Speaking is how we as adults communicate with those around us.  It allows us to interact with other people and influence the world around us to get our needs met.  But for many children with autism, speech is not an option.  These children, often labeled as “non-verbal” may have plenty that they want to communicate with us, but they are unable to speak the words.  However, every child has the right to communicate and the fact that these children cannot speak should not take that right away from them.

For these children with autism, there is another option.  The term Alternative and Augmentative Communication (AAC) describes any means of communication, aside from traditional speech, that allows someone to use language.  This can include using pictures, gestures, sign language, visual aids, or speech-output devices like computers.  This article will show you exactly how to try some of these techniques to help a child with autism learn to communicate and possibly even to speak.

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What Does The Research Say about AAC and Autism?

On this page from the American Speech-Language Hearing Association, you will find the summaries of numerous studies conducted about Autism and AAC.  Many of these are reviews of several different research studies.

http://ncepmaps.org/autism/tx/speech/aac/general-findings/

Through all of this research, one theme emerges:

The use of AAC for children with autism does not prevent a child from speaking.  In fact, these studies reported that AAC may actually increase speech instead.

This is not to say that AAC will definitely help a child learn to speak, but many children in these studies and across the world have found benefits from using AAC and no studies have found any ill effects.  With no risks and possible improvements (in terms of speech production), it’s definitely worth a try!

On top of that, AAC allows a non-verbal child the ability to communicate a message to the listener even if he is not able to speak it.  Imagine if your child with autism was able to push a button to tell you what he needed instead of crying and throwing a fit on the floor.  So what if he wasn’t able to tell that to you with spoken words.  He was able to get a message to you and you were able to help him.  That can go such a long way in building trust between a non-verbal child and the adults in his world.


How to Know if a Child is Ready for AAC

Many people believe that a child needs to have a certain level of skills already in place before they should be allowed to try AAC.  This is simply not true.  Children can learn the needed skills for AAC (such as being able to push a button) while they are already using it to communicate.  If the child is able to see the benefits of learning these skills (they get to communicate), they are going to be more motivated to work hard to master them.  For more information on the myth of pre-requisites for AAC, check out this article:

http://www.speechandlanguagekids.com/what-are-the-prerequisites-for-using-an-aac-device-augmentativealternative-communication/


Free or Inexpensive AAC for Children with Autism

There are many different types of AAC available for children to use and you don’t have to be rich to try.  Here are some options if money is tight or if you’re not sure you want to invest a whole lot of money before you know if it will work:

  • Sign Language: Use signs from the American Sign Language along with spoken speech.  This adds a visual component to language and since children with autism are often visual learners, this makes language easier to comprehend.
  • Pictures: Print off pictures of common objects and actions in your child’s life.  I typically make little cards about 2 inches wide and 2 inches tall.  These can be used along with spoken speech as well to add a visual component.
  • Visual Boards: Make a sturdy board about the size of a lunch tray.  You can make this out of construction paper or poster board.  Then, glue pictures to it that represent the things the child may want to communicate.  The child can then point to the picture of what he wants.

Paid AAC Options for Children with Autism

More sophisticated AAC can be purchased for a price.  While these options may have more features, they also cost more money so they may be better for speech-language pathologists working with many non-verbal autistic children or for parents of children who already know that AAC will work for their child.

  • Picture Exchange Communication System (PECS): This is a specific program where the child exchanges a picture of what he wants for the real thing.  It is a very prescribed program and in order to do this, you must go through special training, purchase special materials, and have another trained adult to do the therapy with you.  Great for SLPs, maybe not as good for parents.
  • Low-Tech Communication Devices: There are many different devices on the market that will allow for a simple layout where the child pushes a picture of what he wants and the device speaks the word out loud for him.  These range from a single button that says only one message to  a board with several buttons, each with a different message.  Here is a page full of low-tech options from Mayer Johnson:

http://www.mayer-johnson.com/category/assistive-technology/aac-low-tech

  • High-Tech Communication Devices: The more sophisticated communication devices are similar to tablet computers with touch-screens.  The child can navigate through pages of icons that represent different things and will communicate different messages when pushed.  These range from very easy to use for the child (one button on the screen) up through very complex. Be warned, these can cost upwards of thousands of dollars!  This is an example of a high-tech AAC device:

https://saltillo.com/products/nova-chat-7

  • Tablet or Smart Phone AAC Apps:  Many of the companies that produce the high-tech AAC devices have released their software on the app stores so that you can download their AAC app on your own device and turn it into an AAC machine.  These apps typically cost hundreds of dollars instead of thousands like their dedicated counterparts.  Many of them also have free trials so you can try before you buy.  Here’s a review of some of the best AAC apps currently available:

http://www.speechandlanguagekids.com/aac-apps-review/


How to Implement AAC with Children with Autism

Ok, so let’s say you’ve chosen an AAC system for a child with autism.  Now what?  Here are some easy steps you can follow to introduce AAC to the child:

1. Show the Child How to Use the AAC

The first thing you must do is model how the AAC is used.  The best way to do this is to use the AAC system when you are communicating to the child.  For example, if you chose sign, start using sign language when you speak with the child.  For more information about using sign language with a child, click this link:

http://www.speechandlanguagekids.com/using-sign-language/

Or, if you chose to use pictures, show the child pictures of the things you are talking about.  For example, if you are offering your child two foods for snack, show your child a picture of each of those two foods and then show him the picture of the one he ended up choosing.  Every time your child asks for more, you can hold up the picture and say the name of the food again.

If you are using PECS, you will find there is a very specific manner in which you are required to introduce the symbols.

 

2. Offer the AAC to the Child

Once you have shown the child how it works, try giving your child access to the same AAC that you are using.  If you’re using pictures, lay the pictures out in front of the child to see if he will point at one or reach for it.  If you’re using a device, leave the device lying around so the child can explore it on his own and possibly use it as well.  If you’re using sign language, he already has access to his hands, so you can skip this step.

3. Help the Child Use the AAC

Make sure you’ve shown the child how to use the AAC many, many times before you try this.  You may want to wait a few weeks before you move on to this one.  When the child wants something, take the child’s hands to help him use the AAC to request it.  For example, you can move his hands to make the sign language sign, move his hand to pick up the picture, or move his hand to push the button.  As soon as you do this, reward the child as if he had said the word.  Hand him whatever he wants and repeat the word back to him (example, “Cookie!  You want a cookie, here you go.  Cookie!”).  Judge the child’s frustration to see if you should keep doing this.  If the child is very resistant, you will want to start off with only doing this every once in a while.  If the child is ok with it, you can do it more frequently.

4. Fade the Prompting

After you’ve helped the child use the AAC for a while, try backing off on the amount of help you’re giving him.  Try pausing for a moment to see if he’ll do it on his own.  If not, prompt him part of the way but don’t do it all for him.  Just try to fade back the amount of prompting that you have to give the child so he becomes more and more independent.

5. Teach New Words

Once the child has mastered a word using the AAC, go back and try teaching new words.  Go back to step one and show the child the new word over and over again before moving on.


More Information on Getting Started with AAC:

For more information about how to introduce AAC to a child, click one of the guides below:

Parents’ and Teachers’ Guide to Getting Started with AAC
Includes information about encouraging the child to use the device

Speech-Language Pathologists’ Guide to Teaching a New AAC Device:
Includes information about selecting devices, writing goals, and taking data to determine if the device is a good fit

 



More Information about Children with Autism:

Click Here to Learn More about Speech/Language Therapy for Children with Autism

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