Written by Amanda Franklin
Augmentative and Alternative communication (AAC) includes all forms of communication (other than oral speech) that are used to express thoughts, needs, wants, and ideas. AAC goes hand in hand with assistive technology (AT). I visited the Pennsylvania School for the Deaf (PSD) to meet with one of their speech language pathologists on what AT they used for communication needs. It was extremely fascinating to learn about the different types of technology, how they get access to the technology, and what strategies and resources they use to help students who need assistance in accessing communication. Deafness is not equitable to signing as some students are not able to establish formal language, may be echolalic, or may have a disability that makes using sign language difficult or not a physically plausible option.
In the classroom, they use a handful of different AT devices and methods. Naturally, sign language is used as much as possible, because it is the students’ predominant language. To facilitate communication for students who struggle with additional disabilities, assistive technology is used to allow them to communicate and participate with their peers and others. It is important to note that AT and AAC is not used as a replacement but is used to augment communication and support the student in the event of a communication break down.
Low-tech Versus High-tech
At PSD, they use both low-tech and high-tech solutions. At PSD, they use picture exchange books, apps on iPads for text to speech, NOVA chat, Proloquo2Go, Accent 1000, Minspeak, and picture cards. The technology most frequently used is the iPad and NOVA chat. NOVA chat was a personal favorite of the speech language pathologist I spoke with as she preferred the predictive quality that it has from the input given by the user. She also prefers devices or products that are connected to a larger company, such as Setillo, Prentke Romich Company, or DynaVox because you can contact them for support or assistance, whereas applications usually do not have that.
I asked if low-tech or high-tech solutions are more commonly used. She said that low-tech AT can be extremely limiting. For students who need to communicate anything more than simple statements, higher-tech solutions are required. However, low-tech can be good for teaching specific concepts or for specific activities, such as guided reading.
Getting access to the technology that she needs for her students can be a struggle. Most of it is often covered by insurance. Lending libraries can be helpful, but the waiting list can often be too long to be worth the wait. Getting in contact with a representative in the area can be your best bet of obtaining the technology that is needed. PATAN’s lending library and PIATT, from Temple University, is how they can obtain some of the technology they need, but by getting devices through insurance, they can be more easily reset or replaced and the student can keep them when they move on from the school into adulthood.
Many SLPs will work in tandem with occupational therapists or physical therapists to build ways to make AT as accessible as possible. For some students, hearing aids can sometimes give the ability to hear at certain frequencies. This can sometimes assist a speech language pathologist. Knowing what a child can and cannot hear according to the “speech banana” (shown below) can inform the SLP what the student may hear or what feedback they might get from a device. The depression or feedback from pressing buttons can also help the student to know whether or not information is conveyed upon touching a screen.
Evaluation and Assessment
Dynamic assessment and scaffolding are the base of evaluation and assessment for an SLP. Specially designed instruction (SDI) is used along the way. She said that checklists are often used, including developmental checklists for social, emotional, and expressive data. When evaluating the use of an AT device, they trial 3 different devices and must provide data and information for why or why not the devices work for the child and whether they meet with the strengths and needs of the student.
In the process of obtaining devices for students it is often important to stress the means in which the devices could be required for medical needs. As SLPs and others who apply to obtain AT for their students/children, it helps to communicate health issues or the need to communicate medical needs. Insurance companies often see value in this over educational value, so conveying needs of the child to communicate medical information is important to recognize in these situations.
Self-Education and Resources
Lauren Enders created an AAC Boot Camp information diagram with content by Lauren Enders, Pat Mervine, Melissa Skocypec, and Cathie VanAlstine (shown below). It is available to print here. It is a great reference for any person who works with someone who uses an AAC device.
Conferences for SLPs are extremely informative as they display the newest technologies and methods for assisting students with communication needs. Prentke Romich Company has a free 3 day training confrence. In Pittsburgh, htere is an AAC Language Seminar Series by the creator of Minspeak, Bruce Baker. ATIA and PATTAN have helpful resources. These resources can be found here. She said Pinterest can also be a very helpful resource for SLPs and parents. She also rattled off some names of some people who are informative or important in the realm of AT and speech language pathology including: Lauren Enders, Gail VanTatenhove, Debbie McBride, and Tracy Kovach.
Overall, there are many resources that can be found locally and online. Speaking with a local speech language pathologist can help you find the resources you need and better understand what resources are needed and available.