Don't Wait! Start AAC in Birth to Three
by Cassandra Stafford, MS, CCC-SLP/L, ATP (Speech-Language Pathologist and Assistive Technology Professional), NWACS Board Member
reading time: 4 minutes
The views expressed in this post are that of the author and do not necessarily reflect the views and policies of NWACS. No endorsement by NWACS is implied regarding any device, manufacturer, resource, or strategy mentioned.
Babies start learning language and communication skills at birth. And there are things we can do to help that development. Even when they are still infants and toddlers!
Sometimes we know early on that a child is likely to have a communication disability. Sometimes we do not realize this until they are older. There is great news though. We do not have to wait to find out! Supporting early language and communication development is beneficial for all children. Regardless of whether they will go on to develop the ability to use spoken language.
AAC, or Augmentative and Alternative Communication, is any way of communicating other than spoken language. If we think about it, all babies start out as AAC communicators! They use
different cries
facial expressions (smiles, grimaces, etc.)
vocalizations (coos, babbling, vocal play, etc.)
gestures (reaching for, grabbing, pointing, etc.)
eye gaze (looking at)
body language (turning head away, rubbing eyes, etc.)
as ways to interact and communicate with us. We can use these natural spontaneous actions as a jumping-off point.
This early stage of development is sometimes called "emergent communication". Dr. Patricia Dowden defined an "emerging communicator" as someone who,
"does not have a reliable method of expressive communication through symbolic language."
Symbolic is an important word in that definition. It means using something to represent (or symbolize) a concept, idea, or thought. Symbolic language includes:
spoken language
written language
sign language
using pictures, icons, or symbols to communicate
The SCERTS model refers to this early stage of communication as "social partners". Children who have spontaneous nonverbal communication but are not yet using symbolic communication.
With children who are emergent communicators, we want to focus on multimodal communication. Build them up as social partners! We want to build on and strengthen their nonverbal communication. Their vocalizations. Their gestures and body language. Their turn-taking and engagement with others.
Make a communication “dictionary” with all the different actions your child uses to communicate. Document what they do, what you think they are trying to communicate with that action, and how to respond. Keep adding to it over time. This “dictionary” will help all communication partners recognize and understand how your child communicates. And it keeps everyone consistent in how to respond to those communicative actions. Describe to your child what you see them doing and what you think it means. For example, “I see you looking at me and reaching your arms up. I think you want me to pick you up.” (Then pick them up.)
We also want to start introducing symbolic ways of communicating. This could be using
objects
pictures or cards with symbols
a communication board with pictures and/or symbols
devices known as assistive technology, communication devices, or speech-generating devices (SGDs)
spoken words or word approximations
We are introducing symbolic communication. A lot of learning through experience and observation needs to happen before we expect a child to use symbolic communication. So, we are modeling symbolic communication to expose them. We are showing them. We are teaching how they could use an AAC system. But we are doing this without any expectation that they will use it right now. We can provide opportunities for them to explore and experiment. But we make no demands that they use these symbolic methods for intentional communication right now.
We are not restricted to only one way of communicating. We can use a combination. It is important to try different things and figure out what works best for you and your child. Remember, this will likely change over time. And that is okay. We want their communication tools to grow with them!
At this stage, it is important to get curious and learn about your child. What are their strengths? What do they like or enjoy? What are the obstacles to their active participation? What helps get them engaged with you? Use the information you gather to start increasing their active participation and engagement in daily routines. Children learn best when they are having fun. So, remember to keep it FUN and MOTIVATING.
"People games" can be a good way to build interaction and communication skills in a fun way. People games include things like:
tickles
blowing "zerberts" on their bare tummy
peekaboo
chase
And since they do not include any toys (the interaction with you is the fun!), people games can happen anywhere at any time! R.O.C.K. this play time by:
Repeating what you say and do
Offering Opportunities for your child to take a turn
Cueing your child to take a turn
Keeping it going and Keeping it fun!
This is also the time to start learning about different communication tools, or AAC systems. A good place to start is the NWACS Learn About AAC page. Check out the link to Types of AAC.
The goal is not perfection. There is no “one right way” to help your child develop their communication skills. The goal is connecting with your child. The goal is to increase their ability to actively engage with you and other communication partners. It is a commitment to your child's language and communication development.
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