by Rachel Riback, MS, SLP (Speech-Language Pathologist); NWACS board member

reading time: 3 minutes

The views expressed in this post are those 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.

Traveling and AAC - two of my favorite things! I am a Speech-Language Pathologist at an elementary school in DC Public Schools. In May, I traveled to Thailand to learn more about how Augmentative and Alternative Communication (AAC) tools are used there. This amazing experience was made possible by Therapy Abroad. This program provides prospective and practicing professionals such as

• Speech Language Pathologists,

• Occupational Therapists, and

• Physical Therapists

with real-world, clinical experiences in various countries across the world. You can learn more about Therapy Abroad and the programs they offer by clicking here.

Our group traveled to Chaing Mai, Thailand, in the northern part of the country. I supervised undergraduate students from Indiana University who were pursuing communication sciences degrees. We used AAC tools to support some amazing people. We were also provided with ample opportunities to explore the area and Thai Culture. We visited street food markets and several Temples, tried Muay Thai (Thai Boxing), and played with Elephants. 

What is AAC like in Thailand?

AAC tools help people communicate when they can’t speak. These tools can be simple or high-tech. No-tech tools include gestures and facial expressions, while lite-tech tools might be symbols and pictures. High-tech tools are usually speech-generating devices. In Thailand, there aren’t many high-tech devices available, so people mostly rely on simple and lite-tech AAC tools. During our trip, we worked with students, their families, and other professionals at different facilities. One of the facilities we visited was the Rajanagarindra Institute of Child Development (RICD). This is a hospital that provides various therapy supports including

• speech therapy,

• occupational therapy,

• physical therapy, and

• hydrotherapy.

This hospital is unique because it’s shaped like a giant piano! There, we worked with Nicole Bender, who is an AT/AAC consultant. Nicole has created a lite-tech Thai AAC system using picture symbols on paper. We used these picture boards with Thai students and their families. Many of them had never used AAC tools before. Once they saw how helpful they could be, the students started using them more. This was important. It showed the staff and families how effective AAC tools can be. Our hope is that it motivated them to continue to use the tools after we left.

This experience was eye-opening and humbling for me. Here are some of my main takeaways.

Be mindful of other cultures:

Different cultures have different ways of communicating. Gestures that we use in America may not be acceptable in other cultures. For example: In Thailand, using your finger to indicate “come here” is rude. Instead, they use their entire hand to gesture. This is reflected in the picture symbol used for “come” in the Thai AAC systems. Exploring Thai culture while working with different people there was helpful. It provided insight into some of the differences in communication styles and expectations. 

Presume competence:

In Thailand, students who can't speak are often labeled as Intellectually Disabled (ID). But when we provided them with AAC tools, we saw that many of them knew more than people thought. This is something I encounter as a school-based SLP in America as well. It is important not to assume someone doesn’t know something or doesn’t have anything to say just because they don’t use spoken language. 

Awareness and Buy-in:

People around the world need more information about AAC. Once the people we worked with in Thailand were provided with the right tools, they could see how beneficial these supports can be. It is important to model how to use AAC tools and be persistent. Training for professionals and caregivers is also crucial to the success of using AAC tools. Using fun and interesting activities is a good way to motivate people to communicate.

This was an incredible experience for me as a clinician and as a human. As someone who is passionate about AAC and culturing myself, this was a great way to get experience with both. I hope to travel to more places to explore and learn about how communication and AAC tools differ across the world.