Regardless of the symbol set selected or the display used, it is critical to keep in mind that augmentative and alternative communication (AAC) systems are not meant to replace speech. Many families fear that the introduction of an AAC system means that professionals are “giving up on speech”. Nothing could be farther from the truth. Millar, Light and Schlosser conducted a meta-analysis of research published between 1975 and 2003 on the impact of speech before, during, and after using AAC. Of those studies that met the criteria for evidence- based analysis, none of the individuals lost speech production as a result of using AAC. Some of the subjects did not increase their production, but most (89%) had at least modest increases in speech production (Millar, Light & Schlosser, 2006). Linda Burkhart made this statement in her book Total Augmentative Communication in the Early Childhood Classroom (Burkhart, L, 1993, p.37):
“By providing a child with a variety of means to communicate, including speech, the pressure to produce speech is diminished. In the past, clinicians and parents worried that giving a child another means to communicate would hinder speech development. Children who are given augmentative skills develop speech as quickly as the control group and often surpass them.”
Several reasons are cited for this phenomenon. The pressure to produce intelligible speech may be reduced knowing that the child has an alternative way to say something. The use of augmentative communication systems allows the child’s language skills to continue to grow and develop. Using speech is the easiest way to communicate. If the child is able to use it, they will choose speech over an alternative form of communication. There is research that supports introducing AAC at an early age before a child experiences communication failure because of a lack of speech production or intelligibility (Romski & Sevcik, 2005).
For those who cannot use speech effectively, there exists a wide range of AAC system options. These range from simple communication boards or displays presented on paper to high tech electronic systems with voice output. No one system can meet all of an individual’s needs. For example, a child may be able to use head nods to clearly and efficiently communicate yes and no to caregivers. However, when discussing course choices for the coming academic year with family and teachers, an electronic system with the option of spelling and accessing pre-stored messages may be more appropriate and efficient.
The success of any communication system is highly dependent upon the skills of the communication partners. The communication partners need skills such as modeling the use of the system, interpreting the symbols selected by the communicator, and even low-level technical problem solving. Often when a communication system is introduced, it is the first time a child has ever seen or used such a thing. From an intervention standpoint, it is helpful to think of how an individual learns a foreign language. One would not give a child a Spanish / English dictionary and expect him/her to be a proficient Spanish speaker. That proficiency would be gained only through listening to the language and by repeated practice with an experienced Spanish speaker. The same holds true for learning to use an AAC system. Good communication partners will provide modeling and feedback as to the accuracy and efficiency of the communication attempts in addition to actually using the system itself to communicate with the child.
To increase the chances of success in learning a new system, activity-based teaching should be used. This model relies on selecting initial teaching activities that are highly motivating to the child, occur regularly, and present multiple opportunities for communication.
The following are some great resources to get you started with AAC: