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Sunday, March 8, 2020

All Aboard! Getting Everyone on Board with AAC

One of the biggest hurdles in AAC implementation is, sadly, getting all of the child’s communication partners on board with using and modeling and…….. well, just plain accepting the AAC system.
This can  be especially true for children who have some speech but are either unintelligible much of the time or who simply don’t have enough words to meet their communication needs.
I remember one child whose family I worked with over a period of a couple of years.  Initially, I recommended a high tech AAC device for this 9-year-old girl with  autism who had a few words, but not nearly enough to be a functional communicator.



The family were resistant to the idea of her carrying around a device and pointing to pictures to make it talk for her.  The school, too, took a “wait and see if she develops more speech” stance.  Unfortunately, we were talking about a child who was 9, then 10 years old.  Already she was miles behind her peers in terms of communication development.
Both  the family and school were, however, interested in how to adapt and modify materials and activities to meet her language development needs.  So we focused on that and I provided many of the same activities I would have for an AAC user.  Eventually, the family went off on their own, and I lost track of her.  In a way, I feel like I failed her, as I failed to get her communication partners to accept that the AAC device would, in the long run, have stimulated her verbal output  more than any of the other activities we were engaging her in.

On the other hand, I have my most favorite story, of a young man with autism who was completely nonverbal and was, at the time I met him, using a PECS board with about a dozen of his favorite reinforcers. This young man was seriously self-injurious and has done permanent neurological damage.

After the evaluation, while waiting for the ordered high tech device to make its way through the labyrinth of school district funding processes, I made him a PODD (Pragmatic Organized Dynamic Display) communication book.  
The teacher and his aide took one look at the 125-page book when I walked into the classroom with that deer-in-the-headlights look.  But they were game for anything to help this student.  They listened as I explained how the book worked, the navigation conventions unique to PODD, and the process of Aided Language stimulation.
Within just a couple of weeks, this young man was engaged with  the power the book gave him.  In one particularly stress-inducing situation, rather than engaging in the SIB that had harmed him, he stopped and grabbed and book, navigated from page to page to find all the words he needed, and constructed a perfect message that consisted of a string of single words that told a narrative.  His aide responded to the communication, he got what he needed, and everyone in the district got on board with PODD!

It’s not always that easy to get buy-in. In fact, it’s rarely that simple or fast.  But sometimes it is and those are the wins we’ll take any day.  The bottom line is that staff and family, just like the students themselves, need to see the power of alternative and augmentative communication.  They need to see the benefits in action.
I was recently told that I could not share that second story with a group of parents, because it would give them false hope, and they had been bitterly disappointed in the past with other “promises” and claims that, in the end, did not work for their severely involved children.  I was saddened by that attitude but understood completely.  Nobody is too disabled to be able to communicate.  We just need to find the way in.  
Don’t stop looking.  It can be done.  And the resulting power we give our students is worth it!




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