Thursday, September 3, 2020

Communication Corner: AAC (Augmentative and Alternative Communication): Consider the Options!

All of your students deserve a voice. For some, finding a voice can mean finding a different way to express themselves.  It is important to determine the most effective modes of communication to meet the needs of your students. Today's Communication Corner focuses on considering the options available when using AAC (Augmentative and Alternative Communication). 


Augmentative Communication is communication that requires support to augment or enhance verbal communication. For example, a person may be able to speak but listeners may struggle to understand unique words. This person may benefit from using gestures, pictures or text to clarify important fringe words in addition to their verbal communication. Even though your student is verbal, it may be important to provide augmentative communication supports to enhance verbal speech to allow the most effective communication.


Alternative Communication is the use of a different mode when a person is not able to communicate verbally. This may include the use of a voice output device, pictures or sign language.  All of your students need a method of functional communication that can be used across the day. It is important that you look at a mode that can be used in different settings, or consider blending a variety of modes that can meet communication needs in different situations. We all use a variety of communication modes. We talk, gesture, point to pictures, and text. Your students will benefit from a variety of AAC options.  Greetings in the hallway can be done with a simple wave. Making a specific request or giving feedback may require pictures or a device. You may have a student who prefers to initiate communication with sign language, but has limited motor skills. You can teach some basic signs (eat, more, go, want) and use a partner facilitated picture scan to clarify exactly what the student wants. Click the image below to access our Modes of Communication table. 



LOOK AT BEHAVIORS
The first two columns on the left of the table look at observable behaviors. Behaviors are a way of communicating. It is important to know what your student is motivated to communicate and how they are currently expressing wants and needs. This will allow you to focus on communication needs that are meaningful to the student.  It will be important to identify a better mode of communication to replace interfering/aggressive behaviors.    


UNAIDED MODES

Unaided modes of communication do not require added supports such as pictures or technology. Communication can be done with a combination of verbal language, signs or gestures. The adult can provide a verbal or gestural model to teach and prompt communication.

AIDED MODES

Aided communication is a mode that requires a tool such as a picture, a pencil or a device. The communication partner may use pictures or text to prompt communication. Here are some picture examples of aided communication:


Picture Supports:
Choice board
Sharon Kolberg
Walter Shade Preschool, West Carrollton

PECS book
Karyn Smith
Tri-Village High School, Tri-Village

Color-coded communication flipbook

Wall poster matching student devices
Allie Clements
Schnell ES, West Carrollton 

Core word board with mini flip tabs for fringe words
Reagan Lucas
Stebbins HS, Mad River 


Sentence strips or yes/no image to prime and prompt verbal language


Text Supports:

Word prediction software to help enhance rate and support spelling/language


Technology to allow text messages such as phone, tablet or computer

Portable dry erase board for written messages 






Speech Generating Devices:
Speech generating devices provide an actual voice for the student. They can be as simple as a message recorded on a button or as complex as a dynamic device with a synthesized voice that allows an extensive vocabulary.  Here is a review of speech generating devices from Cincinnati Children’s Perlman Center.
 

 

Recorded Message Button with picture
Ann-Marie Small
Driscoll ES, Centerville 


A button with the option of sequencing multiple messages can provide rich opportunities for language interaction. The handout below provides ideas for using a button with sequenced messages. Click the image to download a copy.


Go Talk Static display device with different grid sizes



Dynamic display speech generated device
Erika Lauterback
Dixie ES, New Lebanon


Dynamic core word display with color coded category links

Dynamic Minspeak display


Access modes for aided communication:
  • Eye gaze board (object representations, pictures or text)
Ann-Marie Small
Driscoll ES, Centerville
  • Point to object picture or text
  • Move/exchange picture
  • Touch activation
  • Alternative access modes 
    • Head mouse
    • Scanning (single switch or two switch scan)
    • Partner assisted scanning 



Access to communication across the day:

When using an aided communication mode, it is critical that the student has access to the support tools in different environments. Communication needs occur beyond the speech therapy session or language group. Communication occurs in the hall, in the bathroom, at lunch and out on the playground. Here are some examples of strategies that facilitate communication across the day.


Portability for on-the-go communication
Carrie Prickett
Jane Chance ES, Miamisburg

Playground pictures are available for use outside

A variety of AAC options are out to ensure all students have a way to communicate across the day
 Ann Marie Small & Jackie Vollmer
Driscoll ES, Centerville


ENSURE FUNCTIONAL COMMUNICATION
If the current mode of communication is not working you will need to determine why. Consider modifying your facilitation strategies or the mode itself.  Functional use of a new communication mode requires direct instruction, modeling and LOTS of opportunities for practice. Work with the speech therapist or contact the Educational Assessment Team for an AAC evaluation. ALL students should have a functional mode of communication!

Another great tool for determining communication supports for a student is the Student Inventory for Technology Supports (SIFTS). The SIFTS is a web-based tool designed to assist assistive technology (AT) decision-making teams in matching a person’s needs with AT features.  This tool from the Ohio Center for Autism and Low-Incidence (OCALI) can be used to help guide you when determining AAC technology supports. https://sifts.ocali.org/  

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