Tuesday, October 15, 2013

Who Can Benefit from AAC by Andrea Schario

My previous blog post discussed the basics of Augmentative & Alternative Communication (AAC); if you missed it, please check it out here!  Now, I will discuss populations of children who can benefit from using AAC.   Much of this information is also applicable to adults using AAC, but I will continue to focus primarily upon children (0-18 years of age).

For some of my clients, AAC will be the primary mode of communication used throughout their lives.  Certain medical diagnoses (for example, severe Cerebral Palsy) are associated with profound difficulty producing intelligible speech and another mode of communication will be more effective and efficient.   For other clients, AAC use is relatively short-lived and is eventually replaced by verbal communication.  For example, many of my clients between 1 and 3 years of age will use sign language, picture symbols or AAC iPad apps to communicate basic wants and needs like “eat”, “more” and “mom”.  As they gain the ability to express themselves verbally, they replace these modes of communication with spoken words.   For others, like Timmy in my previous post, AAC continues to be used for many years but is combined with other modes of communication.  An immense variety of AAC options exists, and I will be discussing many of these options in future posts.  But first, we need to ask and answer the question: Who are these children who are using AAC?
In my practice, children using AAC fall into two main categories; the first includes children who are nonverbal.  For a variety of reasons, they are not able to use speech to communicate.  Some have disorders that affect the tone, strength or coordination of the muscles used to produce speech.  Others are physically capable of speaking, but have neurological diagnoses that result in a lack of verbal communication.   As you may imagine, there are many combinations of factors that can lead to a child being considered “nonverbal”.  Here are some examples of nonverbal children being helped by AAC (all identifying information, including pictures, has been changed): 

Bobby was born with a severe seizure disorder, and has also been diagnosed with cognitive impairment.  Bobby does not speak, but loves to “be the boss” and tell his brothers what to do!  He uses TalkBoard, an app on his iPad, to direct his brothers, “Do it again!” after they’ve done something silly.  He also loves to play Simon Says and tell his brothers to act like different kinds of animals.
Bridget was born healthy and has no major medical issues.  However, she is a late talker and only uses a few verbal words (e.g., “Mama”, “hi”) at age two.  Bridget’s parents have created a low-tech communication board for her, and she will point to a picture of something she wants (e.g., a ball) on the board.  Bridget will go and get the board herself if she needs to communicate something, and Bridget’s mom recently that that Bridget is now trying to say the names of several pictures on the board!

Carrie has Cerebral Palsy, and has an enormous vocabulary; however, when she speaks she has a hard time coordinating her speech muscles and does not have adequate respiratory support to speak more than one word at a time.  People often have a very hard time understanding what Carrie is saying.  She will talk to her parents most of the time, but with unfamiliar people will use her communication device – a VMax by DynaVox Technologies – to have conversations.  Carrie loves to ask people about their pets, and has pre-programmed buttons on her device that will tell a listener all about her dog Sadie. 

As you can see, AAC can a be short- or long-term need, and can be used successfully with a wide range of communicators.   I would like to dispel the notion that only nonverbal children use AAC; it can be incredibly helpful with children who are able to speak but are not able to express all of their wants, needs, and ideas this way.  I would also like to point out that typically developing children can also use AAC!  Yes, that’s right – using AAC and visual strategies with typically developing children can be an interesting, motivating and exciting way to introduce new words, teach communicative cause-and-effect, and work on social skills.  Use of baby sign language is one example of this, and I will discuss baby sign in detail in future posts.   For now, I hope that you have a deeper and more personal understanding of the types of children who can benefit from AAC;  please keep coming back to learn more!

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