Total communicators and AAC users – The early intervention process
AAC refers to Alternative and Augmentative Communication. ‘Alternative’ refers to a system that is used in place of verbal communication. ‘Augmentative’ refers to a system that is used to supplement spoken communication. These systems can be as simple as using sign as we speak, to complex technologies that utilise eye gaze to activate a screen and have a computer speak a message.
Speech-Language Pathologists often recommend and implement AAC systems for children whose verbal communication is not meeting their present social and learning demands, and therefore might be facing frustration or exclusion. There are many accounts from adult autistic advocates now of the need for AAC for themselves when they are feeling stressed and overwhelmed and their language retrieval is compromised.
At Nurture Nest, we believe in promoting children’s access to additional communication supports from a young age, to bridge their development as verbal skills might improve during therapy.
Children with complex communication needs (CCN)
Children with CCN often require additional support to be included in the classroom and social settings. CCN refers to difficulties with communication, such as those experienced by Autistic children, children with cerebral palsy, Down syndrome, or other developmental disabilities. This can also include children with complex speech-sound disorders such as Childhood Apraxia of Speech (CAS) or dysarthria.
It is important for educators and caregivers to provide inclusive support to children with CCN so that they can fully participate and engage in their environment. Their communication system acts as an aid, just as a wheelchair, hearing aid, or pair of glasses would for children unable to walk, hear or see as their peers might would. Nurture Nest is able to provide in-servicing for Daycares, Kindergartens and Schools for their clients, to support AAC inclusion in the learning environment.
Recent research has shown that if AAC were only modelled in therapy sessions once a week, it would take a child 84years to become a proficient user of that system! It is critical to each AAC user that family, therapists, educational staff and peers are aware of and using their system to promote quicker progress. If we were to be told to speak Chinese without first hearing it in use, we would not succeed. This is the same case for AAC users. Intensive modelling without expectation must occur across settings. AAC systems can range from low-tech options like picture symbols and communication boards to high-tech options like speech-generating devices. These systems can help children with CCN to express themselves and communicate their thoughts and needs effectively.
It allows children to say ‘what they want, when they want, how they want, to whom they want’.
It is important for educators and caregivers to work with speech and language therapists to determine the best AAC system for each child. Detailed analysis will occur in the background by your SLP (and sometimes in collaboration with your child’s Occupational Therapist (OT) and Physiotherapist (PT) also) to determine which systems will be best to trial. Once the correct system has been identified and trialled, a detailed report can be completed for the NDIS to request funding for the system. Then there is often a customisation phase where specific vocabulary and images are added to a system, before implementing it’s use across daily settings.
Another important aspect of inclusive support for children with CCN is creating an inclusive classroom environment. This means that educators should consider the needs of all students when designing their classroom and lesson plans. For example, they can provide visual aids like pictures and diagrams to support students with CCN. Educators can also use strategies like visual schedules to help children with CCN understand the structure of their day and anticipate transitions. Consideration can be given to how an AAC user might complete a task and formulate their responses. Assessments might need modification. Oral presentations might be given as a recording from the device for example.
Educators should also consider the social and emotional needs of children with CCN. This includes creating opportunities for children with CCN to interact with their peers and form friendships. One strategy for this is to pair children with CCN with a preferred communication partner. A communication partner can be a peer or an adult who is trained to support the child with CCN by modelling communication and helping them navigate social situations. Thought can be given to shared interests, to pace of interaction and to patience.
Supporting peers and other partners to tune-into and respond to an AAC learner’s attempts at communication can be critical to the communication connection. This might include interpreting their pointing or vocalisations, gestures and speech-output messages. This also includes teaching other children to ‘watch and wait’ to see what their AAC user friend has to say. These children often need additional processing time, for language and for the movements required to construct their response. The AAC system must be accessible to the child at all times, in every space and classroom, with all partners.
In conclusion, supporting children with complex communication needs requires a comprehensive approach that considers their individual needs and abilities. Augmentative and alternative communication systems can provide a means for children with CCN to express themselves effectively. Creating an inclusive classroom environment and providing social and emotional support can help children with CCN feel more included and engaged in their environment. Collaborating with families and outside professionals can provide additional support and resources to ensure that children with CCN have the tools they need to thrive.
By working together, educators, families, and professionals can provide the best possible support for children with CCN and help them achieve their full potential.