Getting Started With AAC

Blog #18 in the Phonology Means Nothing and Other Astounding and Very Practical Facts about Speech Sound Disorders Blog Series

For more information about this series, see the Phonology Means Nothing Series welcome page.

Considering Augmentative and alternative communication (AAC) can be a little daunting at first. You may be asking yourself, “How do I get started?”  If so, keep reading.

If you would like more information about AAC there is another post in this blog entitled, Communication Benefits of AAC.

How Do I  Get Started?

Follow these five steps.

1.      Locate Resources. Your first step is to find out what resources you have available if you don’t already know. It is possible, in your school district(s), that you have resources like an assistive technology specialist available to consult, equipment that can be checked out, or software you can access to create visual supports.  You may also have professionals in your community that specialize in AAC.

• For instance, many speech-language pathologists in my community have access to computer software with libraries of images. Some examples of such software include (but are not limited to):  Boardmaker sold by Tobii Dynavox and LessonPix by LessonPix.
• It may be helpful to know, many companies that create devices offer opportunities to explore the device at your location for a short period of time. Devices can be rented for a fee for longer periods of time. Some companies that create vocabulary apps offer trial use so you can explore before buying.
• Companies also have varying supports like in person or virtual demonstrations, online manuals, 1-800 tech support numbers, online chats, frequently asked questions targeting tech support on websites as well as other social media, video tutorials on YouTube, resources for AAC instruction, and versions of software for editing. It’s all at your fingertips.
• In addition, there are frequent conferences, either prerecorded or live throughout the year, some free and some for a fee covering AAC topics.

2.      Collaborate. AAC includes a variety of tools like gestures, facial expressions, signs, picture symbols, communication books, and computer-devices (Beukelman & Mirenda, 2013). The specific tools selected are based on the individual needs of the child throughout the day. You will need the family’s and your colleagues' input and information regarding vision, hearing, motor, emotional well-being, communication, culture, and academic needs as it relates to AAC tool selection, and design (Zabala, 2005).  Brainstorm with them. Keep everyone informed. If new to AAC, you will need to assemble team members knowledgeable about AAC as you progress through these first steps (Beukelman, & Light, 2020).

3.      Gather Information. Observe, interview, and review records to find out when difficulties occur, current communication demands of the child and peers, and what has been working or not working across the day (Beukelman, & Light, 2020; Downing, 2009; Soto, 2009; Zabala, 2005). See the following examples to illustrate discovering what is working or not working.

• Example 1. You may note you are already using some forms of AAC like gestures and pointing to items in the environment to clarify a message in your current instruction and communication.  Does that help the child’s understanding? When the child is encouraged to point or use gestures, does it help them convey a message? Are there times the child’s verbal output helps when paired with a gesture? For instance, if the child points to the table with two beverages, orange juice and milk, and verbalizes /ma/. If your answers are yes, then continue to build from there.
• Example 2. Let’s say the teacher reported the child exhibited significant frustration when several words were not understood for Weekend News during Monday Circle Time. The communication target was not in the immediate environment, so a gesture and/or pointing did not clarify the speech attempts. Other options could be more efficient for this task, like picture symbols on a page, in a communication book, or on a device. Maybe with line-drawn picture supports, we’d find out the child was saying a favorite toy was lost over the weekend.

4.      Begin AAC Exploration. Explore and trial forms of AAC to begin to identify which tool provides support for the communication needs identified for the child. Some tips include:

• Keep the child’s needs at the forefront as you look at a range of AAC tools and collect data about what does or doesn’t work (Clarke, 2016).
• There are a number of organizational designs for vocabulary available. Consider it is difficult to communicate and model AAC with limited vocabulary (Farrall, 2015).  Some examples of comprehensive vocabulary sets in a grid display (rows and columns) include (in alphabetic order): Coughdrop, Grid 3, Pragmatic Organization Dynamic Display (PODD), Proloquo2go, Snap Core First, TouchChat, Words for Life, and Unity. For some, especially young children, visual scenes (i.e., picture of events or places with hot spots (buttons)) may be helpful (Light & Drager, 2007). Examples include, Chatable or Scene Speak, This is not an exhaustive list or endorsement of any one product, but solely listed as examples.
• The inclusion of one’s culture and language(s) is critical when providing services, selecting symbols, individualizing vocabulary, and considering AAC tools (Soto, 2020).

5.      Provide Instruction. During AAC exploration or trials, provide instruction and opportunity to communicate. For example:

• Model using the pictures symbols when you are talking (Binger & Light, 2007). You can begin by highlighting keywords of what you say verbally. Consider the sentences: “The toy is gone, help.”  and “How are you feeling?’ The underlined words were said with the device, while the whole sentence was said verbally.
• Additional helpful strategies can be remembered using the acronym S’MORRES (slow rate, model, respect/reflect on all communication attempts, repeat, expand on what is said, and stop/pause for the child’s turn). This acronym was shared on Carole Zangari’s PrAACtical AAC blog, by Dr. Jill Senner and Mathew Baud.

References

AssistiveWare. (2020). Proloquo2Go. AssistiveWare B. V.  https://www.assistiveware.com/products/proloquo2go

Beukelman, D., & Light, J. (2020). AAC assessment. In D. Beukelman & J. Light (Eds.), Augmentative and alternative communication: Supporting children and adults with complex communication needs (5th ed., pp. 19-90). Baltimore, MD: Paul Brookes Publishing.

Beukelman, D., & Mirenda, P. (2013). Symbol and rate enhancement. In D. Beukelman & P. Mirenda (Eds.), Augmentative and alternative communication: Supporting children and adults with complex communication needs (4th ed., pp. 37-72). Baltimore, MD: Paul Brookes Publishing.

Binger, C., & Light, J. (2007). The effect of aided AAC modeling on the expression of multi-symbol messages by preschoolers who use AAC. Augmentative and Alternative Communication, 23(1), 30–43.

Clarke, V. (2016). AAC assessment corner by Vicki Clarke: Is AAC feature matching still relevant? Praactical AAC. http://praacticalaac.org/?s=feature+matching

Coughdrop. (2020). Coughdrop (2020. 08. 13a). Coughdrop. https://www.mycoughdrop.com/

Downing, J. (2009). Assessment of early communication skills. In G. Soto & C. Zangari, Language, Literacy, and Academic Development for Students with AAC Needs. (pp. 27–46). Baltimore, MD: Paul Brookes Publishing.

Good Karma Applications. (2020). Scene Speak.  https://www.goodkarmaapplications.com/scene-speak1.html

Farrall, J. (2015, October 12). What is “Beginning AAC”? Jane Farrall Consulting. https://www.janefarrall.com/what-is-beginning-aac/

LessonPix. (2020). LessonPix custom learning materials. LessonPix. https://lessonpix.com/

Light, J., & Drager, K. (2007). AAC technologies for young children with complex communication needs: State of the science and future research directions. Augmentative and Alternative Communication. 23(3), 204–216.

Porter, G.. (2020). Pragmatic organization dynamic display (PODD) communication books: Direct access templates. Linda Burkhart Simplified Technology for Communication Living and Learning. http://lindaburkhart.com/wp-content/uploads/2016/06/Pragmatic_Organization_Dynamic_Display.pdf

PRC-Saltillo. (2020 a). Opening your iPad, iPad mini, iPhone, and iPod touch to a world of communication. TouchChat. https://touchchatapp.com/

PRC-Saltillo. (2020 b). Unity Language System. PRC-Saltillo https://www.prentrom.com/prc_advantage/unity-language-system

PRC-Saltillo. (2020 c). LAMP Words for Life. https://aacapps.com/

Senner, J., & Baud, M. (2015, April 9). How we do it: S’MORRES and partner augmented input with Dr. Jill Senner & Matthew Baud. Praactical AAC. https://praacticalaac.org/praactical/how-we-do-it-smorres-and-partner-augmented-input-with-dr-jill-senner-matthew-baud/

Smartbox. (2020). Grid 3. Smartbox Assistive Technology. https://www.mycoughdrop.com/

Soto, G. (2009). Academic adaptations for students with AAC needs. In G. Soto & C. Zangari, Language, Literacy, and Academic Development for Students with AAC Needs. Baltimore, MD: Paul Brookes Publishing.

Soto, G. (2020). A culturally and linguistically responsive approach to AAC [Oral presentation]. Assistive Technology Industry Association (ATIA) Conference, Orlando, Florida.

Therapy Box. (2020). Chatable a symbol based app. Therapy Box. https://therapy-box.co.uk/chatable

Tobii Dynavox. (2020 a). Welcome to boardmaker online. Boardmaker. https://www.boardmakeronline.com/Login.aspx

Tobii Dynavox. (2020 b). Snap core first. Tobii dynavox. https://www.mytobiidynavox.com/Store/SnapCoreFirst

Zabala, J. (2005). Using the SETT framework to level the learning field for students with disabilities. Retrieved from http://www.joyzabala.com/