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Sunday, July 21, 2019

Please! Don’t Believe That!

Once upon a time, Romski and Sevcik wrote an article about the myths of AAC . They wrote that “Despite the advances, the inclusion of AAC services and supports into early intervention service delivery for young children has been hampered primarily by myths about the specific types of roles AAC plays.”

That was more than a decade ago and the myths of AAC are still running rampant through our practice.  Here we are, years later, and many of these myths are still found throughout our service delivery - or lack of it.

So, I think dispelling those myths bears repeating.

Romski and Sevcik listed 6 myths of AAC:

1. AAC is a “last resort” in language intervention and shouldn’t be used until all hope of being verbal has been given up.  Research has shown that it is actually important to introduce AAC before the child fails so that he has a communication mode before frustration sets in.

2. AAC hinders or stops further speech development. Research again has shown that use of AAC can actually help children develop speech.  
Many children with significant communication needs do have some words they use.  However, if speech is not functional to meet all communication needs, if there is not sufficient vocabulary, if the child is not understood by all partners, if the child only repeats what he has heard - then he needs AAC intervention.

3. Children must have a certain set of skills to be able to benefit from AAC. While the exact relationship between cognition and language is unknown, we do know that many children cannot demonstrate their abilities without a way to communicate.

4. Speech Generating Devices are only for children whose cognition is intact. 
Advances in technology mean that advanced cognitive skills are not necessarily needed to use high tech systems and, as a wide range of options are available, there are many tools that children can bee taught to use effectively

5. Children have to be a certain age to benefit from AAC. Again, research shows that providing children a mode of communication early is beneficial and will not hinder speech development.  
AAC has been cited as an evidence based strategy for facilitating speech in young nonverbal children.
Waiting too long to provide AAC intervention in the belief that the child is too young denies the child the opportunity to learn language, acquire vocabulary, and express himself appropriately.  Research shows that intervention provided after 3 years has a less significant impact.

6. There is a representational hierarchy of symbols from objects to written words. Romski and Sevcik site the research that shows that children do not actually learn less abstract symbols better or faster. To the child, all symbols work the same way. We just need to teach them consistently.
Requiring the child to use multiple systems as they work their way through some artificial hierarchy only makes learning to communicate harder.  Having different displays, different arrays, and constantly moving vocabulary targets is discouraging to some children and takes the emphasis off of communicating and puts focus on the system - which is not where it belongs.

In fact, according to ASHA (the American Speech-[Language]-Hearing Association), all individuals are considered potential candidates for AAC.   ASHA and the Joint Commission for Persons with Disabilities have a “zero exclusion” criterion and consider not whether an individual is eligible for services, but rather consider where along the continuum they are currently operating as a starting point .  As long as there is a discrepancy between needs and abilities, an individual qualifies for services in AAC. 

Voice output is closer to the back and forth of the natural language learning process, it provides auditory feedback while the child is learning symbol meaning, and allows the child the opportunity to “play” with his voice, the way that typical children do.  The high tech system also provides better opportunities in most cases for scaffolding and modeling.  Only a ‘smart partner’ assisting in scanning or a good provider of aided language stimulation provides more feedback and models.

One more misconception is that teaching the student to identify and discriminate the pictures is all that is needed by way of teaching students to use them.  Too often, students are given this skill training, provided with a communication system, then deemed to have “failed” because they don’t use it effectively.  We must remember that we are EDUCATORS.  We need to provide appropriate intervention; including operational, linguistic, social, and strategic use.  We need to teach these kids to communicate with this mode - one that they have no prior experience with.

For a brief handout explaining these myths, click here to download.

Get ready for the new school year with confidence. 
And, keep on talking!

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