What is an Augmentative and Alternative Communication Evaluation?

By: Laura Van Zandt, MS, OTR/L

Did you know October was National Augmentative and Alternative Communication (AAC) month? AAC is a specialized area of clinical services. Here at Easterseals DuPage & Fox Valley, we are very lucky to have several therapists who specialize in helping individuals find their voice through AAC. We have both Occupational Therapists (OT)  and Speech-Language Pathologists (SLPs) involved in a multidisciplinary team evaluation to determine the best strategies and/or communication systems to help a child learn to communicate.

As an OT, I first became interested in AAC when I was working with a little boy with autism who received a high tech speech output device. It was amazing to see how having his new voice provided so many new opportunities for him. It helped with his overall regulation as he now had a system to share his wants, desires, and needs.

AAC looks different from person to person and varies from low tech options, light/mid tech and high tech systems. If you think your child might benefit from AAC, our team evaluative approach may be helpful. Below is more information on what each team member does to best help your child.

1. Many parents often have questions about whether or not a device will hinder their children’s ability to speak. This is absolutely not the case. Research demonstrates that AAC does not keep children from learning to speak.  In fact, users will make gains in language AND speech because AAC helps a child connect with others, produce successful communication, and provides consistent speech models. The child I described above, went on to learn a ton of new words after he got his device! When we begin to use AAC with toddlers, it doesn’t mean we believe they are never going to talk; instead, it often means, we believe they need a way to have a meaningful connection to others through a common language which helps serve as a bridge to spoken language.
2.  Do try and introduce forms of AAC early. Using AAC can be very helpful for a toddler who is beginning to make gestures, eye contact or sounds to communicate messages, but isn’t yet using spoken language. Often these toddlers are frustrated they can’t communicate certain thoughts and messages. Once they start to see and learn the power of communication through signs, pictures, or more formal AAC apps/devices, they begin to feel a little less frustrated.

3. Model, model, model. When using any type of AAC, we can never model enough. This means that everyone in a child’s life should use AAC too! As with all language learning, AAC is learned because those around the child speak the same language. If you think about it, early communication development (between birth – 12 months) is only modeling – caregivers communicating without any expectation while being connected with their baby using a common language. I love it when my clients bring their devices to therapy. If your child is already receiving therapy services, ask the therapist to use your child’s communication system during sessions to connect and engage with your child. When using AAC, continue to use verbal speech to model and help children understand the pictorial representation of language and develop the words.

4. When you schedule an evaluation, you will see both an occupational therapist and a speech therapist trained in AAC. Both therapists are knowledgeable in a variety of access methods such as hand access, switch scanning, and eye gaze technology. The occupational therapist will specifically look at:

• the child’s overall posture and strength to allow for upper extremity (or any other extremity) use while accessing the communication system
• determine optimal positioning of both the child and the device to ensure the most efficient method of access
• the child’s vision, auditory, and sensory processing needs
• the child’s visual and/or auditory scanning ability
• the child’s visual/auditory tolerance
• any adaptations to engage different sensory systems, as well as monitor for sensory overload and/or assist in sensory regulation for device access.

The speech therapist is extremely knowledgeable in the vast array of AAC communication systems and AAC strategies available. They will help determine the communication system and language page best suited to bridge the gap between the child’s receptive and expressive communication skills. The evaluations are done in a play based manner to help the child feel comfortable. And play is how children learn!

Here at Easterseals we offer a team approach for evaluating children for AAC needs. For children that could additionally benefit from AAC, we will see them for co-treats to help expand their language within play based therapy sessions.

When the child’s specific goal is to assist in overall regulation and play to support device access, then a co-treat can be extremely valuable between Occupational Therapy and Speech Therapy. OTs are trained in setting up sensory rich environments to support regulation and drive play. These activities can be very motivating for your child’s communication. There are endless opportunities to model language depending on your child’s unique development.

To learn more about Assistive Technology at Easterseals DuPage & Fox Valley, click here. 

 

Additional resources: www.speechscience.org