Interestingly enough, the answer to this question is the same as it would be for any child with a language delay or disorder. We don’t really need to do a lot very differently for students who use augmentative communication, except to add picture communication models to our speech (otherwise known as Aided Language Stimulation, about which I've posted before).
Turn-taking is the basis for communication engagement. One person does something, the other person does something to respond or follow. This is how conversations are built.
So how to start building the foundation of turn-taking long before our kids are ready to engage in conversational interactions? Take turns. Start by doing the same thing as the child. Scaffold a response from them, then you repeat the pattern. Say a message and make an action for your turn.
Continue to model messages and actions and you go back and forth. Resist the urge to say “Your turn” and “My turn;” rather make your message match the action. Wait a reasonable time for your child to take a turn, but then prompt or scaffold as necessary to make it happen.
If you can, keep the back and forth going for at least 3 turns. If the child isn’t actively participating, then stop, but otherwise try to keep it going through modeling and prompting. You can end the interaction by saying, “All done.”
Waiting is a good cue all by itself. It helps to decrease the child’s dependence on other prompting. Use your body language and facial expressions to indicate you are waiting for the child to do something. Look “expectant.” After a few seconds, point to the activity or item. If necessary, help him to take his turn, but without speaking.
Waiting also serves to foster initiation rather than responding. When we stop filling in all the quiet spaces, we allow time for the child to make a message. And when we stop asking questions, we stop creating interactions where the only thing for him to do is to respond.
Match your child’s communication. Do what he does, say what he says. Then you can add just a little bit more. In this way the child sees messages at a level with which he is comfortable, and then at the next level he can try. If your child isn’t interacting - for example if he’s only banging or throwing a toy - try showing him one thing he can do with that toy. Then add one word or picture to go with it. Adding a message to the action begins to build communication.
Gradually, you can begin to add two word or picture phrases. Don’t ask that the child do anything at this point, just continue to match his actions and model simple messages.
Gradually, you can begin to add two word or picture phrases. Don’t ask that the child do anything at this point, just continue to match his actions and model simple messages.
By putting the focus on actions rather than labels we introduce more meaning into the interaction. A label isn’t necessarily communicative. It doesn’t indicate what the message is, unless the message is simply, “This is a ___.” That is rarely what the child really wants to say.
Try making a comment. This is a model of something he can say, and precludes simply responding to a question.
Remember, too, to carefully attach meaning to what you are saying to the child. Make the words you use have a meaning that is clear to the child and to the context. Many of the teachers and parents I know want to teach the child to say “Please” and “Thanks you” and often use terms like “Good job” or “Good boy” or even “That’s good.” These words don’t have meaning attached to them, and may even cause the child to attach the wrong meaning. Be specific about the words you use and make sure they are meaningful.
Engineering the environment provides multiple opportunities for communicating that might not ordinarily arise. Changing the environment to change the need to communicate increases the opportunities for the child to learn to use his messages.
One of the easiest ways to do this is to make it more difficult for the child to access the desired items and activities. Be careful not to do this so much that you frustrate him. Just enough to provide increased opportunities for him to need to communicate to get what he wants.
One of the easiest ways to do this is to make it more difficult for the child to access the desired items and activities. Be careful not to do this so much that you frustrate him. Just enough to provide increased opportunities for him to need to communicate to get what he wants.
One part of engineering the environment can be to create scripts to use in an activity beforehand. Think about the activity and the items and actions involved. Make sure you know where the words are located in the aac system. Create an activity based page if it is appropriate and is a repeating activity. For example, I play a lot with bubbles as that is often a preferred activity for kids with whom I work. So, on my toys page, where I have my bubbles button, the bubbles button links to a bubbles activity page. There I have the pronouns involved (you, I, it), the actions (blow, catch, pop, wipe), more and again and all done. I also have descriptive words like high and low, big and little to direct and describe. Now you have a plan and the tools needed for interacting in a given activity.
In addition, the most important thing we can do for our aac users is to be the model communication partner. Using the/an aac system to communicate TO the child when you are talking to him will provide the best models of how someone uses aac effectively, of how to find needed vocabulary in the aac system, and of what kinds of word to use for what purposes. I’ve spoken before about Aided Language Stimulation - also called Partner Aided Input. But I think it cannot be said enough.
What else can you do? Try parallel talk and self talk. Describe what is going on right now. What are you doing? What do you think about it? What is the child doing? Comment on it. Break down the messages. Provide a message and then repeat the keywords only. This is called breaking down the message. Building up the message is done by providing keywords, then repeating the message with more elements to clarify the meaning. For example, “Snack time. It’s time to have a snack.” Provide input at the child’s level, but also at a step above. And remember, provide this input verbally, but also on the aac system.
Also try looking carefully at what the child is doing. Often communication attempts are missed because we are not paying careful attention to what the child is doing. Be sure to respond to those attempts, and, if necessary, ascribe meaning to them.
Have a safe and happy New Year.
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