OPTA 215 (Supporting Clients)
What is AAC?
Augmentative and Alternative Communication (AAC) is a variety of methods to support communication, NOT including speech, that helps a person express their thoughts, needs, ideas, wants, etc.
Example of AAC
-Gestures (pointing, reaching)
-Sign language
-Facial expressions
-Low-tech communication boards
-Mid-tech and high-tech speech generating communication devices
Complex Communication Needs means
A person with Complex Communication Needs (CCN) cannot communicate through speech alone.
Some people with CCN cannot speak at all. Others may be able to speak, but they cannot be understood by people who are unfamiliar.
In all cases, AAC is usually recommended.
What Does AAC have to do with OTA PTA?
-Knowing how to communicate with someone who uses AAC
-Understanding your role in supporting AAC use within a session
-Increasing comfort with AAC technology
Expressive Language Support
-Symbols to express thoughts, feelings, emotions
-Symbols to make choices, direct others
-Symbols to ask and answer question
Receptive Language Support
-Symbols to help me understand
-Symbols to help me predict what is happening next
-Symbols to help me make meaning and learn
Alternative Access for AAC
-Switches (so many switches!)
-Eye Gaze
-Head Mouse/ Head Pointer
-Equipment Mounting
Myth #1 Requesting the most important thing that we need to teach clients
facts:The truth is that, for most people in most situations, expressing wants and needs is SECONDARY to social communication. (Exception- Some Autistic people)
-When you meet someone new, would you rather be able to tell them a joke, or tell them that you need the bathroom?
Myth #2: AAC will delay or negatively impact speech development.
FACT:
Evidence suggests the opposite!
89% of studies showed an INCREASE in speech production
11% of studies showed NO CHANGE in speech production
(Schlosser, 2006)
It’s just easier to talk. It’s faster, and you have immediate access to every word that you know.
If they CAN speak, they WILL speak. And AAC may help!
Myth #3: Someone with an AAC Device should use it exclusively all the time.
FACT:
It is true that the AAC device should be accessible to the user as much as possible, but…
Communication is multimodal in nature.
Also, the device probably shouldn’t go into the pool or out in the rain unless it’s properly protected (but you could consider a laminated core board).
Myth #4: Behaviour needs to be addressed before a communication device is considered.
FACT:
Behaviour IS communication.
Is compliance communication?
Challenging behaviours have been shown time and again to be associated with poorly developed communication skills.
(Carr & Durrand, 1985; Carr et al, 1997; Romski & Sevcik, 1996).
Walker & Snell (2013) meta-analysis found: that “AAC has positive effects in decreasing challenging behaviors”
Concerned about device damage? There are options!
Stategy 1: Speaking AAC to teach AAC
-Babies hear between 4000 and 6000 words every day, but it takes nearly a year, and sometimes more, before they say their first word. (I did the math for you- that’s more than one million words).
-What does this mean for AAC learners?
Stategy 2: Modeling/ aiding language input
Just as a client learns to speak by listening to the speakers around them, a client learning to use AAC learns from models of the users around them.
Stategy 3: creating Communication Opportunities
-Practice within all activities.
-Follow their lead.
-“Sabotage” the situation for modeling opportunities.
-Involve families, staff, and peers.
Stategy 4: Wait Time
-Many people using devices take longer in general to process spoken messages, and then to come up with a response.
-PLUS, using a device for communication takes a LOT longer than speaking.
Stategy Instead of testing
-Give choices;
-Comment and wait;
-Ask for feelings or opinions;
-Ask about actions and descriptions (e.g., when reading stories)
Supporting Clients
-Have the device available and ready for use at all times– can you imagine talking to the doctor and having no voice to say what’s wrong?
-If the device is not available (for example, in the pool or if it is sent away for repairs), make sure that a low-tech communication option is within reach.
-Respond to all attempts to communicate with the device, even if you believe the message to be incorrect. This teaches the client that they have POWER over their world by using their device.
-Allow for all means of communication– for example, if your client waves “hello”, you know what they said and do not need them to find “hello” on the device.
-Don’t move vocabulary around on the device if you can help it– the client is learning a language through motor planning, and if you move words, they could have a very difficult time relearning it!