As a Speech-Language Pathologist (SLP), one of the biggest barriers to working with Augmentative and Alternative Communication (AAC) users is device rejection or abandonment. Much of the specialty’s focus to combat this involves:
- boosting family, caregiver, and special education staff trainin
- addressing the various myths about AAC devices and evidence-based practices
- increasing access to funding for the device
- feature matching and device customization to increase AAC user ownership
While those hurdles are important, our unease as SLPs is not discussed. How can we expect our clients and their families to take ownership of an AAC device if SLPs are unsure about it? To fully address device rejection or abandonment with our clients, our profession requires introspection. We need to engage in building confidence and capacity in our teams. And we, the AAC and Assistive Technology (AT) Specialists, should lead the charge.
introspection: reflecting on one’s own actions, thoughts, and behaviors
Many surveys over the years have found that SLPs are uncomfortable with AAC/AT. Saunders, Page, and Lesher (2021) surveyed 272 school-based SLPs about their confidence in providing AAC assessment. They found that those who had specific AAC training and experience working with AAC users were more confident. In contrast, those that didn’t have training did not feel confident assessing AAC.
“In this study, most SLPs felt they had inadequate coursework and clinical training in AAC during graduate school.”
Saunder, Page, and Lesher, 2021
Another part of our discomfort with AAC is the lack of building capacity across settings. Many settings now have an ‘AAC specialist’ on the team to work with AAC users and their families. This ‘expert’ model lacks interprofessional participation and collaboration. Each year we are seeing an increasing need for SLPs confident in AAC.
interprofessional: involving multiple professions (e.g., SLP, OT, and teacher could be on an interprofessional team)
“Capacity-building is defined as the process of developing and strengthening the skills, instincts, abilities, processes and resources…”
United Nations
Andzik et al. (2018) surveyed special educators across the US. They found that 81.7% of special education students used speech to communicate and 18.2% used AAC. That is a significant part of our caseloads. With increasing client needs for AAC, we can no longer rely on the ‘expert’ model to meet the needs of the people we serve. It is important that we focus on building confidence and capacity within our teams to better serve our clients.
clinical fellow: an SLP in a supervised mentorship by an ASHA (American Speech-Language-Hearing Association) certified ALP during their first year of work post-graduation working towards their full certification
As an AT/AAC specialist, here are a few ways to help your colleagues feel more confident with AAC:
- Supervise clinical fellows and graduate students. Teach the next generation of SLPs in AAC.
- Foster bidirectional mentorship. Talk with other SLPs on your team about their special interests/expertise. Be open to calling them with caseload questions.
- Collaborate with teams. Listen to your teams’ needs. Work with them to create sustainable goals.
- Share knowledge and resources with colleagues.
bidirectional mentorship: a mentoring model that promotes collaboration between the mentor and person being mentored
Need some resources? Here are some to help your colleagues build confidence:
- Learn from and amplify AAC users – the real experts. USSAAC’s AAC Speaker Connection highlights AAC users available for speaking engagements.
- Get free access to AAC apps as an SLP and spend time exploring the apps. Connect with your local device representative for free access for evaluation purposes.
- Seek AAC specific training. There are several free or low-cost options available such as:
- Check out your local/state AT center for help with various devices.
- Visit the ASHA portal on Alternative and Augmentative Communication.
References
- Andzik, N. R., Schaefer, J. M., Nichols, R. T., & Chung, T. (2018) National survey describing and quantifying students with communication needs. Developmental Neurorehabilitation, 21:1, 40-47.
- Sanders, E. J., Page, T. A., Lesher, D. (2021). School-Based Speech-Language Pathologists: Confidence in Augmentative and Alternative Communication Assessment. Language, Speech, Hearing Services in Schools, 52, 512-528.
- United Nations. “Capacity Building.” United Nations – Academic Impact, United Nations, article link. Accessed 7/27/23
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