“All people with a disability of any extent or severity have a basic right to affect, through communication, the conditions of their existence. Beyond this general right, a number of specific communication rights should be ensured in all daily interactions and interventions involving persons who have severe disabilities. To participate fully in communication interactions, each person has these fundamental communication rights:

1. The right to interact socially, maintain social closeness, and build relationships
2. The right to request desired objects, actions, events, and people
3. The right to refuse or reject undesired objects, actions, events, or choices
4. The right to express personal preferences and feelings
5. The right to make choices from meaningful alternatives
6. The right to make comments and share opinions
7. The right to ask for and give information, including information about changes in routine and environment
8. The right to be informed about people and events in one’s life
9. The right to access interventions and supports that improve communication
10. The right to have communication acts acknowledged and responded to even when the desired outcome cannot be realized
11. The right to have access to functioning AAC (augmentative and alternative communication) and other AT (assistive technology) services and devices at all times
12. The right to access environmental contexts, interactions, and opportunities that promote participation as full communication partners with other people, including peers
13. The right to be treated with dignity and addressed with respect and courtesy
14. The right to be addressed directly and not be spoken for or talked about in the third person while present
15. The right to have clear, meaningful, and culturally and linguistically appropriate communications”

— Communication Bill of Rights (NJC)

Why focus on communicative competencies in AAC?

When we first learn about using AAC to communicate, it is easy to focus on the tool. The AAC system. For communication partners, learning a new way to communicate, using a new tool to do it, can be overwhelming. And maybe even scary. But learning how to use the AAC system, the tool (operational competence), is only one skill area of many needed to use AAC to communicate. The communicative competencies in AAC is a framework to help us remember many of the other skills that are also needed.

How can we apply this to AAC interventions? Use these skill areas to choose appropriate goals and objectives to help the person develop the various skills needed to become a proficient communicator.

skills contributing to communicative competence

The Ultimate Goal

The goal of AAC interventions is authentic communication from the person. That the person can get their intended message across to their communication partner.

The Communication Bill of Rights (above) states 15 specific basic rights of all people. These include:

the right to express personal preferences, opinions, and feelings
the right to ask for and give information
the right to refuse or reject
the right to make choices from meaningful alternatives

How can we apply this to AAC interventions? Remember that communication is a basic human right. And that right means the person is able (and allowed) to say what they want, when they want, how they want, to whom they want.

Additional Considerations

The phrase “Maslow before Bloom” is shared a lot in education circles. Especially over the past year and a half.

What does this mean? We must meet the person’s basic needs before they can focus on learning.

Bloom’s Taxonomy of Educational Objectives

How can we apply this to AAC interventions? When a person is having an “off day” with their communication, do a check of Maslow’s Hierarchy of Needs. When progress is not happening as quickly as we had hoped, do a check of Maslow’s Hierarchy of Needs.

Are there any basic needs that you can address? Is the person too hot, too cold, uncomfortable, tired, not feeling well, hungry, thirsty? Is the person dealing with emotions related to something that has happened? Is the person not feeling safe or comfortable in certain situations or with certain people?

Do you need to go back and first work on building rapport?

Do you need to provide more supports so that the person feels confident enough to try to communicate?

Learning to communicate with AAC takes time. A lot of time.

“I just figured out how many hours a typically developing infant is awake and exposed to language via the spoken symbol before they begin to use the spoken symbol expressively at around 12-18 months of age. If you then look at a child with an AAC system who only gets exposure to his system 2 times a week for 20 minutes with the SLP, it will take him 84 years to have experience commensurate with the typically developing child. Taking that a bit further, we don’t say language is in it’s ‘adult form’ until between 9-12 years of age. That means that for that length of time, a typically developing child is practicing using the spoken symbol, getting feedback and correction from listeners, seeing it modeled over and over.... now you look at the child with a device who only gets access to the system twice a week for 20 minutes with the SLP - it will take him 701 years to have the same amount of experience as his typically developing counter part.... and all of this assumes that no one is ever sick or takes a vacation.... So when no one wants to use a device until it is ‘mastered’.... in therapy..... hmmmm... what IS wrong with this picture... One might assume that an atypical developer might need MORE time to practice, NOT less time...”

— Jane Korsten, 2011 (QIAT Listserv)

By 18 months of age, babies have heard approximately 4,380 hours of spoken language. And they are just beginning to use spoken language. Children do not use fully developed (“adult form”) language until after 9-12 years. 9-12 years of teaching, modeling, practicing, feedback and correction.

How can we apply this to AAC interventions? When it feels like it is “taking too long” for the person to learn to communicate with their AAC system, check that you’ve provided an adequate amount of time. And that you have provided an adequate amount of aided language input (also known as AAC “modeling”). Many people who use AAC may need more time than their neurotypical peers to become proficient communicators.

AAC interventions must be culturally and linguistically responsive.

How can we apply this to AAC interventions? Check that you have prioritized the person’s (and their family’s) goals and needs. At every stage of the process. Check that the AAC system includes vocabulary and symbols to match the cultural and language needs of the person.

What do we do if it feels like AAC is not working for a person?

More often than not, we need to change our intervention strategies, support, and/or expectations. Not the AAC system.

References:

Bloom, Benjamin (et al), Taxonomy of Educational Objectives: The Classification of Educational Goals, originally published by David McKay Company, Inc., 1956.

Brady, N. C., Bruce, S., Goldman, A., Erickson, K., Mineo, B., Ogletree, B. T., Paul, D., Romski, M., Sevcik, R., Siegel, E., Schoonover, J., Snell, M., Sylvester, L., & Wilkinson, K. (2016). Communication services and supports for individuals with severe disabilities: Guidance for assessment and intervention. American Journal on Intellectual and Developmental Disabilities, 121(2), 121–138.

Download a PDF version of the National Joint Committee's Communication Bill of Rights [PDF].

Maslow, Abraham. A theory of human motivation, originally published in the Psychological Review, 50(4), 370-96, 1943.