You Don’t Need Expensive Tech: The Truth About Using AAC

Where to start with AAC

With the world of technology evolving all the time, there has never been more options out there for children who are unable to or have difficulty talking. A quick google search and you find a bewildering array of apps and dedicated devices that all promise to address any and all communication difficulties. As a parent it can be really hard to know what is best for you and your child and you can easily get drawn into the trap of spending lots of money on something that doesn’t do what you want and isn’t the magic solution you were hoping for.

As a Speech and Language Therapist the first thing I consider when I’m thinking about how best to support a child that is unable to or has difficulty talking is, what will help them to communicate the multitude of things that children want to communicate to others. For some children I will support them to improve the clarity of their speech so that more people can understand them and they can clearly say more things. Whilst making progress with speech enables children to quickly and easily communicate with others, progress doesn’t happen for all children for many different reasons. For those children who need more time to develop their speech I’d think about what other ways of communicating they already use (maybe that’s leading you by the hand to the snack cupboard to let you know they want a biscuit or hopping up and done to show they need the loo) and what other ways of communicating they could learn to use that will make communication easier and more effective. In technical terms I would be thinking about introducing AAC for these children.

AAC stands for Augmentative and Alternative Communication or in other words anything that can add to or support communication. AAC can take lots of different forms from the computer that speaks out a message when you look at a picture on the screen, to an app on an iPad that you can type a message into for it to read out, to a book with picture symbols in that you can point to let someone know how you are feeling. AAC can range from something that costs thousands of pounds and needs charging every night to something you can print off in the office when the boss isn’t looking.

Is high tech AAC worth the money?

The question is, is it worth spending money on technology or would a laminated communication board work just as well? As with a lot of aspects of therapy it really does depend on how it’s used, not just by the child but also by the adults in their life too. Think of it this way, a baby typically takes around a year before he or she says anything and this is after hearing thousands and thousands of words spoken around them. So if we introduce a different way of communicating to a child, we can’t expect them to instinctively know how to use it and start using it competently straight away. In the same way we would take time to learn a new language and make most progress if we spent lots of time with people speaking the language we’re trying to learn, children learn to use AAC best when the people around them use AAC too. So is it worth spending money on AAC, well yes if your child can use or access the technology (for example, if your child has difficulty controlling their fine motor movements touching a small button on an iPad screen might rule that out as the best AAC option for them) and you and the other people in your child’s life are prepared to put work into using the AAC with them.

Using a laminated communication board or book can be a great place to start with using AAC as there is little cost involved, no complicated technology to programme or get your head around and you can experiment in limited situations that suit you and your child. You might choose to have a choice board on the snack cupboard with pictures of all of the available snacks on so that your child can ask for what they want by pointing to the picture. You could choose to have a core board (a board with picture symbols for common words such as more, again, stop) with you when you’re playing together and point to the again picture when your child wants you to do something again. Or you could even put together some photos of the different places and people your child sees during a typical week and have a visual timeline on their wall so you can talk about what’s happened and what’s going to happen in the week.

You know your child best and you might have read that last paragraph thinking, well that’s all well and good but my child wants to talk about more than just snacks or I know they have way

more to say than asking me to do something again. This is where a communication app or device really comes into its own. Dedicated communication apps such as TD Snap, Proloquo2go, Grid or Weave Chat have thousands of words already saved into them meaning that there is a multitude of things that can be communicated using them. We can never truly know what a child can and wants to communicate unless they have a way of letting us know and giving them access to lots of different words can unlock language we didn’t know they had. But, they are not a magic wand, children need consistent support to learn how to use a device and adults around them that are engaged and respond to what they communicate using the device. Devices also need to be maintained and updated so that the language in them reflects what the child wants and needs to be able to communicate. After all, how children talk and what children talk about changes as they age and new phrases come and go with the latest viral video (although I’m not sure how many parents would thank me for programming 6-7 onto their child’s communication app).

AAC and Speech Development

Parents often raise concerns that giving their child AAC will stop them from speaking or ever learning to speak. That’s understandable given we know that prolonged, unsupervised screen time can negatively affect children’s language development however, there is actually no evidence that AAC stops speech development. There is however lots of evidence that AAC supports speech development and also reduces frustration. By using AAC we naturally slow down and emphasise the key words or ideas we’re trying to communicate. This, alongside seeing a picture or symbol really supports children to understand and also use language themselves. So, if your child is struggling to make themselves understood it is definitely worth giving AAC a try.

Getting started with AAC

Start small and keep it simple

You might want to try printing off some photos or pictures of your child’s favourite things and

encourage them to show you want they want by pointing to the picture. The ACE Centre has lots of free printable symbol charts available for you to download www.acecentre.org.uk that you can use alongside everyday activities. If you’re interested in trying an app Weave Chat is free and available on Apple, Android and Amazon and is a good way of exploring what a communication app can offer.

Model AAC – this is the most important step
Remember children learn to use AAC in the same way they learn speech: by seeing and hearing it used. Use the AAC while you talk by pointing to symbols, pictures, or words as you speak. For example, say “You want more?” while pointing to more, or “Let’s go outside” while pointing to go.

You don’t need to expect your child to use it back straight away and remember to respond as if they’re deliberately communicating with the AAC even if you think it might just be chance that they’ve pointed or pressed something. Think of your role as a guide not an examiner.

Use AAC during everyday routines
Daily routines are the best opportunities for communication. At mealtimes, point to words like hungry, more, drink, or finished. During play, use go, stop or your turn. At bath or bedtime, wash, help, finished, or sleep. You can also use AAC to talk about your feelings (e.g. I’m tired after all that football) and also how your child might be feeling (e.g. you’re smiling, I think you’re happy) . Try to use AAC consistently each day for routine activities, that gives your child the best opportunity to learn how AAC can be used.

Success stories from practice

As a Speech and Language Therapist, some of my most memorable moments have come from seeing the difference AAC has made to children I have worked with.

Recently I worked with a little boy called Charlie (not his real name). Right from the start it was obvious that he had lots to say, even though spoken language was difficult for him at the time. I

introduced a simple core communication board alongside a communication book. By pointing to symbols, he was able to clearly communicate his likes and dislikes and confidently use core words such as more to get his needs and wants met. Having a reliable, visual way to express himself allowed his personality to shine through.

When I first started working with Amelia (not her real name), it was quite a different story. Amelia had developed some spoken language but lacked the confidence use it in school. Alongside her teachers we introduced AAC through play charts during motivating play activities such as bubbles and playdough. As her confidence grew, so did her communication. It started off with Amelia pointing to ‘more’ to request more of her favourite bubbles and playdough. Through regular and consistent use of AAC, Amelia began using longer sentences and her spoken language has now developed significantly. Over time, she no longer needed AAC to express her needs – it had supported her communication and confidence at the time she needed it most.

AAC is valuable and an amazing form of communication. If you would like support using AAC for your child contact us as SpeechWise Therapy. We are always happy to help. Together, we can help your child communicate in a way that is best for them.

Written by Khadijah and Gail