I know) . . . but you’re the one who needs to make this happen. It’s on you. It’s on you, unfortunately, because this is a rapidly growing field, and the therapists/teachers that you work with might not be aware of all of the new stuff out there. It’s on you because speech therapists carry giant caseloads and aren’t technically required to be highly educated about or suggest AAC .*, ** It’s on you because the special needs schools and teachers won’t meet your kid until kindergarten, and then will spend a few months getting to know him before requesting as assistive tech evaluation, and now your kid is 5/6/7 and frustrated and acting out (or worse, shutting down).** It’s on you because the preschool teachers/therapists have never seen a little kid on a big, total communication device/app and wouldn’t even think to suggest anything outside of a communication board or PECs, because they aren’t even aware that that’s a legitimate possibility.** It’s time to expose your child to AAC, to give them alternative ways of communicating. If you haven’t heard of AAC, it's awesome, and I’m going to walk you through a few options in just a minute. If you have heard of AAC, but haven’t tried it yet, I’m going to take a paragraph to dispel a few of the concerns that might have caused your hesitation. First, the use of AAC will not prevent/impede the development of speech. Here are a few links and research that disprove this fear, and an important study that showed babies who learned sign language simultaneously with speech developed speech at the same timeline as a control group and ended up with larger vocabularies.*** Second, your child doesn’t need certain skills, understandings, or cognitive abilities to start using AAC. You don’t wait for a baby to become skilled or “smart enough” before you speak to them . . . there’s no need to wait any longer to start modeling AAC use with your child. Third, you don’t need to wait to see if maybe speech is right around the corner---AAC is not a “last resort.” Speech will keep on progressing alongside of the progress made communicating with the AAC system. Fourth, your child does not have to be older! We started toying with different things around 18 months, and I wish that we had started earlier. We had to switch systems a few times before finding the perfect one, but the work that we did from 18 months-3 yrs laid the foundation for when we found her perfect system at 3.5 years. Start simply, start small, just get started already. Are you convinced yet? Think for a moment of what it would be like to have to rely on speech for communication, knowing that you couldn’t get any sounds out that made sense. Imagine that you were in an accident that rendered your voice useless and landed in the emergency room . . . people talking at you, asking you questions . . . what would you do? Hopefully someone would bring you a piece of paper and a pen . . . you know, an alternative way of communicating, a way in which you could be immediately successful while waiting for your voice to heal. Your child needs the same. So where do you go from here? 1. Talk to your speech therapist about AAC. If they don’t know much about it, talk to other speech therapists, or teachers, or a developmental pediatrician. If you can’t find answers call a special needs school in your area and talk to their speech therapist. If there’s a local children’s hospital or therapy center, talk to them. If you can find a support group for parents of kids with special needs, speak to the person who runs the group. Post on local message boards asking for the names of top speech people in the area. If there are advocacy groups for people with disabilities in your area, talk to them. Don't be afraid to reach out to groups that serve specific disability populations (groups for children with cerebral palsy, Down syndrome, autism, etc) even if your child isn't a part of that population-these groups generally want to help families, regardless of your diagnosis, and may be able to steer you towards good resources. Keep asking around to see if you can get referred to someone in your area that knows about AAC/assistive technology and can point you toward a local expert or resources. 2. If your child has an IEP/IFSP, speak to your caseworker or the official in charge of the document. (You might want to work with your child’s preschool/school on this, if they are already school age.) You want an assistive technology/augmentative communication evaluation, and you want to request it, in writing, immediately. (I’m not sure if different states have different processes for these things. This is a good topic to discuss with the people/groups that you found in point #1.) 3. If at any point in Step 1 or Step 2 a professional indicates that they don’t feel like your child is ready, that they aren’t familiar with multiple options (example: they say something like “Oh sure, we have several children using -insert app name-,I guess we could try that” instead of actually creating an individualized plan), or they seem otherwise resistant, then proceed onward to the next steps. You’re going rogue. You’ve got to take the lead on this yourself. You need to get educated so that you can do it correctly. You can do it. (I had to do it, too.) 4. It’s time to hit the internet and read about AAC. Join (or peruse) a message board/online community for parents of kids with special needs, kids with speech issues, kids who have apraxia, etc. (yahoo groups or babycenter groups might be a good place to start). Use google. Look for some general posts/articles about AAC---good buzzwords would be: PECS, picture cards, Boardmaker, communication boards, communication books, PODD books, AAC devices, AAC, AAC apps, communication apps. Read other people’s stories, learn about how children use different types of AAC. 5. In conjunction with #4, search YouTube. Look for videos of kids using different communication systems. Use the same buzzwords that I listed above. See that it’s possible, see the different skill levels. If you think “my kid couldn’t do that” just remember that most people don’t upload the videos of all the times that it didn’t work. 5 and a half: It's time to remember that this is a marathon, not a sprint. You might be reeling from too much information. Take a night off. Then get back at it. Go slowly, but keep going. Now that we have a system in place, there are entire months in which I am not purposefully researching, just modeling and working our system. Then I start reading again. 6. Realize that you’ll probably end up trying several things, and that’s ok. Here is a list of things that we tried with Maya, along with links that will take you to blog posts (most of which have pictures and/or video) so that you can see we’ve tried many things, too: picture cards/PECS household labels (this wasn't really a system, just a supplement to the picture cards) Proloquo2Go (a communication app that I customized in a probably-incorrect way to use as a starter system. In the end, she could use it but I didn't love the set up and it's growth potential.) Communication Boards I used Boardmaker, and it worked well. I still make occasional boards for specific circumstances. The Word Book A big, fat homemade binder for when single communication boards weren't enough any more. It worked well. Tech/Speak She used it at school. A perfectly good tool, but I felt limited by the vocabulary size. Not a great fit for us, but a great fit for many. Speak for Yourself This is the AAC app that we use now. If you check out my YouTube page (dmgnieder) you can see a bunch of videos of Maya using her talker. This post has a few in progression over our first four months. edited to add that we also did a 6 week trial with a Dynavox Maestro communication device. Clearly (as I forgot about it) it wasn't the best fit for us, but it great for many others. 7. Realize that AAC is really, really individualized. It is not a one-size-fits-all operation. It’s possible that you saw something in #6 that seems like it could work for your child, or that what you saw gave you an idea that would need some tweaking, or that you saw nothing helpful at all. That’s ok. Some children start AAC with a high tech device/app, some start with a simpler choice-based app, some start with a communication board, some start with tangible cartoon picture cards . . . some start with laminated photographs of actual objects . . . some start with using the actual physical objects themselves (and if your child can't use their hands to point to cards/pictures/device, don't worry, then there's eye gaze technology). Any starting point is infinitely better than not starting at all. (Prior to picking a system I recommend that you read some of the research and opinions of the people that I mention in #9--they may guide you toward some of the more sound, research-tested options. If you're going with an iPad app, Jane Farrall's list is a good place to start.) 8. Once you find something that seems like it might be worth trying with your child, it’s time to learn about best practices and how to start using it. Picking out an AAC system seems like the trickiest thing ever, until you have it in your hands and realize that now the tricky part (so-what-the-heck-do-I-do-with-this-thing-now) starts now. For me, the most important lessons (and reminders) have been about modeling and waiting and using core words as soon as you can. This was my take on modeling & waiting. 9. Find out who the experts are and read their stuff. Research papers, websites, sites that mention them, etc. Go hear them speak if you can. They will teach you about best practices---how to use your child's system with them, get them to embrace it, and teach them how to communicate. Here are some people who know their stuff, inside and out: Linda Burkhart, Cathy Binger, Karen Erickson, Jane Farrall, Carol Goossens', Gretchen Hanser, Katya Hill, Jennifer Kent-Walsh, Janice Light, Caroline Musselwhite, Gayle Porter, Gail van Tatenhove **** 10. Find some good AAC blogs/resources, follow them on Facebook/twitter/Pinterest, and don’t be afraid to reach out. On Facebook I particularly recommend PrAACtical AAC and Lauren Enders---both are very active and share tons of articles and links. I also like the core word suggestions from the Center for AAC & Autism, and I follow several apps--including the aforementioned Proloquo2Go and Speak for Yourself. If you want to find people to follow on Twitter start following the hashtags #AAC #augcomm #SLPeeps #ATpeeps. Some of my favorite twitter users (tweeters?) are: @CommGreenhouse @USSAAC @parkerrobin @ISAAC_AAC @janefarrall @SpeechTechie @speak4AAC @sayit_any_way (Oh, and our FB page is Uncommon Sense Blog and my twitter handle is @UncommonBlogger) **** 11. A few other possible helpful sites: YAACK, Speaking of Speech, AAC at Penn State, AAC Intervention, AAC Kids@PSU **** 12. For extra motivation from a parent who went against the advice of various professionals and fought to get his daughter an AAC system, read Schuyler's Monster: A Father's Journey with His Wordless Daughter Besides being interesting and motivational, it's also just a good book (and I'm picky about books, so when I say "good" it means entertaining, witty, and solid from start-to-finish). 13. *This step is important* Remember that I am just a parent. I am not a professional. I am the mom of an adorable nonverbal girl who went out into the great wide internet in search of a solution that could help my kid communicate. (although while I am "the mom" I'm not "just the mom") This blog post is the closest I can come to a master list: the reasons to try AAC as soon as possible and all of the steps/tips/tricks that I can think of giving someone who is newly on the road to AAC. Undoubtedly, I am leaving things out (and I’m hopeful that some wise professionals and parents will fill in the gaps by leaving helpful tips and resources in the comments section of this post--please!). Good luck. This needs to happen. You have to try. The internet is wide and there are resources out there. And the first time that your kid "says" something through AAC that they aren't able to say with their speaking voice, all of this work will be totally worth it. From, A mom who wishes that she knew earlier * Per ASHA, in their position paper on the roles/responsibilities of SLPs with regard to AAC **If you are a speech therapist, preschool teacher, preschool therapist, kindergarten teacher, or elementary school therapist who read this paragraph and thought “Hey lady, wtf? I’ve been suggesting that stuff for years!” . . . well, thank you. Thanks for pushing our nonverbal kids who are capable of so much more with regards to AAC and assistive tech than most people give them credit for. This paragraph is about the others---who are, unfortunately, the majority that I've encountered. ***Holmes, K. M., & Holmes, D. W. (1980). Signed and spoken language development in a hearing child of hearing parents. Sign Language Studies, 28, 239-254 and Daniels (1994), in “The Effect of Sign on Hearing Children’s Language” ****Undoubtedly I have forgotten some amazing people/websites here. Please, knowledgeable folks, remind me (and everyone) who else we should be reading/following in the comments below.

I find a lot of professionals and parents alike who don’t really understand what AAC means. So, first, to break it down, let’s look: A= Alternative A = Augmentative C = Communication Alternative is typically what we’re talking about in AAC. These students need an alternative to speech because they are completely non-speaking, or because they have so few words that they cannot meet their communication needs at all. Augmentative is the one part people tend to forget. To augment is to add to. And that’s what we do with AAC for individuals who have some speech, but not enough to meet all of their communication needs. It’s also what we do for individuals who have speech, but their speech is unintelligible so much of the time that they need a functional repair strategy, so that they can fix the breakdowns in communication when others don’t understand them. One of the biggest groups I see with this difficulty is those individuals with cerebral palsy whose speech is so dysarthric that it is unclear to most of their listeners much of the time. Another group I see with this need is children with apraxia of speech who may have some speech, but it does not function for their all of their needs. AAC as a repair strategy is a novel idea for some, and is a “hard sell” sometimes. We speech-language pathologists take the ‘speech’ part very seriously. But when we’re not meeting the needs of our students, we need to step back and remember that our goal, really, is communication; that last pesky letter in AAC. AAC as a way to augment what speech the user has is often delayed while teams work on speech to the point where students themselves are frustrated with their inability to communicate. One of the most persistent myths about AAC is that it shouldn’t be used for students who have some speech. That it will delay their speech further or become a “crutch.” However, research now tells us that far from delaying speech, AAC used consistently can actually help students develop their speech skills more. And, far from being a crutch, it is a tool that helps students develop their language and communication skills. So, what, exactly, is communication? According to the National Joint Committee for the Communication Needs of Persons with Severe Disability, it is: “any act by which one person gives to or receives from another person information about that person’s needs, desires, perceptions, knowledge or affective states. Communication may be intentional or unintentional, may involve conventional or unconventional signals, may take linguistic or nonlinguistic forms, and may occur through spoken or other modes” This definition puts the focus on the extent to which there is shared meaning between the communicator and his partners - NOT on whether the interaction is spoken. AAC refers to all modes that make communication easier; and can include gestures, facial expressions, alphabet or pictures, computers, and signs. So, before you say, "He's note ready for AAC,” remember - even babies communicate. No one is too impaired to learn some communication skills. I’m pretty sure that if you look at your students who “aren’t communicating,” that you will find that they truly are. Ascribe meaning to what they do do, and……… keep on modeling. Want some year-long help with meeting the needs of your aac users? Here is a kit to get started and keep you going all year.

Elanor has had her talker for over a year now. For the better part of that year she could hardly make sounds, let alone words. Things are ve...

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