AAC Basics and Strategies

Week 1: AAC Basics

  • Definition of AAC (Augmentative and Alternative Communication)

    • Encompasses all forms of communication, aside from oral speech, utilized to express and understand thoughts, needs, wants, and ideas.

    • Examples include:

    • Sign language

    • Gestures

    • Alphabet or picture symbols

    • AAC is defined as anything facilitating communication that either substitutes or augments speech.

    • Functional aspects of communication addressed:

    • Social interaction

    • Information exchange

    • Making requests

    • Social etiquette

    • Communication is recognized as a fundamental human right.

Why is AAC Important?

  • Right to Communicate

    • Recognizes communication as a basic human need and individual right.

  • Cultural and Societal Importance

    • Communicative interactions are vital for societal and cultural integration.

  • General Purposes of Communication

    • To socialize and interact with others.

    • To exchange information.

    • To articulate requests.

    • To adhere to social etiquette.

  • Predictability in Communication

    • Different levels of predictability exist in communication scenarios.

Who Uses AAC?

  • Population

    • Individuals requiring adaptive assistance for expression through speaking, writing, or understanding.

    • Various communication disorders can necessitate AAC:

    • Congenital Conditions:

      • Severe intellectual disability

      • Cerebral Palsy (CP)

      • Autism Spectrum Disorder (ASD)

      • Developmental Apraxia of Speech (DAS)

    • Acquired Conditions:

      • Amyotrophic Lateral Sclerosis (ALS)

      • Multiple Sclerosis (MS)

      • Acquired Brain Injury (ABI)

      • Stroke

      • Parkinson's Disease

      • Voice disorders

      • Palliative Care needs.

Indicators for Starting AAC

  • Indications that AAC may be necessary:

    • A child not achieving normal communication development.

    • Expressive or language difficulties present.

    • Considerable expressive/receptive gap.

    • Demonstrated frustration in communication.

Four Domains of AAC System Design

  1. Operational Domain

    • Focuses on the management of the specific AAC device or techniques.

    • Notably observable by non-AAC communicators when interacting with AAC users.

  2. Linguistic Domain

    • Encompasses knowledge of the linguistic code of spoken language and AAC tools.

    • Requires understanding of language structure and symbol integration.

  3. Social Domain

    • Centers on pragmatic skills in communication.

    • Covers topic maintenance, transitions, and engaging attention.

    • Challenges due to dependency on competence of communication partners.

    • Addresses the double empathy problem where:

      • Autistic individuals may struggle to communicate with neurotypicals but perform better with others in the same neurotype.

  4. Strategic Domain

    • Involves strategies to address communication breakdowns.

    • Includes:

      • Requesting clarification or additional information.

      • Recognizing when a listener has misunderstood.

      • Repeating or clarifying the message.

Developing Competence

  • AAC users should ideally develop competence in all four domains but may not achieve this uniformly.

  • AAC systems support cognitive development, including:

    • Thinking

    • Reasoning

    • Problem solving.

Unique Goals for Early Communicators

  • For clients entering the symbolic stage, specific AAC-related needs persist, including:

    • Awareness of device power and battery functioning.

    • Ability to request communication resources when not immediately visible.

AAC Statistics

  • Canadian Statistics:

    • Approximately 1.5% of the population aged 5+ face speaking or comprehension issues.

    • Around 3.8 million Canadians (13.7%) aged 15+ report a disability.

    • Estimated 1.5% (318,000) of individuals aged 4+ have communication disabilities.

Definitions

  • AAC: Tools and strategies aiding communication beyond oral speech, designed to reduce frustration, promote social inclusion, and ensure access to basic rights.

  • Early AAC Use: Strongly recommended without prerequisites.

Week 2

Social Domain in AAC

  • Potential difficulties in AAC user communication with neurotypical individuals due to misinterpretation.

  • Autistic individuals often face pressure to conform to neurotypical norms and may feel isolated in these interactions.

    • Neurotypical individuals misinterpret autistic communication; often misattributing social struggles to a lack of skills.

Importance of Understandings in AAC Interaction

  • Communication interactions are bidirectional; understanding involves recognizing social interaction traits across different neurotypes.

Strategic Domain Development

  • Development of adaptive strategies crucial to prevent communication breakdowns. Such strategies include:

    • Requesting additional information.

    • Recognizing listener confusion.

    • Clarifying or repeating messages.

Competency Development Approach

  • Goal to help clients become adept in operational, linguistic, social, and strategic domains, even though this may not occur homogeneously.

  • Language aids cognitive development: AAC systems can support thinking and problem-solving capabilities.

Unique Aspects of Early Communication Goals

  • Common Concerns: Ensuring basic operational readiness of AAC devices including:

    • Power status

    • Battery efficacy

    • Client's ability to locate fault communication tools.

Week 3&4: Facility and Context of AAC Device Use

Organization of AAC Boards

  • Two primary layouts: word-based versus sentence-based.

  • Board designs such as:

    • Grid layouts

    • Subject-Verb-Object (S-V-O)

    • Fitzgerald Key (color-coding approach for semantic and syntactic relationships)

    • Visual scene displays portraying contextual themes (e.g. birthday events).

Vocabulary maintenance

  • Requires consistent updates from caregivers and professionals.

  • Maintaining literacy as a long-term focus to promote independence in AAC users.

Professionalism in AAC Practice

  • Practitioners must cultivate self-awareness and understand others' perspectives to promote collaborative discussions.

  • Problem-solving should be a joint effort in case of device adaptations by outside providers.

Interaction Patterns with AAC Users

  • AAC Users generally:

    • Play a passive role in conversations.

    • Limited initiation of interactions.

    • Express a narrow range of speech acts.

    • Operate with various linguistic limitations.

  • Conversational Partners often:

    • Dominate discussions, limiting the AAC user's active participation.

    • Pose mainly yes/no queries, restricting turn-taking opportunities.

    • Focus more on AAC technology than the communicative intent.

AAC Conversation Rates

  • Typical communication speeds average 150-250 words per minute; many AAC users communicate significantly fewer (5–25 words per minute).

Strategies for Rate Enhancement

  1. Consistent Item Locations: Supports motor learning by keeping high-frequency terms in the same location.

  2. Accelerated Vocabulary: Include pre-stored rapid messages for regular interactions (e.g. greetings).

  3. Vocabulary Organization: Optimize organization within the AAC.

Prediction Techniques in AAC

  • Various levels of prediction can be utilized:

    • Letter prediction based on common patterns.

    • Word and phrase predictions utilizing frequency/syntax based models.

Low Tech to High Tech in AAC

  • Low Tech: Inexpensive, non-digital, easily manufactured options like communication boards or visual schedules.

  • Light Tech: Battery-operated devices for recorded communication.

  • High Tech: Advanced systems for digitized output and varied applications (e.g. communication in social media).

Aided Language Stimulation Approach

  • Involves modeling AAC use during spoken language interactions; essential for building vocabulary comprehension.

  • Encourages consistent use of AAC tools by partners through engaged practice and interaction.

Week 5&6: Engaging AAC Users in Literacy Development

Coachable Skills in Literacy for AAC users

  • Linguistic Competence, Operational Management, Social Engagement, and Strategic Communication Repair are crucial aspects.

  • Always presume user competence, fostering independent communication methods.

Fitzgerald Key Application Example

  • Color-coded signaling for different linguistic categories (nouns, verbs).

  • Programming locations consistently aids in user comprehension and memory efficiency.

Goals in AAC Interaction and Coaching

  1. Engagement Strategies:

    • Customizing methods for the specific user's interests and strengths.

  2. Incorporating Helper Planning:

    • Use collaborative review sessions to model and reflect on language use.

  3. Therapeutic Relationship:

    • Continuous interaction modeling with no pressures, utilizing leisure and play-based activities.

Importance of Effective Communication Partners

  • Partners must also receive education on engaging and supporting the AAC user's communicative efforts.

  • Techniques include:

    • Micro-modelling strategies during engagements.

    • Explicit scripting for desired phrases during communication.

Recognizing and Responding to Client Progress

  • Monitor responses through:

    • Changes in body language.

    • Interaction patterns with AAC tools.

Continual Professional Development

  • Addressing barriers means updating personal skills continuously and focusing on different aspects of facilitation and interaction in AAC.

Week 7: Human Rights and Communication

Ethical and Legal Aspects of AAC Implementation

  • Legal frameworks supporting AAC access:

    • Human rights protections underpinning AAC in educational and clinical settings.

Harsh Implications of Discrimination Without Support

  • Global advocacy efforts to improve AAC access highlight pressing ongoing challenges for disabled populations seeking communicative equality and independence.

Week 8: Factors Affecting AAC Development

Emergent Literacy for AAC Users

  • Critical focus on foundational literacy skills developed through engaging reading experiences and extensive vocabulary exposure guiding learning efficacy and retention.