We communicate in all kinds of ways - we use oral speech, we text, we point, we gesture, we roll our eyes, we smile.
We communicate to express our thoughts and feelings, our wants and needs.
Communication is a fundamental human right. It is an integral part of the human experience.
Everyone deserves the chance to express themselves to the world and to be heard and understood by others.
Not all communicators have access to the same communication toolbox. For complex communicators, their oral speech may be difficult to understand, unreliable, or inaccessible.
Complex communicators need AAC in their communication toolbox too!
But hold on! My kid is young, they haven’t finished building their toolbox yet! If we put AAC in the box, does it mean giving up? Does it mean my child won’t develop oral speech? I don’t think they’re ready for AAC….
Parenting is hard, there are so many unknowns. As hard as we wish, no one has a crystal ball that can predict the future. However, research gives us evidence that providing young children with AAC is hugely beneficial.
Let’s break down some of the myths about AAC and look at the evidence….
Myth 1: AAC Will Keep Kids From Talking
→ AAC supports your child's language use!
Research shows that AAC intervention grows children’s oral language skills. Children often use MORE spoken target vocabulary words when given AAC. And many improve their other language skills like phonological awareness and narrative production from using AAC (Walters, 2021, Lanarika-Rocafort et al 2020).
When we give children access to AAC, we give them more tools to use!
Meet Colm
As a clinician, I have seen this in my own clients. Let’s call my client Colm. I had been seeing him in the school setting since he was three years old, and I worked with him for three years. As a three year old, Colm vocalized some using vowels, but really didn’t really use any other oral speech. He loved text and books. As a new clinician with limited resources, we used a communication board and picture symbols in our first year together while I learned more about AAC, how to access it, and how to implement it. My second year, we finally had access to devices with voice output: GoTalks and Snap. GoTalks are a hardy communication device with recordable buttons. Snap is an AAC software program that can be used on an iPad. Colm lit up when he was able to use voice output devices.
He was thrilled to explore the vocabulary pages, hear the voice say what he put in, and see it affect the classroom. Colm then received his device through private insurance, and we spent the extended school year and my last year with him working with it. The boy who previously only used vowels at 3 now asks for “Pete the Cat”, tells us “oh no, ew”, protests “no, all done, bye!”, and says “mama” – AAC helped him get there and will continue to help him grow his language.
Myth 2: My Child is Too Young for AAC
→ Research supports AAC intervention in children as young as 1.
Research has shown that children under 2 ½ grow their language skills when provided AAC intervention. When we look at the research as a whole, children preschool and early elementary age grow their communication skills (Leonet et al., 2022). The National Joint Committee for the Communication Needs of Persons With Severe Disabilities, publishers of the Communication Bill of Rights, has a formal position statement: age should not determine eligibility for AAC. This goes both ways, children cannot be too young and they conversely cannot be too old. Communication is a right across the lifespan.
We talk about the importance of early intervention when children are having difficulty learning to talk, eat, or walk. We support kids at an early age regardless of what their needs are. Research doesn’t support the “Wait and See” (for more on this, see our March blog post HERE). Waiting has worse outcomes for speech and language development. Whether or not children need AAC, earlier is better. AAC users are no different.
Myth 3: My Kid's Not Ready Yet
→ There are no prerequisites to AAC for children.
Children deserve presumption of competence. At Talk Time, we believe that children have the ability to think, learn, and understand - no matter how their brains or bodies work. Our job as speech language pathologists is to find children the tools they need in order to participate in their daily lives. Some people think that a child has to be a certain age, that AAC has to be the last resort, that a child needs a certain level of fine motor skills to use a device, or that a child has to have a specific intellectual capacity. But, we know from the research that early intervention is best to support children. AAC does not have to be a last resort, usually families and users wish that they had been given access earlier (Donaldson et al., 2020). A child doesn’t need specific fine motor skills because we can adjust devices to them, especially with help from occupational therapists and physical therapists.
If you want to say that there is a prerequisite for AAC, it’s the prerequisite that we assume competence. For more on this topic, check out AssistiveWare’s post that shares Jordyn Zimmerman’s experience when she was not presumed competent.
BUT…
Even though there are no prerequisites to AAC, not every device is right for every child. This is where speech language pathologists come in. AAC systems need to be feature matched to each child - every system has its pros and cons. For example, a child might not have the motor abilities to make their own selections on a screen, so we may need to figure out a different access method like using eye gaze or a button to ‘click’ the choices. Some children are overwhelmed by too much information on one screen, so we work to customize the display. When access is difficult, a team including an occupational therapist or physical therapist may work together to find the ideal set up for the child.
Everyone deserves the chance to express themselves to the world and to be heard and understood by others. AAC gives that chance to children and adults with complex communication needs.
What can you do?
Ask a speech language pathologist about AAC for your child! If you have questions or concerns, or just want to talk out your thoughts, an SLP is the perfect person to talk to. If you’re curious about what using AAC looks like in families, there are some great resources shared below - as well as several adult AAC users!
If you want to reach out to us at Talk Time, please email us at info@talktimeboston.com.
Resources:
AAC Users
Families with children who use AAC
Professionals and/or Organizations Specializing in AAC AssistiveWare
Citations:
Brady, N. C., Bruce, S., Goldman, A., Erickson, K., Mineo, B., Ogletree, B. T., Paul, D., Romski, M., Sevcik, R., Siegel, E., Schoonover, J., Snell, M., Sylvester, L., & Wilkinson, K. (2016). Communication services and supports for individuals with severe disabilities: Guidance for assessment and intervention. American Journal on Intellectual and Developmental Disabilities, 121(2), 121–138.
Donaldson, A. L., corbin, endever*, & McCoy, J. (2021). “Everyone Deserves AAC”: Preliminary Study of the Experiences of Speaking Autistic Adults who use Augmentative and Alternative Communication. Perspectives of the ASHA Special Interest Groups, 6(2), 315–326. https://doi.org/10.1044/2021_persp-20-00220
Romski, M., Sevcik, R. A., Adamson, L. B., Cheslock, M., Smith, A., Barker, R. M., & Bakeman, R. (2010). Randomized comparison of augmented and nonaugmented language interventions for toddlers with developmental delays and their parents. Journal of Speech, Language, and Hearing Research, 53(2), 350–364. https://doi.org/10.1044/1092-4388(2009/08-0156)
Walters, Casy; Sevcik, Rose A.; Romski, MaryAnn (2021). Spoken vocabulary outcomes of toddlers with DD (Walters et al., 2021). ASHA journals. Dataset. https://doi.org/10.23641/asha.14265365.v1