COMMUNICATION FOR ALL – How AAC Helps Children Find Their Voice

This post was originally written for Child Guide Magazine. Check out the many resources Child Guide offers as well as this article and others HERE.

What comes to your mind when you hear the word “communication”? Do you think of talking? That is what most people consider to be communication. But what if you don’t have a voice to talk? Or if when you talk no one can understand what you are saying? How do you communicate then?

Speech-language pathologists help those without an audible voice find their “voice” by introducing them to AAC. What is AAC? Augmentative and Alternative Communication (AAC) is just that; other ways, using high or low technology, to communicate. AAC includes something as simple as a head nod to something as high tech as a speech generating device.

The American Speech-Language and Hearing Association defines AAC as all forms of communications, other than oral speech, used to express thoughts, needs, wants and ideas. AAC can be aided or unaided. Unaided AAC is using body language, gestures and/or sign language to communicate. Aided AAC is when tools and/or equipment are used, such as pictures and speech devices.

Communication is a right of all people and it is the job of a Speech-Language Pathologist to help children access that right in the absence of the ability to speak. But how does one decide which AAC approach is best for the child? There are recommended criteria that typically have to be met for the child to be considered as an AAC candidate.

1. Does the child understand cause and effect? Cause and effect is the foundation of communication; I do something and get something in return. Sometimes cause and effect can be taught using an AAC device.

2. Manual dexterity and fine motor skills. To be able to access sign language as a means of communication the child must have the fine motor skills to perform two-handed signs. Also, to be able to push a button to activate a speech device, the child must be able to control the motor movement of the arm and hand. Tilt switches (a simple head tilt) and eye gaze systems exist to allow children with minimal controlled movement to access AAC.

3. Motivation! The child has to be motivated to communicate to be successful with any type of communication option. A highly desirable reward just might motivate any child to use their AAC!

So what does AAC look like for real kids? How does their voice sound? Meet Claire and Ethan, two AAC user success stories!

Claire Elias, daughter of Mark and Melanie Elias of Frederick, Maryland, is an adorably sweet 4-year-old girl. Claire loves the color pink and hugging her stuffed animals. She loves to watch Minnie Mouse and Sophia the First and her best friend is her twin brother, Chase. Claire has an incredibly happy disposition and a smile that lights up a room. Claire uses AAC to express herself. At the age of 2 she began using an iPad with a communication app to request toys and answer yes/no questions. The fine motor movements necessary to operate the iPad proved to be a difficult for Claire. Now she uses a PODD (Pragmatic Organization Dynamic Display ) book to communicate. A PODD book is a picture system that allows Claire to use visual gaze to make requests, ask questions, comment, etc. Claire will be 5 in June and will attend Kindergarten next fall. Her PODD book goes with her everywhere, just like her voice.

Ethan Judd, son of Christy and Jeff Judd of Inwood, WV, is a 6-year-old kindergartener at Bunker Hill Elementary. Ethan has an awesome sense of humor and a determined mindset. His favorite colors are green and orange and he loves, and often wins, playing UNO. Because of his tracheostomy, Ethan was unable to access his voice during his infant, toddler and preschool years. During this time Ethan used a combination of sign language and an iPad with a communication app. Since then Ethan has gained respiratory strength and now mostly relies on his voice to communicate. Sometimes he accompanies his speech with sign language to increase his intelligibility (the clarity of how he is understood). Ethan’s story is an example of how AAC bridged the gap for him until he was strong enough to vocalize. AAC gave Ethan a voice when his wasn’t available to him.

Claire and Ethan’s stories are just 2 of many, many AAC success stories. If you know a child who has yet to “find” their voice, contact an SLP close to you to help. Communication is a right of all individuals, no one should be denied!

Lacy Morise, M.S. CC/SLP, better known as Miss Lacy, is a Speech-Language Pathologist with the WVBTT and Loudoun County Schools. She is co-owner of Milestones & Miracles, LLC (www.milestonesandmiracles.com), a company dedicated to educating families about the importance of PLAY. She loves to use verbal and nonverbal language approaches to help kids access their right to communicate!