I’ve shared before that we must view our young AAC users as a whole. As SLPs we need to consider each student’s home environment, their culture and all those times at school when we aren’t around to watch and model AAC for them. AAC use needs to occur everywhere, if the child is going to be successful with it.
Which means supporting and working with parents of emerging AAC users. It also means working with colleagues to support students and creating a team environment. As SLPs there is a lot we can do in this space. Including understanding the parents, helping them overcome barriers to access and seeking their input into plans.
Barriers families face
I work in a Title 1 school in the US and the families I work with often face barriers to getting access to AAC for their child.
Families, particularly those from diverse backgrounds are often not aware of their right to speak out and ask for things for their children. Or they don’t feel comfortable doing it.
That is if they know. For many of the families I work with, they are new to this country and don’t realize AAC devices even exist or that services are available. There is often not a translator to help them ask.
If they do know to ask, in many states there is a lot of red tape and phone calls around accessing the support. Adding this on to stresses that families are already facing can just be too much.
As SLPs we can advocate for the family and influence what device they get. We also need to keep advocating after that first device. We can make sure the student’s AAC changes with them as they grow. The child may have gotten a Big Mac and now has more capability. We need to make sure they have access to that. We can also advocate when devices get old or break. It’s so important to keep that connection with the parents and advocate for them.
If the student needs AAC to access education then it is the school’s job to provide it. We can make parents aware of this.
Involving parents (and colleagues)
Your student is not going to get the best outcomes if we don’t involve parents and our colleagues in supporting the students. I get a lot of questions about how to do this. It isn’t always easy but it is possible by:
Building connections. As SLPs it’s our job to talk to the teacher and connect. If you’re doing an AAC evaluation then try to include everyone on the team. Give whoever is going to work with the child an opportunity to provide input and feel like they’re part of the whole process.
Keep lines of communication open at all times. Ask the teacher what are their goals for the student, what is in their IEP and how you can you help them to reach these goals. Asking where the communication breakdowns are right now is a great place to start.
Don’t make assumptions with parents. It’s important we don’t lead with our egos. Seek first to understand which may mean backing up a bit and slowing down. Just know it’s going to be a process. It isn’t going to be an overnight change. It takes years and years of building and growing. Making sure to involve everyone where you can.
Tell success stories. Have examples to share with colleagues and parents. You have to share these stories and get people excited and to see the possibilities. We want them to see what could happen.
Accept people will make assumptions about you. When you go into a community for the first time, people will make assumptions about you and this is ok. Don’t think you can change those assumptions immediately. Hang in there and keep talking to people. Attend everything you’re invited to.
Listen. I’m never the loudest person in the room, I’m more a person who watches. I don’t go in thinking I know everything. I let people show me who they are and have respect when learning about a different culture. I want my highest spirit to meet their highest spirit.
No professional jargon. Be really aware of not using professional jargon when working with families. Use parent friendly language and then introduce what the different terms we use all the time mean. This then helps them navigate the system without you.
Include the family. A key question is to ask parents is “what would you like your child to communicate?” You can also program family names into devices.
Promoting Culturally Responsive Therapy
I want the children I work with to embrace their communities and I want to encourage other SLPs to do this too. To facilitate this I do the following:
Parent Groups. I’ve been facilitating these once a month via Zoom. They’ve been such great groups. I include parents and teachers and we talk about things like AAC and the importance of modeling as well as providing an opportunity for questions and answers. The parents have gotten to connect with each other which is so important.
Free Facebook Group. I’ve got a free Facebook Group for speech therapists, speech therapist assistants, teachers and instructional assistants who work with children who use and/or need Augmentative Alternative Communication (AAC). This is a space to ask questions without judgement and to connect with others. You can request to join here: https://www.facebook.com/groups/theAACconnection.
Speaking at conventions. I often speak at local and national conventions. Baslcally any opportunity where I get to share the message about AAC and culturally responsive therapy.
There is so much we can do to support our families and colleagues and I love seeing parents sharing their culture with their children.
One of my strongest beliefs is that all children with complex communication needs should have access to support regardless of their background. As SLPs we have an important role to play in ensuring this.
But I know it can feel intimidating at first. Particularly if you’re also navigating AAC for the first time. I recently did an interview with Tamara Anderson from Building Successful Lives on this topic. You can find the interview here:https://www.youtube.com/watch?v=zeVMsp3xv-4
If video isn’t your thing, I’ve summarised why this is important to me and ways to support your students.
Why is getting AAC to all children who need it important?
It’s not just Alternative!
AAC has two AAs. But we focus on the alternative rather than the augmentative. It’s supporting the child with what they already have. If the child has very limited verbal speech then using AAC can be a bridge to developing bigger language skills.
It can also provide an alternative way for the child to communicate when they’re having a communication breakdown or when they’re really tired. I often see students with autism who under times of great stress or during times of sensory overload find visual communication easier than using verbal speech.
It’s important not to wait. We want to get AAC into a kid’s hands as soon as we think they need it. They can start building those important language skills straight away so they’re not behind.
Advocating for and creating diverse materials for AAC users with complex communication needs
There is so much you can do as an SLP in advocating for and creating diverse materials.
1.View the child as a whole. The first place I like to start is by creating a climate and environment where we’re viewing each child as a whole. This means not just looking at his disability or where he needs help with communication. It also means what environments are they communicating in at school and at home. This is going to be a way for them to communicate wherever they are, so thinking about that is a great place to start.
2.Include language spoken at home. We used to think that it was confusing for the child if they were using multiple languages. Studies have now shown this isn’t the case. Children with complex communication needs can be bilingual or even multilingual. This ties back into viewing the child as a whole. We don’t want to alienate parents from children. We want children to embrace their home life and culture.
Don’t just think about the language but also the different phrases they might use at home. There is a lot to think about. Words don’t always translate directly. You might find it difficult to find a translator if the language used at home isn’t a common language in your community. But I promise your efforts will be rewarded.
3.Appropriate icons and symbols. Can your children see themselves reflected in their apps and core boards? The skin tone of the symbols can play a part in this. In the last year some of the big AAC companies (Touchchat and Proloquo2go) are making it so much easier for us as SLPs to adjust the symbols in one step. Others are coming on board so keep an eye on the website of the apps your students are using.
4.What voice are you using? If you are using computer generated voices can you choose one to sound as much like the student would sound if they could speak? Acapela Group is doing wonderful work to create more diverse voices.
Increasing the language and literacy of AAC users
As well as the bigger picture activities listed above there are simpler actions we can take to increase the language and literacy of AAC users:
· Modelling. I talk a lot about the importance of modelling. That is we as the communication partner use the communication device as well. Even if you only have a core vocabulary board you can point too.
· Incorporating words. Your student may not be able to read, but they can often recognise words. If you’re doing a visual schedule you can still add words as the student can recognise what words are. They can have letter awareness.
We can also encourage playing with letters. This could be through playing with magnet letters or using a keyboard.
· Give them the gift of story. We all have wonderful stories to share and giving students the gift of story is one of my favourite things to do. To start, have some active engagement in books. Get creative and make it fun. If children have been read to in a boring way when they see a book come out they think it’s time to go to sleep.
See if you can figure out how to make it fun and exciting. I like using puppets, the Tarheel Reader site, and interactive books with velcro pieces. It’s all about not being boring. Children understand the power of stories.
Just like with any kid we want to find a book that the child is interested in. For example, If a child likes cars then find a book on cars.
If you’ve enjoyed this blog post and are looking for ways to build on your knowledge then some great ways to do this are:
Reach out to other SLPs in your region or even on social media. On Instagram search on the hashtag #AAC. There are amazing SLPs on Instagram sharing all about AAC.
You can get so hung up on AAC and how complex it is. But at the end of the day… it’s just language and we know what language is. Look at the child and see where they are in their communication skills. All kids are communicating even if not verbal. Figure out what the next step is. Where do you want them to get?
Work out how the device works – google the devices – there are lots of videos out there. Reach out to other SLPs if you get stuck.
If a student needs a device and they don’t have one, do you have an AAC specialist in your district and what is the policy? Start doing the research. We don’t want our students to miss out.
It may all seem very daunting but it’s the best feeling when you can give a voice to a student and a family.
AAC core boards combine pictures and words of core vocabulary to support communication. Core vocabulary is vocabulary that is commonly used such as “You”, “I”, “Get”, “Do” and “Where”. Core vocabulary refers a small number of words that make up >70-90% of what we say on a daily basis. While many of the AAC apps have core words built in, there are also low tech options that can be printed out and glued to poster board.
In using core boards we point to the words while we’re talking. We say things like “want more?” “you like it”. They are wonderful tools formodeling.
We’re giving each child a visual that they can see and eventually point to. The words will always be in the same place (so they don’t have to search for them). The visual cue helps the student identify the word and by combining the visual with a written word, we can start to increase a student’s literacy as well.
Tips for using core boards
Do it consistently. Use the core board every day. The vocabulary on the core board is intentionally selected as words that your child will use regularly. By focusing on these words we are teaching a functional vocabulary. Your child can use these words all day, everyday, everywhere: from classroom to playground to cafeteria to home.
Start by modelling them. At first don’t expect your child to point to words, it’s enough for you to model them, so they can hear and see them. Be patient.
Use it for more than requesting. We often start with “I want” as there is a lot of motivation for students to ask that question. But we don’t want that to be the only thing they learn. Start modelling other phrases such as “I like” or “I go” to encourage communication.
Do fun activities. Think of ways that you can use the core board for fun activities.
In being helpful, don’t forget to model. Sometimes we’re so busy being helpful we miss great modeling opportunities. If a student is asking you for help with something, rather than simply helping them, whip out the core board and model the word help without demanding an immediate response.
Use expectant pauses. Are you letting your student say what they want to say and leaving expectant pauses? Or are you trying to make your student say what you want him to say. Make sure you give your student time to think and answer.
Model mistakes. We need to model making mistakes and how to repair them too. Just like learning to walk, it’s okay to stumble and fall. As long as you keep going.
To start or build on using core boards, I’ve put together a document setting out where you can download free core boards to get you started. Clickhere to download your copy.
As SLPs we often work with emergent communicators. How we model with them needs to be tailored to their specific needs. Below I share more about what an emergent communicator is and my best tips for using AAC modelling with them.
What is an Emergent Communicator
Emergent communicators can use the following modes of communication:
other non-symbolic modes of communication. For example: smiling, reaching for what they want, taking your hand to what they want. They make wants known indicated by reaching toward something, looking at it, and leg movements.
Introducing AAC to Emergent Communicators
My number one tip for introducing AAC to emergent communicators is to remember beginning communicators talk about what they want to talk about. Make sure what you are modelling is meaningful and hopefully fun to them.
Once you are communicating about something they are interested in, then it’s important to model without expectation. Invite don’t demand that they take part in the activity.
Being prepared as an SLP
As an SLP, it can feel intimidating navigating how to use a device and knowing what to do when using AAC. Particularly if it’s the first time you’ve worked with AAC or a particular device.
If this is you, then quickly get familiar with the device. Most devices are fairly straightforward to use once you’ve used them a few times. I’ve been sharing reviews of devices and apps on Instagram. You can find them in my Instagram feed.
I recommend knowing a few basics and starting with core words like in, put, finished, more, want, like, go. Choose an activity that happens everyday like snack time, circle time, lining up time. That way you’ll get lots of practice every day.
Remembering to keep it fun, simple, consistent and real.
Setting goals is a great way to help you do this. To help you set AAC goals, I’ve created the Ultimate AAC Goal Planning Blueprint which you can download for free here.