Autism and Augmentative and Alternative Communication (AAC)
WhatsApp discussion dated 29/7/18 To 4/8/18
Augmentative and Alternative Communication (AAC) is defined as the use of other methods to replace or support verbal communication.
strategies that improve communication for those who are
1. non-speaking
2. natural speech does not meet their needs for functional
communication
There are two main types of AAC — *Unaided Systems
You do not need anything but your own body to use unaided systems. These include gestures, body language, facial expressions, and sign language. *Aided Systems
* Aided system uses some sort of tool or device. There are two types of aided systems—basic and high-tech. A pen and paper is a basic aided system. Pointing to letters, words, or pictures on a board is a basic aided system. Touching letters or pictures on a computer screen that speaks for you is a high-tech aided system. Some of these speech-generating devices, or SGDs, can speak in different languages.
*What types of AAC interventions are available?
AAC interventions include a wide range of systems from no technology (gestures, signs), to low technology (communication board, wallet), to high technology (speech generating devices).
*Who usually uses AAC devices
AAC users are individuals that have difficulty expressing their thoughts and ideas verbally (e.g. people with Cerebral Palsy, Autism, Apraxia, Muscular Dystrophy, etc.). Some AAC users will only need to use their system for a period of time while their verbal communication skills are being addressed through intervention, others will use AAC systems throughout their lives.
In order to best match a child's needs to a proper AAC device, it is imperative that a Speech Language Pathologist with AAC knowledge is available to make the appropriate recommendation. Some AAC devices require a considerable investment so it is advisable to seek a professional consultation prior to making a purchase.
*Finding an AAC System .
Seek the help of professionals who know about AAC and can help you to find the best system for you.
To find the best AAC system, you may work with a team that includes you or your loved one and the following individual(s):
Speech-language pathologist, or SLP
Doctor
Occupational therapist
Physical therapist
Social worker
Learning specialist
Psychologist
Vision specialist
Assistive technology professional
You may work with a vocational counselor to help you get back to work using AAC. You may also see a person who knows the technology, called a rehabilitation engineer.
This team will look at your speech and language, motor skills, vision, and more. They will look at how you communicate and what you need to be able to do. This information will help them decide what type of AAC system might be best for you.
*Inexpensive AAC for Children with Autism
: There are many different types of AAC available for children
1.Pictures : Print off pictures of common objects and actions in your child’s life. I typically make little cards about 2 inches wide and 2 inches tall. These can be used along with spoken speech as well to add a visual components 2.Sign Language : Use signs from the American Sign Language along with spoken speech. This adds a visual component to language and since children with autism are often visual learners, this makes language easier to comprehend.
3.Visual Boards : Make a sturdy board about the size of a lunch tray. You can make this out of construction paper or poster board. Then, glue pictures to it that represent the things the child may want to communicate. The child can then point to the picture of what he wants.
*Paid AAC Options for Children with Autism
1.PECS:This is a specific program where the child exchanges a picture of what he wants for the real thing. It is a very prescribed program and in order to do this, you must go through special training, purchase special materials, and have another trained adult to do the therapy with you. Great for SLPs, maybe not as good for parents.
2.Low-Tech Communication Devices: There are many different devices on the market that will allow for a simple layout where the child pushes a picture of what he wants and the device speaks the word out loud for him. These range from a single button that says only one message to a board with several buttons, each with a different message.
2.High-Tech Communication Devices : The more sophisticated communication devices are similar to tablet computers with touch-screens. The child can navigate through pages of icons that represent different things and will communicate different messages when pushed. These range from very easy to use for the child (one button on the screen) up through very complex
Eg Tablet or Smart Phone AAC Apps: Many of the companies that produce the high-tech AAC devices have released their software on the app stores so that you can download their AAC app on your own device and turn it into an AAC machine
*How do I decide which AAC device is appropriate for the child?
When deciding which AAC decide to use, consider the following:. Child’s current cognitive visual, and fine motor abilities.The child should be able to access the device given her current abilities and level development. For children with limited fine motor abilities, a 2×1 picture grid with large pictures may be appropriate. For children with vision impairments, icons may need to be modified (e.g., made larger, put against contrasting backgrounds). For children who are blind, you might consider tactile symbols. For children who have difficulty discriminating between multiple items, children may require explicit discrimination training, and teachers may consider starting with two icons. Consistent availability of the device . To be an effective means of communication, the AAC device should be available to the child at all times. For example, if a child moves from place to place or teacher to teacher frequently, you might consider AAC devices that can be attached to his person (e.g., communication bracelet). For a child who spends a large portion of his day in a wheelchair or stander, be sure to consult a physical therapist and occupational therapist to determine the most appropriate access method and possible mounting systems.
Collaborative decision - making.Teams of adults who regularly interact with the child (i.e., teachers, parents, speech pathologists, and other professionals) should collaboratively determine how AAC might improve communication for a specific child. Because AAC devices should be used consistently across the day (e.g., during all school activities, in-home routines, and in the community), agreement among all team members is important. In much the same way that young children with typical development receive consistent help in developing verbal communication (e.g., many adults who model and respond to verbal language), AAC users need support from communication partners who understand the importance of AAC and are willing to support its use.
Nidhin,# SLP shared his experience that ACC mostly in our country is considered when there is no speech development.He implied that it is very important to start ACC even from a very early age to avoid communication frustrations.He added that ACC is a catalyst when simultaneous verbal stimulation is provided with nonverbal mode.
Many parents doubted if ACC impedes verbal speech and commented that could be the reason why ACC is not preferred in an initial stage of therapy.Nidhin clarified that ACC facilitates communication and by prompt verbal stimulation.
Anjali K Ravi, #SLP shared her experience in dealing with children using AAC (PECS and Touch Chat app for Ipad).She pointed out that communication is not only restricted to ACC apps but sign language and verbal approximations are well reinforced.She suggested "proloquo2go" depending on child's progress.Sge pointed out that the golden rule of using an ACC is that parents or professionals never use ACC to communicate with the child, instead they give verbal simple directions for the child so that the child communicates through ACC.
Proloquo2go
Shereen Idiculla #SLP agreed upon the observations made by Nidhin and clarified that ACC has encouraged communication and promoted the possibility of verbal output as a consequence of good communication. She shared her experience observing kids on the spectrum communicating so beautifully which was quite unexpected ,thanks to the founders of ACC or else these kids would have been underestimated a lot.She clarified and reiterated that ACC doesnot impede speech development in any way and only enhances it. A heart touching conversation between a mother and her son was shared in which the son was using an App Play Talk for Android of which Shereen was part of the team who developed the ACC.
Play Talk AAC
The group expressed our heartfelt gratitude to Shereen and team for their services to the community. Parents provided many positive reviews on "play talk" for its simplicity ,ease and user friendly nature.
Lakshmi Jayakrishnan suggested "Verbally " for our kids.
Verbally AAC
Chitra Paul shared her experience using "Avaz" and introduced other Apps like "Jellow" developed by IIT,Mumbai and "Cough Drop"
Tarun's and Chitra's Journey
https://play.google.com/store/apps/details?id=com.dsource.idc.jellowintl
https://play.google.com/store/apps/details?id=com.mycoughdrop.coughdrop
Maya Suresh provided a lot of links on how AAC helps our kids.
https://www.asha.org/public/speech/disorders/Growing-Up-with-AAC/
https://www.speechandlanguagekids.com/what-are-the-prerequisites-for-using-an-aac-device-augmentativealternative-communication/
https://www.iidc.indiana.edu/pages/aac-website-resource-list
https://youtu.be/lSN318WaJzA
Akila Vaidyanathan of Amaze Trust ,Coimbatore shared that AAC and AT have been a life saver for many in the spectrum at Amaze.She shared a YouTube video on how a young gentleman is using the AAC , "Clicker" and "Avaz" for communicating.
https://www.youtube.com/watch?v=dBIY8ZkEqZs&t=8s
We salute you Akila Madam for all the wonderful services you provided for our community.
The discussion proved to be quite fruitful in terms of how to develop communication in minimally verbal kids in the spectrum.
Thank you all.
#Asd parents and Therapists,Kerala.
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