The attitudes, beliefs and knowledge of communication partners are pivotal in the success story of Augmentative and Alternative Communication (AAC). The people around every individual with complex communication needs must believe that everyone has a right to communicate. We must provide them with a communication system that enables that right. We must believe in their ability to use language and give them a system that enables them to use language. The people around them must believe in their ability to learn language – and we need to implement aided language input and other forms of language/communication teaching and learning to get this started. Then we once more need to show our positive attitudes and our belief as we attribute meaning to their first communication attempts and then continue to support and encourage them as they move to more and more complex systems. If we “do not have the skills and commitment required to provide supports for AAC system use, abandonment of the system is likely” (Beukelman & Mirenda, 2013).
Aided Language Stimulation at Adelaide West Special Education Centre
Communication is never just about the individual – and AAC implementation should never be just about the individual either. Speech Language Pathologists are taught to see our interventions as being focused on the client and the individual, but we need to move beyond this. Until we work on and with the whole environment, AAC will not be as successful. When I first started working in this area I remember hearing older therapists talking about “systemic change” and thinking that that had nothing to do with me. But I now know it has everything to do with me.
As a young therapist I assessed each individual client I worked with. I developed and recommended AAC systems and worked in classrooms or day centres to get those systems in use. More than once this implementation fell over – the AAC system stayed in the cupboard for most of the week. I started to identify a new syndrome that I called “speech pathologist syndrome” – which involved the use of AAC only when a speech language pathologist was near.
Looking back I can see clearly that where AAC was successful it was because of the environment around that user – more frequently because of some of incredible people in that environment. Parents who knew the principle of “the least dangerous assumption” (Donnellan, 1984) by instinct and who willingly put it in practice while teaching me about making communication “all day every day”. Teachers who worked to teach me and their students how to use (and create) communication opportunities in the classroom. And the many wonderful AAC learners themselves who taught me to more than I can say.
These days I have a much higher success rate with AAC implementation (and the incidence of speech pathologist syndrome is greatly decreased!). Of course I do the traditional Speech Language Pathologist roles – getting to know the individual, doing traditional and dynamic assessment, recommending and customising a GOOD AAC system (such as PODD or core vocabulary) and making sure that that system works and is updated as needed. But the difference now is that right from the beginning my “intervention” focuses on the environment and the systems around the individual. I frequently give a teacher and/or parents a copy of their student’s communication system – and I spend lots of time working with them, explaining how the system works, getting comfortable with it and helping them to understand that they are absolutely pivotal in the success of the system. I talk about the importance of aided language input, I remind them that communication happens all day, every day. And I ask them to make sure that the individual’s AAC system is available everywhere they go. I give them small targets and then constantly up the ante as their skills, beliefs and understandings grow. I use tools like the Periodic table of AAC, the Communication Bill of Rights, and the AAC Boot Camp poster to remind people of the importance of this journey and I use videos of AAC users to show them where this journey is taking us.
Of course, this can sometimes be difficult to get funding bodies to accept as they prefer to fund sessions with an individual – but if I make sure that I always work in the individual’s classroom or home then I can definitely meet both my needs and theirs. And I explain to the funding body that a good AAC system has to be implemented accompanied by the right attitudes, beliefs and knowledge for successful communication to be the outcome.
And I always make sure that everyone is introduced to Jane Korsten’s wonderful quote that I first saw on QIAT Listserve:
It is critical for an individual to not only have symbols, but also to have experience with those symbols in a symbol rich environment / print rich environment. The typically developing child will have been exposed to oral language for approximately 4,380 waking hours by the time he begins speaking at about 18 months of age.
If someone is using a different symbol set and only has exposure to it two times a week, for 20 – 30 minutes each, it will take the alternate symbol user 84 years to have the same experience with his symbols that the typically developing child has with the spoken word in 18 months!!!
The typically developing child will demonstrate language competency around 9 – 12 years of age having been immersed in and practicing oral language for approximately 36,500 waking hours. For 9 – 12 years that child has been using and receiving corrective feedback while practicing with the spoken word.
At twice a week, 20 – 30 minutes each time, it will take the alternate symbol user 701 years to have the same experience.
Jane Korsten (2011) QIAT Listserv 4th April
- Beukelman, D.R. & Mirenda, P. (2013). Augmentative and Alternative Communication: Supporting Children and Adults with Complex Communication Needs (4th ed.). Baltimore: Paul H Brookes Publishing Co.
- Donnellan, A. (1984). The criterion of the least dangerous assumption. Behavioral Disorders, 9, 141 – 150
And a big thanks to Carole Zangari and Robin Parker at PrAACtical AAC for creating such an incredible and rich online resource around AAC for us all to use!