by Tanna Neufeld, MS, CCC-SLP (Speech-Language Pathologist); NWACS President
In honor of AAC Awareness Month, I thought it would be fun to explore all of the ways in which I have seen AAC help kids communicate. AAC helps individuals across the lifespan, of course, but I work closely with children and families, so I thought I’d share from that perspective today. Learning how to use AAC certainly takes time and dedication, as does teaching a child how to use AAC. Despite the effort, and at times what can seem like incredibly delayed gratification for that effort, I believe in AAC because I have seen it work! If you are a parent or professional feeling overwhelmed, confused, or even skeptical about how AAC fits into your child or student’s journey to communication, I hope this combo of success stories and tips gives you guidance and hope.
1. AAC Supports Language Learning & Reduces Confusion
There is a difference between “speech” and “language. Speech is our spoken words. But language doesn’t necessarily have to be spoken. We use language to communicate in a variety of ways - through speaking, writing, and even in our thinking and problem-solving. Many kids who struggle to speak are simultaneously on the quest to learn language. Part of learning a language is being able to perceive a word and make connections to what it means in your world. When children have trouble processing the spoken language of their parents and other communication partners because of delays or differences in their development, they can sometimes miss out on this very important connection - between a word and what it means in their world.
I worked with a little boy who was struggling significantly to understand spoken language in addition to his struggles speaking. He was often unresponsive when others asked questions or provided directions. It wasn’t always clear whether he didn’t hear others, didn’t understand what was being asked, or just simply didn’t want to participate. To try to support more successful interactions, we started using simple gestures and signs when communicating key words in directions, choices, or questions. We noticed that he watched us and seemed to be listening more intently to our communication than before. When playing or talking about books together, our team pointed out key concepts in the pictures or the environment by pointing to the pictures or objects or acting out the concepts. With just these simple adjustments of adding some visual support when communicating with him, we started to notice increased response to directions and questions, and overall longer interactions with more participation from him.
Using AAC strategies, such as pictures on a communication board or a communication app, gestures, or sign language, helps support a child’s ability to attend to and understand the spoken words they hear. These “visual support” strategies help a child understand directions and expectations, of course, but they also help a child make those important connections between words and their meaning because visual language moves more slowly and sticks around longer than purely spoken words. Visual learning is also a relative strength for many young children, especially those with developmental differences whose vision is intact. When we support kids in understanding more of the communication in their lives and in participating in interactions more readily - such as by following a direction more successfully or responding to a question accurately - we lay a stronger foundation for their receptive language. Also, when we speak to kids using AAC, we immerse them in visual language that they can use later to express their own wants, needs, and ideas if speech remains limited or does not develop at all.
2. AAC Helps Fix Breakdowns
Communication (and AAC) is a system of tools and strategies, not just one device or method. We all use a system when we communicate - such as gesturing when speaking, using facial expressions, pointing when providing directions, and even acting things out from time to time. We may use these strategies to enhance our message or even to add clarity when we think a partner is not understanding. Sometimes we even use communication that doesn’t involve speech intentionally - such as when we text or email, or write a note to a colleague during a boring meeting so we can coordinate lunch without seeming rude. Some kids who use AAC may have the ability to speak (and many will develop speech) but are limited in some way. This might be because others, especially new or less familiar partners, don’t understand their speech. Or perhaps they lose their ability to speak with consistency because of other challenges, such as sensory or emotional. For these children, AAC strategies support them in repairing communication when their speech is not understood or when it’s just too difficult to speak in a given moment or situation.
I worked with a teen girl who had so much to say! She was physically limited by her cerebral palsy but she spoke in full sentences and had amazing stories to tell and questions to ask of others. Her muscle weakness made speaking quite tiring for her and her speech was difficult for many to understand, especially when she was tired. When she was about 5 years old, she started to learn a pictured AAC system with some spelling features. We worked together to help her understand what to do when others did not understand her speech and how to help them understand by using different strategies, including her AAC device. She didn’t need to use her AAC all of the time - her family and close friends understood her very well because they were familiar with her speech patterns. But if she had something new to share and there was a breakdown, or she had a new partner to communicate with, she had the tools and skills to do so, which broadened her opportunities to connect with more people about more topics.
Over time, when we introduce AAC strategies consistently through modeling, and teach children the what, why, and how of repairing their message when others don’t understand, we offer each child the power to have more successful communication exchanges, about more topics, with more people. We also reduce frustration (and likely the behavior related to that frustration) around not being understood or not being able to participate. When children who struggle to communicate experience more success in their communication attempts, they make more attempts, which leads to more communication - it is a truly beautiful cycle!
3. AAC Offers a Voice
This one likely may not be news to you as AAC tools like communication books, apps, and the like are known better than ever as a means of helping children who are not yet speaking to have a more effective way of communicating. By “voice” here I am speaking figuratively, although many AAC systems - such as tablets with communication apps and dedicated communication devices from specialized companies - indeed offer voice/speech output. But not all kids use AAC strategies that offer a spoken voice right away - or even at all - and that does not mean that AAC doesn’t provide them with a “voice”. AAC tools and strategies offer children with limited or no speech the ability to express themselves in other ways and to enhance the way they already communicate to assure that others understand. I’ve mentioned above how important successful communication experiences are in building more of the same for kids who struggle to communicate. One of the ways we can add to this platform for success - even if we are pretty sure a child will eventually develop speech - is to provide access to AAC early and to emphasize the immersive modeling of AAC as if it were a second language. Think of it like this:
If I want my baby (who is not yet speaking at all) to learn English (my native language) and Spanish (not my native language), what would I do? Well lucky for me (and him), his nanny speaks fluent Spanish. So we team up, I speak English to him, she speaks Spanish to him, therefore immersing him in both languages. As he listens to the words we speak and recognizes how each connects to his world (the objects, the actions, the feelings etc.), he starts mapping both languages in his brain. If we keep at it, he will learn to speak both languages. He will also learn when to use which language and with whom, because kids are amazing and their brains are little language absorbing sponges!
So let’s jump back to this idea of AAC as a second language. We always speak to kids to model language (verbal language) but if we add this second language - the visual language - on top of our verbal language, our kids with complex communication needs are immersed in both and we set each child up to navigate communication more effectively given the demands of the partner, the situation, and whether speech goes on to develop or does not.
For the story portion of this AAC success, I thought that rather than sharing one story of one child finding his voice with AAC, it would be more fun to point you to some videos of truly amazing kids and adults using AAC to make their voices heard. I’ll keep adding to this playlist over time so check back frequently for more inspiration from these powerful communicators! Have a video link that you think belongs in the playlist? Share a link in the comments or email us and we’ll add it to the list!
Get Inspired by AAC Users on YouTube
AAC-Related Videos (NWACS Pinterest Board)
How has AAC made a difference for you, your child, or an individual you support? Share your story in the comments!