Everyone should be able to say whatever they want to say, but it's more profound than that.
• It's about choosing your own words and deciding when you will use them or not. It's about choosing how you will communicate.
• It's about the opportunity to feel seen and heard.
• It's about expressing your unique personality.
• It means being able to build relationships where your voice is equally valued.
The decisions we make can impact the probability that our learners will experience autonomous communication. The goal of communication autonomy should be our guide. As you balance options along your AAC journey, consider how choices and decisions will impact communication autonomy in the long term.
What is meant by autonomous communication?
The person who uses AAC:
• has few restrictions on what they can say
• is responsible for their language production
• can express himself/herself by communicative intentions
Communication autonomy refers to where messages begin.
• Communication autonomy is not the same as making choices.
• Autonomous communication is not necessarily advanced or complicated language.
Communicative autonomy is not dependent on the individual's ability to individually operate their AAC system but refers to where messages originate. For example, a person who relies on a partner to turn pages in their communication book can support communication autonomy by using strategies to direct their partner to the pages they need to express their own messages.
• Autonomous communication is not necessarily independent
• Independent communication is not necessarily autonomous
• No symbolic, expressive language
• No prior experience with AAC
• Communicative intent may be developing
• Requires the support of a close partner
• Limited communicative reliability
• Exploring access
Primary Goal: teach symbolic communication
Before prompts and cues, the AAC user also needs these:
• modeling without expectation
• engaging contexts
• relationship and connection through any communication modality
• response to any AAC use as meaningful
• natural and informative feedback
You might think that an "emerging communicator" is an individual who is just getting started with AAC. That is close, but I want to make an important distinction between different beginners.
Example: the exceptional "beginner" with AAC.
These are the "beginners," but they can communicate as soon as they are given the means. The more common "beginner" is someone who can communicate very little, for example, a young child with severe motor impairments. These children rely entirely on non-symbolic communication methods, such as pointing, gestures, facial expressions, body language, and intonation. They may be learning alternative communication, but the results are changeable so far.
Forget about highly structured, repetitive practice. The most significant learning for emergent AAC users will happen when you least expect it. Model AAC in everyday life and enjoy your time together. Trust the process and stay the path. There will come a time when the AAC user will surprise you with something to say. It won't be anything you expected.
Your response to these moments can teach them a lot. Give them feedback about what they did or could do to make their message clear. It may sound silly, but don't forget to respond to what they said! Your teaching in these moments is often the most effective because you're talking about something important to your learner. We know it's important because they started the conversation!
Emergent AAC goal writing
You may wonder what to target and how to write goals for emergent communicators. Autonomous communication needs to be at the center of our teaching, so our goals need to show that. Goals must emphasize what the AAC user wants to say and whenever they want to say it.
Skills to consider:
-Establishing an access strategy for AAC
-Attention to aided language input within natural contexts
-Expression of an increased number of early developing communication functions (requesting, protesting, commenting, directing)
-Initiation of AAC to communicate regardless of what they say
-Contributing to a co-authored message within natural contexts
-Establishing a means of initiation if they are not able to access it independently
-Establishing head nods for partner-assisted scanning
• Given verbal referencing and wait time, the AAC user will demonstrate the use of intelligible head nods for yes/no to select for partner-assisted scanning with an increased number of partners.
• Given ongoing aided language input within natural contexts across the day and targeted modeling of complaints, the user will contribute at least one word to co-author a complaint, expressed to a teacher or peer.
The way you talk to the AAC user matters
Listen to yourself when you speak to your AAC user.
The way you shouldn't talk to the AAC user:
• "Good talking."
• "That's using your device."
• "If you want it, tell me in a sentence."
• "Oh, you're just playing with that device."
• "Tell me with your talker."
If you were in their shoes, would you like to be talked to this way?
The way you should talk to the AAC user:
(the capitalized words are modeled on the AAC device)
• "GREAT idea!"
• "I don't understand. Adding a word might help."
• "You said, "tired me". It sounds like you're saying, I FEEL TIRED. Ugh, me too! Let's take a break."
• "I heard you say "when lunch". Good question! Hey, mom! WHEN IS LUNCH?"
• "You said "WANT TV". Got it! You WANT WATCH TV."
These are some helpful ways to respond respectfully to the AAC user.
Building relationships and connection
Building meaningful relationships is one of the most important things a person can do in their lifetime. It also is one of the most challenging things a person can do.
Communication is necessary to build relationships, so a person with a communication disability has difficulty building relationships.
Here are some tips for building that relationship with your AAC user:
-Don't put pressure on them.
-Talk to your user as you would anyone else their age.
-Interact with them like they are someone with something to say and contribute.
-Get curious about their interests. What do they like? What seems to get/keep their attention? Enjoy those things together.
-Establish a real context to communicate about. AAC is the conversation around an activity, not the activity itself.
-Respect and respond to all models of communication.
-Give them time to get comfortable and communicate.
-Demonstrate that you value their AAC system by using it to talk to them. Always get consent when using their device.
-Don't expect instant rapport. Building a strong relationship requires trust. You show you are someone they can trust over time.
How you respond is so important
Modeling is the first go-to in teaching AAC, but how we respond to an AAC user can also be a great teaching tool. Responses like "good talking", "good job telling me with your talker" or "that's telling me with your device" are doubtful for a whole lot of reasons. We want to respond to what our users say with their AAC.
You can say instead:
• "You added a word. That helped me understand what you were trying to say better."
• "You said (message). Now I understand that you (what they communicated)."
• "You looked at me when you played your message, so I knew you were talking to me."
Sometimes our help may not be helpful
Consider the supports you are providing. Are they genuinely helping your AAC user grow into a competent, autonomous communicator? Think about this more.
You're not helpful when you:
-hide or protect your user from the realities of their communication differences because they need to know what they have to do to be better
-prompt or cue for specific language because you don't know what they want to say
-regularly speak messages for your AAC user because they remain dependent on you
-regularly interpret or clarify messages that, without your help, would be completely unclear
-try to finish or predict your AAC user's messages because you don't know what they want to say
Here are some of the things SLPs do that can discourage AAC use:
① A focus on assessment rather than instruction may not be what the learner needs. Too much quizzing and the learner will give up. "Joey, show me ___." "Where's the ___?" "Can you find ___?" "Point to ___."
② Responding too quickly can impair both learning and independence. Our AAC users need a lot of pause time to process the language they hear, then organize and execute their responses. When we jump in to repeat, rephrase, or prompt, we may be stepping in the path of their learning and independence.
③ Failing to understand what the communicator wants to talk about is the most certain way we know to discourage AAC use. We may want the learner to make choices or comment or ask a question. But suppose the communicator really wants to connect by telling stories, for example. In that case, we'd try to provide some visual scene displays or other message layouts to allow them to talk about things going on in their past/present lives.
Your attitude matters
What to do for the AAC user to feel good and use their AAC system? That starts with us.
• Show them all it can do
• Use it yourself
• Focus on connection and shared enjoyment
• Celebrate the successes, no matter how small
Show the AAC user how unique AAC can be. Use it yourself to talk to them. Focus on connecting with them and enjoying your time together.
Can AAC feel overwhelming at the start? Yes, totally. Start small and build from there. Celebrate all successes, no matter how small they seem. Do your best to speak positively about your user's communication and AAC even when those challenges appear. They are listening, so keep going!
The AAC superpowers
All of us can cultivate these superpowers. We just have to do some things:
• Believe in yourself and your learner. You both have so much potential!
• Believe that it's possible.
• Have patience. Someday you'll look back and be surprised how far you've come.
• Have the willingness to listen and learn. Listen to those who have walked this road before you and listen to your AAC user more importantly.
AAC gives us the power to:
-Practice communication partner skills.
-Create communication opportunities.
-Implement words in social and instructional contexts.
-Create, implement, and share great resources.