Five Signs A Child Needs Augmentative/Alternative Communication

Five Signs A Child Needs Augmentative/Alternative Communication

By Rachel Madel and Christopher Bugaj | Originally published in the Back-to-School 2019 issue of AC&E.

“You were a late talker too,” your mom says as she sips her latte. “I wouldn’t worry about it. Look at you. You turned out fine. Just give him time. He’ll talk when he’s good and ready.”

You want to listen to your mom. She’s your mom! She’s been the cornerstone of wisdom your entire life and she’s never steered you wrong. She was right about that jerk you dated back in 11th grade. She was right when she told you to eat your vegetables. She was right about a lot of things. So, she’s likely right about this too, right?

Maybe.

Your well intentioned, reassuring mother might be absolutely right. Your child might begin talking (or talking more) any day now. But what if she’s not right? What if speech doesn’t develop like you hoped it would? While you wait to find out, might valuable time be slipping by when your child could be learning tools that could help him to communicate?

How do you know when a child needs a device to help communicate?

Tools which help people communicate are called Augmentative/Alternative Communication (AAC) and can range from simply utilizing pictures to using a high tech device such as a tablet, iPad, or computer. Here are some guidelines that can help anyone decide when to consider AAC:

The child isn’t talking at all

According to development research, typically developing children start saying words by the time they are between 12 to 18 months old and are beginning to combine 3 to 5 words together into sentences by the time they reach preschool. Ask yourself: what is the child’s primary way of communicating? If a child is over two years old and primarily relying on gestures (i.e. pointing, grabbing your hand, etc.) then starting AAC is essential in helping that child expand his/her communication skills.

Child isn’t talking much

Sometimes children are using words but they aren’t using enough of them. This is especially relevant when thinking about preschool and early elementary school children. You may encounter a child who can piece together thoughts into simple sentences but are missing essential conjunctions (like “and” or “but”), prepositions (like “in” and “under”), and other grammatical markers (“run” vs “ran” or “mouse” vs. “mice”). For some children formulating complex sentences is taxing.  Utilizing technology can help make the process of putting words together in the right order more visual and more memorable which  allows them to start creating longer and more sophisticated sentences.

Child is talking, but isn’t intelligible

Often parents and teachers get accustomed to the way a child is speaking and become master translators. Parents often recognize when their child is not being understood and, in turn, begin to learn to understand what their child is trying to communicate. A true test of a child’s intelligibility is whether or not listeners who are less accustomed to the child’s speech, such as extended family and friends, understand what the child is attempting to say. Making speech sound errors is a typical developmental process that begins to subside as children develop appropriate musculature and coordination in their lips, tongues and jaw. By 3 years of age, an unfamiliar listener should be able to understand 75% of what your child has to say. If a child is having a hard time being understood, AAC can be used as a tool to help a child clarify his/her message.

Child is scripting or only saying nouns

This is especially relevant when you’re thinking about children that have a diagnosis of autism spectrum disorder (ASD). Children with autism may have a large and detailed vocabulary of nouns, but lack relevant verbs, adjectives and prepositions. These parts of speech are essential in the creation of sentences. Students with ASD might also have the capacity to memorize long scripts from past experiences and tend to use these scripts in a variety of situations. Sometimes these scripts can even be used in context but it is difficult to have a memorized script for everything someone might ever want to say. Sometimes students who are using scripts do not understand the meaning of the individual words  that allow them to create novel sentences that they haven’t heard before. Using AAC creates a visual representation of these abstract language concepts. With practice, instruction, and when others model using these words on a device, children with autism can expand their vocabularies and develop the ability to create novel sentences.

You, or anyone, thinks your child needs AAC

If you are asking the question, then your child needs AAC. If any educator, doctor, family member, family friend, stranger you meet on the street, or anyone else even brings up AAC as an option, then your child needs AAC. Using technology to help someone communicate can never do harm. Copious research suggests that AAC can only ever help. Using a device to say a word provides another modality by which someone can learn what a word means. Most communication devices are designed to combine a visual representation of a word (symbol), with the orthography (text), and auditory output (sound). Put simply, communication devices allow students to simultaneously hear how a word sounds, see a picture of the word, and see how it is spelled. When these words are paired with experiences to help the child learn the meaning, he or she learns how and when to use the word. If a student is destined to use verbal speech as his or her primary form of expression, then a device only works to make those connections faster. Communication devices do not restrict verbal speech. They only work to enhance and improve the experience of communicating with others.

Once an idea of using a communication device has been broached, the real work begins. Families collaborate with professionals to begin selecting what the system should be. Stakeholders in the child’s life meet to brainstorm specific needs and then use that list to find a system that meets those needs. Once a system is put in place, everyone can begin to use that system to model how and when words are used. Given enough time, with enough of the right instruction, and access to the right tools, the child can and will learn language.

It might be cliche, but the old adage holds true. Every journey starts with a single step. The sooner you take that first step, the sooner you get to your destination. In the case of a child’s ability to communicate, it’s never too early to start.

Rachel Madel is a Los Angeles based speech-language pathologist who is on a mission to help empower parents and educators by demystifying the use of technology for children with autism. Rachel is the co-host of a weekly podcast called Talking with Tech,” that helps professionals and caregivers learn more about how technology can support communication in children with autism. You can follow her work on Facebook, Instagram or YouTube and download her free Autism App Guide.

Christopher R. Bugaj, MA CCC‐SLP is a founding member the Assistive Technology Team for Loudoun County Public Schools. Chris hosts The A.T.TIPSCAST; a multi‐award winning podcast featuring strategies to design educational experiences and co-hosts the Talking With Tech podcast featuring interviews and conversations about augmentative and alternative communication. Chris is the co‐author of The Practical (and Fun) Guide to Assistive Technology in Public Schools published by the International Society on Technology in Education (ISTE) and has designed and instructed online courses for ISTE on the topics of Assistive Technology and Universal Design for Learning. Chris is also the author of ATEval2Go, an app for iPad that helps professionals in education perform technology assessments for students. Chris co-authored two chapters for a book published by Brookes Publishing titled Technology Tools for Students with Autism. Chris co‐produces and co‐authors the popular Night Light Stories podcast which features original stories for children of all ages. Chris has presented over 300 live or digital sessions at local, regional, state, national and international events, including TEDx, all of which are listed at http://bit.ly/bugajpresentations. His latest book The New Assistive Tech: Make Learning Awesome For All, also published by ISTE, is available for order now!