Look around at every stop light and you will see the soft addictive glow of smartphones. Minivans off for a family vacation are burgeoning with tablets and some other thumb-numbing form of entertainment. For more particular consumers, any technology prefaced with an “i” will do.
For people with complex communication needs, tools for learning and speaking have become more affordable and accessible. But this easy access is not without its challenges.
It’s true that augmentative and alternative communication (AAC) platforms have made it into the cool kid circles, but this can make it more confusing for families and therapists to make informed decisions. Beyond You Tube and Candy Crush, it is important to remember the why and how of AAC and assistive technology (AT). Here are some points to ponder before getting too bedazzled.
- “AT and AAC are the same thing.” Not so much. While AAC falls under the umbrella of assistive technology, it requires a specific skill-set. Just as “related service provider” or “allied health services” includes SLP services, I would not assume the job of my physical therapy colleagues and start recommending orthotic devices. Same with AAC and AT; both tools aid and assist, and include low tech (such as a pencil grip, picture schedules) and high-tech interventions (anything that plugs in). The difference here is who is involved: AT includes a wide range of professionals well-versed in making recommendations, from special education teachers to AT certificate holders. AAC does not. In AAC, the “C” stands for communication. It is within our scope of practice per ASHA guidelines. As far as I know, it’s not under the domain of other disciplines. Period.
- “I don’t get it, he has an ipad, he should be able to (fill in your random ability here).” A large reason for device “abandonment” is a mismatch between the tool and the user. As SLPs your job is to consult with other experts to make sure it fits the child’s needs in terms of accessibility; fine motor, vision, and positioning are just a few considerations. AT, particularly high-tech AT, requires additional considerations, with the primary focus being, does it aide and assist?
- “Everybody has one.” ‘Nuff said. Social pressure should not guide recommendations. AAC is prescriptive. I know it can be difficult, but stay strong and focused on what is appropriate and effective.
- “He is so good at using technology, so then why can’t he…?” My 10 year-old can use keys to unlock the door, but I wouldn’t give him the keys to drive to the store and pick up milk. Technology is a tool. AAC is a tool that requires explicit teaching. SLPs and parents are teachers that guide the process. Here is where it is important for us to educate, model and educate some more. As evidence-based practitioners, we need to take data. Data guides us on what’s working to guide what needs to be changed. For my students with autism spectrum disorder, it has been so helpful working with, and learning from, certified behavioral specialists, and come up with a system that everyone can use.
- “She uses it at school, and home is a time to relax, not work.” Consider the social circles of communication partners described by Deanna Wagner and colleagues (2003):
(adopted from Wagner, Daswick & Musselwhite, 2003)
Becoming a confident communicator means practice: practice at home, practice with friends and friendly acquaintances, familiar and unfamiliar people, and within the context of different places. Don’t aim for perfection. Just aim for opportunities to practice!
Kerry Davis EdD, CCC-SLP,is a speech-language pathologist in the Boston area, working with children who have significant communication challenges. She conducts trainings and workshops, and serves as a volunteer speech pathologist and consultant for Step by Step Guyana, a school for children with autism in South America. The opinions expressed in this blog are her own, and not those of her employer.