Don’t Be Afraid to Use AAC (Even if It’s Temporary)

Whenever I meet a child who is unable to fully express their wants, needs, and ideas using spoken language, I ask myself if additional support, such as augmentative and alternative communication would be beneficial.  

Augmentative and alternative communication (AAC) refers to a set of tools and strategies that support spoken language.  AAC can include gestures (e.g., shrugging to convey “I don’t know”), signs, pictures that represent words, communication books made up of several pictures, and speech-generating devices.  

Speech-generating devices (SGDs) have become a popular form of AAC.  Many families choose to purchase a communication app for their tablet that consists of many words represented by pictures.  When a picture is touched, the word is spoken aloud by the SGD.

Families often worry that if their child is introduced to AAC, they will lose the motivation to try to speak with their mouth.  While this is a perfectly valid concern, the research suggests otherwise.  Rest assured that using AAC does not prevent children from learning to speak and in fact, it often supports their spoken language development.  Below, we will take a look at some of the benefits I have found when introducing AAC to children who are not yet speaking or who are not speaking very often.

Increased Learning Opportunities

I have noticed that many of the children I work with who have communication difficulties also have attention difficulties.  

What we know is that children are meant to learn language as it naturally occurs in their environment.  However, if a child struggles to pay attention to their environment and subsequently, the language being spoken within that environment, they have less opportunities to learn new words and sentences.  

A challenge is that spoken language is fleeting.  In one moment, a word is spoken, and in the next, that word is gone.  If a child wasn’t paying attention to a spoken word, there is not a way to refer back to it.

This is where AAC and other visual supports can be a game changer!  Visuals, such as pictures, can remain in the environment for as long as needed and don’t disappear.  By pairing visuals with spoken language, we are giving children with communication and attention difficulties many opportunities to learn new words. 

Child-Initiated Exploration

Motivation plays a significant role in the learning process.  By allowing children to show us what motivates them, we set ourselves up for success in the language learning process. 

When a speech-generating device is used to support a child’s spoken language, the child has the opportunity to determine which words are modeled, how often those words are modeled, and when those words are modeled.  This is because the child has the autonomy to select whichever pictures they want and then hear those words modeled by the SGD itself.

Traditionally, it is an adult, whether that be a parent or a therapist, who chooses which words are modeled using spoken language, how often those words are modeled, and when those words are modeled.  The challenge is that the words we choose to model might not be the words the child wants to say.

Imagine the following two scenarios regarding a child who loves dinosaurs, but isn’t able to say the word “dinosaur” yet.

Scenario 1:  The child is playing with their favorite dinosaur toy and they want to say “dinosaur.”  If they have an SGD, they can select the picture representing “dinosaur” and hear how the SGD says “dinosaur.”  The child can select that picture over and over again to hear “dinosaur” repeated many times.  Over time, the child might try to say “dinosaur” (e.g., “dah”).  After hearing many more models of “dinosaur” on their SGD, the child’s production of “dinosaur” may improve (e.g., “dah-nah”).

Scenario 2:  The child is playing with their favorite dinosaur toy and they want to say “dinosaur.”  They don’t have an SGD, but their mother approaches and says “more” (referencing more toys) because this has been the target word in speech therapy.  The child hears “more,” but this isn’t the word they want to say.  As the mother continues to model “more,” the child eventually stops paying attention to the models. 

Now imagine if the mother was supported in knowing how to join her child’s play and exploration in scenario one.

Connection

Speech is different from communication and is just one way that we communicate.  Communication is simply conveying one’s thoughts through any means necessary.  We can communicate through text, emojis, GIFs, gestures, facial expressions, body language, tone of voice, eye contact, pictures, and speech.  By allowing children to express themselves through whichever medium works best for them, we are showing them that we value what they have to say more than how they say it.  This builds trust and allows us to connect deeply with our child.

“We are showing them that we value what they have to say more than how they say it.” 

- Caitlin Burke

In my professional experience, I have never regretted introducing AAC to support a child who is struggling to communicate.  I have seen children use new words and sentences, self-regulate, self-advocate, share their personality, and connect with others.