Augmentative and Alternative Communication
Speech pathologists work in many areas. One thing that we do is work with people who are non-speaking to support them to learn new ways of communicating. These “new ways” are called “Augmentative and Alternative Communication” or AAC. There are lots of different AAC devices to suit the many different people who use them. Supporting someone to learn to use their AAC device is a bit like learning a new language; it takes lots of time, exposure, and encouragement.
How do we teach AAC at the moment?
In current practice, speech pathologists, family members and support workers may encourage an individual to use the AAC device through prompting. Prompting could be gesturing to the communication device or saying the start of a sentence for the individual to finish using their device.
One method of prompting is called ‘facilitated communication’, or physical assistance. This is where a speech pathologist, family member of carer, will physically assist the person to select a symbol on their device. It is important to note that research evidence does not support facilitated communication as an effective means of supporting an individual to use an AAC device. Speech Pathology Australia does not condone the use of facilitated communication. Furthermore, providing physical assistance violates an individual’s bodily autonomy.
Moving away from prompting
There is a growing movement of clinicians who are advocating for a shift away from all forms of compliance-based strategies for supporting individuals to use AAC. Compliance based strategies may utilise all kinds of prompting to elicit a targeted response for the individual, using their device, followed by a reward, or reinforcement for using their device. Research evidence supports that the use of reinforcers in teaching AAC may actually decrease motivation for the individual to use the device in the long term because it does not allow them to use their device to communicate when they want, how they want, and to whomever they want to communicate to.
How do we support an individual to use an AAC device without prompting?
Communication is at the centre of everything that we do. We communicate our needs and wants, but most of all, we communicate for authentic connection and interaction with others around us. Supporting an individual to learn to use an AAC device as a new way of communicating, should begin with a respect for the device as a means to creating authentic connection and interaction with others. To support this, speech pathologist, family members, carers and all communication partners can ensure
- The AAC system has a robust bank of language
- That modelling of using the AAC device is done without expectation that the individual should respond in a particular way, to a particular person at a particular time
- The AAC device supports the individual’s motor planning
- The AAC system is available at all times!!!
For those who use their vocal cords and mouth to communicate with others, our voice is a part of our identity, it is the method through which we deepen our connection with those around us and share who we truly are. Let us move towards supporting individuals who use AAC, to use it to express their true selves and make meaningful connections.