Introduction to AAC Devices in Autism Treatment
One of the most common areas of concern addressed during ABA therapy involves communication delays and a child’s inability to communicate his or her wants or needs. As a BCBA, I have been part of many conversations with parents about choosing a method of communication for their child. One option that can be considered is an Augmentative and Alternative Communication (AAC) device. AAC includes everything from sign language to picture-exchange system (PECS) and high-tech devices such as iPads or GoTalks. When I discuss these option with parents, some common questions or concerns are frequently raised.
Does choosing to use an AAC device mean we’re giving up on my child ever talking?
While it is true that introducing a communication device is sometimes only done if attempts at teaching vocal speech have not worked for a child, it doesn’t mean anyone is “giving up” on your child using natural speech. Oftentimes, it will be recommended that your child continues receiving speech therapy while also learning how to operate a communication device. The main goal when using an AAC device is to give a child an effective way to communicate his or her wants and needs – this might be easier and faster for him or her to learn. Sometimes this is taught along with vocal communication when a child starts receiving services because using the device is “easier” than producing speech vocally. The goal is still always to get a child to communicate using his or her voice as much as possible. However, occasionally, children have difficulty controlling muscles involved in the speech/respiratory process or have other neurological or cognitive limitations that affect speech production. Make sure to have a doctor evaluate your child for any physical limitations that could affect speech production.
Will my child stop trying to vocalize/talk if they use augmentative and alternative communication?
No! This is one of the biggest misgivings about starting to teach a child to use an AAC device. There are several research studies that actually show an increase in vocalizations for children who start using AAC devices! Millar, Light, and Schlosser (2000) found 50 of 69 participants showed an increase in speech production (number of words and/or vocalizations) following AAC interventions and only two of the participants showed a decrease in speech use. Even though your child’s therapists might be prompting use of the AAC device for communication, they will also be speaking the words to your child and trying to get some vocal output. It’s all about making sure to always reinforce any speech sounds a child makes so vocal speech becomes something the child is motivated to use.
How do I start using an AAC device?
Starting to use an AAC device with your child is a big decision that should be made with input from professionals such as a Speech Language Pathologist, Occupational Therapist, and a Board Certified Behavior Analyst. Your child will need to have several prerequisite skills such as the ability to manipulate a device (e.g., turning it on and off) and fine motor skills that allow him or her to scroll through a tablet and select specific icons. Your child also needs to be able to discriminate between several pictures to select the icon that is relevant.
Will I be expected to use the augmentative communication device with my child at home?
Yes! Even though you might be able to understand your child’s vocal speech, if your child’s words cannot be understood by others then it isn’t really functional communication. A good example of this is when a child’s parents go out of town and need a babysitter or even get grandma over to watch him or her. Without the parents there to “translate”, those people might have no idea what your child is trying to communicate.
What are some popular AAC devices and programs?
Probably the most common device used today is an iPad with a Proloquo2Go or GoTalk Now app on it. There are many others, and I recommend consulting with a Speech Language Pathologist to help you select the best one for your child.
Millar, D., Light, J., & Schlosser, R. (2000). The impact of augmentative and alternative communication (AAC) on natural speech development: A meta-analysis. In 75th annual conference of the American Speech-Language Hearing Association, Washington, DC.