How to model AAC with our minimally speaking students?
How should we start? Should we use prompts? What kind of prompts? hand-over-hand or just pointing? Should we wait, and, if so, how long? Introducing an alternative communication system (AAC) to our child is for many of us a confusing and sometimes scary prospect, but it needn’t be! Let me reassure you and share some tricks of my practice in this area.
Once we have decided to try for a picture based communication system, I usually start with a paper-based single page with between 48–88 core-words. I choose the number of words depending on where the child is developmentally and also verbally.
If a child does have a small handful of words already, I might start with the 88-cell board below. If, on the other hand, my student is completely non-speaking and still quite little then I might go for the 48-cell below here or I might have even less cells to start with. Again, sometimes I start with an electronic device in my clinic just to trial and introduce the idea and to see if, or how, a student responds.
Below are some samples: a 49-cell board which I made for a child in a nursery setting
Below a Saltillo WordPower board that can be downloaded from the Saltillo website:
Example of a slightly more advanced board, again from the Saltillo Website
And here below one example of a board I made for a specific activity for a child who loves water and sand play:
It is perfectly possible to be very flexible and create a suitable board for any student, starting with as few as 2–5 cells and working up to over a 100 (very small ones) on a sheet of A4 or A3 paper.
So once we have a good board for our child, what now? How do we start introducing this into our daily life?
We can start by showing/pointing to the word GO within a play activity. For example:
- a car run,
- or a marble run,
- or a spinner activity,
- a wind-up toy,
- anything that can be stopped and started easily.
How to start?
I will talk us through each of the steps using the example for the word ‘GO’.
First phase
The first phase is a TEACHING/ LEARNING PHASE. In this phase we do not expect our student to do anything, to copy us or to point to the board. If they do that it is of course a huge bonus and we will celebrate it.
Our job is to simply MODEL/SHOW/GIVE EXAMPLES of how we can use the board, by steadily and regularly pointing to the chosen word or words. We do so across the day and across settings:
- play
- meal time
- getting dressed/undressed
- bath time
- going to the car/shops
- etc
Once we can be sure that our student has been submerged and SOAKED in seeing the coreboard being used, say after some 3–4 weeks of using it consistently…
Second phase
We can begin to move into the second phase which is the PRACTICE PHASE. By now the student has seen the boards and he or she has seen the word GO (as a example) modelled many times.
Now we can start to see if we can tempt our student into trying this out for themselves.
What sort of TEMPTING are we talking about? Take a look at the Prompt Hierarchy below, which shows us what to do to get our student to be independently communicating as soon as possible.
The PROMPT HIERARCHY: what sort of prompting should we do, should we expect something from our student or how should we view this stage?
- TEMPT AND PAUSE
I have the AAC near to the toy and each time the child starts another round of the activity I say clearly ‘GO’ and I point to the picture as do so. I then pause and wait to see what happens. NOTHING? Then…
- USE SIGNS AND BODY LANGUAGE
Next time the child starts another round I might be very animated and do a Makaton sign for GO as I say ‘GO’ and I make a very over point to the picture again. Then I wait. STILL NOTHING? OK then…
- OPEN-ENDED QUESTION
Now I might say ‘GO’ and follow with: ‘OOH I WONDER IF THERE IS A PICTURE TO POINT TO…’
‘OH LOOK HERE IS GO!’ I then point to GO.
STILL NO RESPONSE?
- ASK FOR A RESPONSE
I might say ‘GO’ followed by ‘LOOK! LET’S POINT TO GO HERE ON THE PICTURE.’
STILL NO RESPONSE?
- PHYSICAL TOUCH
Next time I say ‘GO’ I will try and take the student’s hand, help isolate their finger and help him or her to point to the actual picture.
REMEMBER: Prompting serves a very important function in scaffolding learning for students BUT if we are constantly prompting kids, then we are teaching them to only communicate when someone tells them to. We want our student to become as independent in speaking and using words as possible.
So once I have done Physical Prompting I will try and phase back down to number 1 where all I need to do is point to the picture or look at the board with the aim that the student will then point to the picture.
Take away points:
- Keep the learning phase pressure-free and model without expecting our student to jump in. In other words, let’s model first without expectation. Later we can have a little bit of expectation.
- After they’ve been exposed to and have been ‘soaked’ in plenty of AAC input, then, YES, we can create an opportunity to help them say or point to the word on their own.
- We can model BOTH with and without expectation.
- Only after LOTS of exposure, use the least to most prompting hierarchy and start creating opportunities for a student to become an independent communicator.
Do get in touch if you have any questions or comments or if you would like some practical help.
I am always pleased to hear from you.
Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.
