When children or adults cannot use speech to communicate effectively in all situations, there are options.
Unaided communication systems – rely on the user's body to convey messages. Examples include gestures, body language, and/or sign language.
Aided communication systems – require the use of tools or equipment in addition to the user's body. Aided communication methods can range from paper and pencil to communication books or boards to devices that produce voice output (speech generating devices or SGD's)and/or written output. Electronic communication aids allow the user to use picture symbols, letters, and/or words and phrases to create messages. Some devices can be programmed to produce different spoken languages-ASHA.org
Amy Skinder-Meredith Ph.D., CCC-SLP
This concern comes up a lot. Dr. Gary Cumley addresses this question in his article, Why Is There Reluctance to Try AAC With Children Who Have Apraxia?. Dr. Cumley has researched the use of AAC in children with CAS and has found that the introduction of AAC actually increases verbal output from children, rather than decreasing it.
To me, the key issue is that the child understands the power of communication, whether it be sign language, AAC or verbal. If the child understands that when they communicate effectively by any means (e.g., sign, AAC, gesture) and they get what they want, they’ll understand the benefits of communication. Now, anyone who has used an AAC device can tell you that it is not the most efficient way to communicate if you could be verbal instead, thus if a child is able to become a verbal communicator, chances are they will. Supporting this notion, research has shown that as the child is able to be more verbal, the use of the AAC device will fade out. In addition, children with Down Syndrome do well with visual cues. If the AAC device had pictures with words, that will help link visual symbols to communication. Furthermore, if the AAC system has speech output it will give the child an auditory model every time they communicate their message. This could be one of the reasons why verbal output increases. I think it is important for families to know that just because we are implementing an AAC device, we are not necessarily giving up on verbal communication. It is merely to ‘augment’ their verbal communication. When a child has CAS or is highly unintelligible for any other reason, it is crucial that they have a way to work on expressive language skills. For example, if motorically, the child can only communicate verbally “Ma” but they want to say, “I am really hungry, Mom. Can I have snack?” AAC provides this more sophisticated language output. This in turn, can help decrease frustration and allow for much better relationships for the child.
For more information, I recommend reading another article by Dr. Cumley from the Apraxia Kids website: Children with Apraxia and the Use of Augmentative and Alternative Communication.
This Ask the Expert was taken from the course entitled: Incorporating Principles of Motor Learning in Speech Therapy with Clients with Childhood Apraxia of Speech presented by Amy Skinder-Meredith, Ph.D., CCC-SLP.
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