Strengths-based Support for AAC Users
In the past couple of years, I’ve been learning more about strengths-based practices and strategies to support authentic communication in children. Did you know that strengths-based practices in speech-language pathology also apply to Augmentative and Alternative Communication (AAC)? As I’ve learned more about the medical model of disability and how it has negatively affected my training in speech therapy, I have been thinking about the way I was taught to implement AAC with children, and how most of the strategies I was taught were compliance-based and do not foster a child’s authentic communication or autonomy. I’m so glad I have learned how to change this!
What is AAC?
Some children need an alternative system to communicate if they are non-speaking, or to supplement verbal speech if their verbal speech is hard to understand or isn’t always accessible to them. AAC comes in many forms, and can include sign language, pictures, a digital communication app, and a printed communication board. If you think about it, most of us use AAC to some degree. We text and type emails. We use emojis, GIFs, memes and gestures to help get our point across. These are all forms of communication that replace or supplement verbal speech.
I was originally taught to help kids with AAC by being in charge of selecting and programming certain vocabulary into their AAC system that I thought they should know how to say. I was also taught to only give them access to a limited number of words until they were proficient with those words before adding more words. Other practices involved making sure children could identify concrete pictures before moving them to drawn symbols and testing them to see if they could understand the pictures before giving them access to a full, robust communication device. Another thing I used to do is the Picture Exchange Communication System. This involves having a “preferred item,” such as a cracker, and encouraging a child to give me a picture of the cracker before they could get one. If they brought me the wrong picture, they would have to go back and get the correct one before I’d give them what they wanted. Or, if they had an electronic talker, they’d have to find and press the right button on their device first before getting the item that they wanted. Looking back, this seems misguided at best. Why are we withholding things that kids want or even need, such as food, in order to “entice” them to communicate? How does this teach authentic communication? Well, it doesn’t. We don’t know what a child wants to say. Only the individual knows what they want to say at any given time. I’ll say it again. We don’t know what others want to say. We can make a guess, but it’s only a guess.
When I took the course Authentic AAC by Kate McLaughlin at LearnPlayThrive, my mind was blown after learning about a strengths-based, affirming way to implement AAC. This training brought up so many good points and I realized that supporting AAC users from a strengths-based approach really aligned with my values. Here are some of the strengths-based strategies I learned:
Modeling AAC without expectation
This means that we talk with AAC and we don’t expect the child to do anything if they don’t choose to. But through modeling, we’re normalizing AAC as a language in the child’s environments and we are showing learners where they can find words in their system to communicate their thoughts if they choose.
Giving learners access to a robust AAC system with hundreds of words right away
Instead of requiring children to prove that they are ready, a strengths-based practice encourages us to give access to all the words to all learners and to believe that all children can learn. My practice used to focus a lot on the phrase “I want,” so that AAC learners could request items and things that they wanted. However, since I was so focused on working on requesting, I missed out on teaching learners more about all the other things we use communication for, such as protesting and commenting on things like we like and don’t like. As my practice has shifted to a strengths-based approach, I am now looking at communication more holistically for AAC learners, and encouraging caregivers to model all types of communicative functions for them on a robust AAC system so they can communicate so much more beyond requesting wants and needs.
Being aware that we don’t know what other people want to say, even children
What if we really reflected and understood that we can’t have authentic, connected interactions when we’ve already planned what our learners are going to say to us during the interaction and when? For example, something I used to do is blow bubbles, and then stop, and then encourage the child to press “more” on their communication device, and then I’d blow more bubbles. Or if they walked, away, I’d encourage them to press “all done.” But what if they were walking away to get a little break and they weren’t done? Or what if they really didn’t want more bubbles, but another activity, but their only choice in that moment was to say “more?” I learned that by creating these contrived “opportunities” for AAC users to communicate doesn’t promote authenticity because only the learner knows when there are opportunities to communicate. Instead of creating these made up “opportunities,” within very structured activities, let’s model AAC in real interactions, pause more, talk less and give more space to our learners so they can initiate communication in they way that they want to. And when they do, let’s respond! If I think about myself, only I know when there’s an opportunity for me to communicate, or when I’d like to say something or not, and how I’d like to say it and to whom (ref. Gayle Porter). This also applies to our learners.
Examining the power dynamics between speaking and non-speaking individuals
Since I’m a verbal communicator, I can choose words and speak them quickly to express my thoughts. Also, verbal speech is considered the gold standard for communication in our culture and society. All of this translates to power, and by understanding and reflecting on my own power as a verbal communicator, I can better understand and respect the challenges and effort it takes for a non-speaking person to communicate.
Accepting all modes of communication and making activities with our learners about connection and shared joy, instead of all about the AAC system
By responding consistently to gestures, vocalizations, pointing, body movements and facial expressions, and considering them an equally valid way of communicating, we accept the learner as a whole person and we can focus on connecting with them. Sometimes when we focus too much on the AAC system and whether or not AAC users can accurately find words on their device or not in that moment, we lose out on joyful, connected interactions with them. We still want to model the system so that they can learn where words are, but we can’t forget to connect.
By using an affirming, strengths-based approach, we can support AAC users in a way that affirms who they authentically are. I work with AAC users and their families to support authentic communication in everyday interactions. Using strength-based strategies in my practice has resulted in learners saying new, unexpected things on their AAC system and learning to communicate what they’re really thinking and feeling. This approach has completely changed my practice! If you have an AAC learner in your life, or if you know someone who would benefit from using AAC to communicate, contact me for a free consultation.