Implementation and Strategies
AAC should be...
Aided Language Stimulation
Aided Language Stimulation/Modeling is a research-based approach to implementing and teaching individuals how to use their AAC systems by having the communication partner both speak and simultaneously point to the word or words they are expressing on the individual's communication system.
The communication partner does not have to find every word expressed on the AAC device. Start modeling 1-2 words beyond the level the individual is communicating. For example, if an individual is at the single word level, when targeting 'more', say 'you want more' and point to that same phrase on the individual's communication system. This will assist in modeling the expansion of language and acquisition of vocabulary in natural or more instructional contexts.
Core Vocabulary and a Robust AAC System
A robust AAC system supports a variety of communication functions and connections like: making friends, asking and answering questions, refusing, sharing personal experiences and feelings, making real choices, joining in the community, and self-advocating. An AAC system should mirror natural speech development and allow modeling to support language learning. We presume potential by giving access to a large vocabulary to increase an individual's opportunity to communicate what they want, how they want, and when they want.
Core words: most frequently used words in a language. They are used in a variety of contexts and can be combined to form many different sentences. Core words make up about 80% of the words that we use everyday. Some examples of core words include:
I, you, me, he, she, it, we, they
is, am, are, was, were, be
do, does, did, have, has, had
to, the, of, and, or, but
go, see, come, give, get, want
eat, sleep, play, love, know, like
Fringe words: less frequently used words that are specific to a particular topic, individual, or environment. They make up about 20% of the words that we use every day. Some examples of fringe words include:
animal names (dog, cat, bird, fish, etc.)
food names (pizza, ice cream, apple, banana, etc.)
place names (home, school, park, store, etc.)
activity names (run, jump, play, swim, etc.)
emotional words (happy, sad, angry, scared, etc.)
Core words are important for learning and communicating, but fringe words are also important because they allow us to talk about the specific things that are important to us. For example, if we have a pet dog, we might use fringe words like "walk," "fetch," and "bone" to talk about our dog. If we love to play sports, we might use fringe words like "ball," "bat," and "goal" to talk about sports.
Both core words and fringe words are important for language development. Core words provide the foundation for language, and fringe words allow us to communicate about our specific interests and experiences.
As you know, individuals with Complex Communication Needs who express themselves using AAC require more time to think of, formulate and express themselves. Providing adequate ‘wait time’ is an important consideration for communication partners while interacting and engaging with persons who use AAC systems. Sometimes the need to ‘wait’ may seem uncomfortable at first but over time, practice, and when given focused attention, the amount of wait time needed for each individual will become more natural. As communication partners, we can wait expectantly for AAC users to respond and engage.
Following their Lead
The strategy of Following their Lead promotes a child/student-directed approach to AAC intervention where the communication partner has the opportunity to observe and respond to what the child is engaged in and to integrate the use of the AAC system across a variety of situations that are of interest to the student. Additionally, communication partners can provide and embed the use of other AAC strategies (such as Aided Language Stimulation and Wait Time) when they engage with students.
Six Steps to Follow the Child’s Lead - This handout from Hanen does not focus on AAC but outlines ways to follow the child’s lead in general and may assist you in your practice.
The Descriptive Teaching Model is a strategy used by many teachers and therapists to help individuals with complex communication needs, learn to use core vocabulary to describe topics or curricular-specific vocabulary or nouns. (Van Tatenhove, 2009). By providing open-ended questions to foster the expression of ideas, individuals can learn to use core vocabulary more flexibly to answer questions by describing words if they do not have the specific vocabulary word programmed on the device. Focusing on the use of core vocabulary to express the concepts, ideas, and features of the target word, can build more flexible use of core vocabulary and lead to increased communicative competence.
Teaching Learners with Special Needs - (Descriptive Teaching Mode) by Kate Ahearn September 15, 2015
Recasting is a helpful strategy that assists individuals who use AAC gain expressive grammar, syntax and vocabulary. When the communication partner immediately responds to utterances by modeling or ‘recasting’ a more expansive version of their message, (e.g. STUDENT: “want crackers” ADULT: “I want more crackers, please.”), this provides a dynamic interaction where there is no expectation of repetition. It is recommended that the strategy of RECASTING is utilized frequently and vocally emphasized by changes in loudness and pause time. (Parker, 2012).
Shared reading is an evidence-based instructional approach whereby the adult helps to guide the emergent reader to interact with a book by leading with a comment, asking a question or responding to what the student may say; providing wait time in order to allow for processing and opportunities for interaction, Notari-Syverson, Maddox and Cole, 1999). In this approach, the adult reads with the student, not to the student. Shared reading can be conducted in a 1:1 or in small or larger group dynamics.
Extending, Elaborating, Expanding
The AAC strategy of Extending, Expanding and Elaborating focuses on communication partners responding to what students express by providing immediate, (simultaneous) verbal and AAC system modeling based on the student's unique language goals. As an example, students at the single-word level may have a goal to produce two-word utterances and therefore the ‘add a word’ approach could be utilized, (providing modeling by adding a word to the utterance/word produced). Such added words could be targeted as: pronouns, verbs or descriptors, (for added specificity). Intermediate to advanced communicators would have different, higher-level language goals and targets that are individualized. When using the Extending, Expanding and Elaborating approach, it is suggested that such modeling is carried out in a positive, upbeat tone and with correct grammar and syntax.
Once students begin utilizing their recommended AAC systems (whether low or high-tech), educational and therapeutic teams often focus on how and when such systems can be implemented and utilized meaningfully throughout the day. Sometimes teams create Participation Plans which can help guide and outline the process. The specific approach is as different and as unique as each communicator and the strengths and needs of the individual and the team must be taken into consideration to ensure that OPPORTUNITY BARRIERS, (usually imposed by the people in the environment) and ACCESS BARRIERS, (which can be related to the individual who uses AAC) do not deter progress. (Beukelman & Mirenda, 1988; 2013)
Using the AAC Participation Model to Guide Implementation Planning, PrAACtical AAC/Kelly Fonner) Video (1 hour) as well as short summary.
The act and practice of Presuming Competence has been referred to as the least dangerous assumption, (Anne Donnellan, 1984) and applying this ‘mindset’ may be highly beneficial when selecting and implementing an AAC system for the individuals with whom we work. As parents, educators, therapists and others, we all want our students to be able to say, ‘whatever they want, however they want, whenever they want,’ and once a student is exposed to and provided with a robust communication system it can provide them with opportunities to learn and use a rich core and fringe vocabulary to express themselves using a wide array of communication functions. Communication is a human right and we are in a position to open up their access to words that have power. When we Presume Competence we believe everyone can learn.
Honor and Support ALL Forms of Communication
Students with Complex Communication Challenges who use AAC, may use not only their communication device or low-tech systems, but many other forms of communication as well. It is important to honor and support those forms of communication out of respect for the person communicating and their choices about what is easiest, most efficient and even more comfortable for them at the time. Many students may have limited speech, or may gesture, but when they use such systems, please respond naturally and please do not direct the student to then use their AAC system to say it a second time, (unless clarification is needed). We are all multi-modal communicators, ourselves using speech, gestures, text messages, email, writing, and so this makes sense. Building many forms of communication will help achieved increased communication competence.