Using AAC during play with your child

ByLondon Speech and Feeding
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Playtime! It’s a magic time for exploration, learning, and connection.

If your child is struggling to use words with his/her mouth, we can always use a robust Augmentative and Alternative Communication (AAC) device to help find their words. We know that using such a device does never stop or delay children to speak with their mouths. On the contrary it helps, enormously!

Can playtime still be a blast? Absolutely! In fact, incorporating AAC into play can be a powerful way to boost communication skills, build confidence, and create a truly inclusive play experience. Here’s how to make it happen, with a focus on core words and core scripts for our GLP’s (the building blocks of communication used by everyone). In this video I am using the core word ‘IN’ and ‘MORE’.

The Magic of Core Words

Core words are the most frequently used words in everyday communication. They might be verbs like ‘want’, ‘more’, ‘go’, or ‘stop’, or adjectives like ‘happy’, ‘sad’, and ‘hot’. These words are the foundation for building sentences and expressing needs and desires. They’re perfect for children using AAC because they’re simple to understand and use.

Let’s Play! Here’s How

1. Choose Your AAC System

Many options exist! It could be a low-tech picture board with core words, such as the one you see pasted on my cabinet door in the background, or it can be a dedicated AAC app on your tablet. Here I am using the GRID app but I also love using others, such as LAMP Words for Life.

2. Make it Fun and Functional

No pressure! Integrate your AAC system seamlessly into your play routine. Here are some ideas:

  • Car/trains: Use core words to describe what the cars are doing: (‘down’, ‘go’, ‘stop’, ‘again’ ‘fast’ ‘slow’).
  • Dress-up: Use core words to choose clothes (‘want’, ‘hat’, ‘shoes’).
  • Tea Party: Use core words to ask for and share (‘more’, ‘juice’, ‘give’).
  • Building Blocks: Use core words to describe what you’re building (‘tall’, ‘big’, ‘house’).
  • Dolls/Stuffed Animals: Use core words to act out scenarios (‘sleep’, ‘eat’, ‘cry’).
  • Arts and Crafts: Use core words to describe colours (‘red’, ‘blue’), actions (‘draw’, ‘paint’), and feelings (‘happy’, ‘sad’).

If your child is a Gestalt Language Processor you will want to model meaningful, fun scripts instead of single words! As above, but use phrases:

  • Car/trains: Use scripts to describe what the cars are doing: (‘it’s going down’, ‘let’s go’, ‘make it stop’, ‘want it again’, ‘that was fast’, ‘it’s so slow’).
  • Dress-up: Use scripts to choose clothes (‘I’m gonna wear this’ ‘that’s a lovely hat’, ‘let’s choose shoes’).
  • Tea Party: Use scripts to ask for and share (‘I want more’, ‘more juice’, ‘give me this’).
  • Building Blocks: Use scripts to describe what you’re building (‘a tall one’, ‘that’s so big’, ‘it’s a house’).
  • Dolls/Stuffed Animals: Use scripts to act out scenarios (‘it’s time to sleep’, ‘let’s eat’, ‘he’s crying’).
  • Arts and Crafts: Use scripts to describe colours (‘a red crayon’), actions (‘let’s draw’, ‘I’m gonna paint’), and feelings (‘I’m happy’, ‘that’s so sad’).

3. Model, Model, Model

This is key! As you play, constantly model using your child’s AAC system.

  • Point to the picture or word or script you’re using.
  • Speak clearly and slowly while pointing.
  • When using core words for either Analytical or Gestalt Language Processors, try using good phrases. For example, instead of just saying ‘juice’, say, ‘you want more juice?’

4. Make it a Team Effort

Get everyone involved! Encourage siblings, grandparents, and caregivers to use the AAC system with your child during playtime. The more consistent the approach, the faster your child will learn and feel confident using their voice.

5. Celebrate Progress, Big and Small!

Every step counts! Acknowledge and celebrate your child’s efforts, whether it’s reaching for their AAC system or successfully using a core word. This positive reinforcement will keep them motivated.

Remember

  • Playtime should be fun, not stressful. Don’t force your child to use their AAC system. Let them lead the way and follow their interests.
  • Every child develops at their own pace. Celebrate your child’s unique communication journey.
  • Seek professional help when needed. Your SLT can provide tailored strategies and resources to support your child’s development.

By incorporating AAC and core words into playtime, you’re not just fostering communication; you’re creating a space for your child to thrive, explore, and build strong connections.

So, grab those toys, power up your AAC system, and get ready for a playtime adventure filled with fun, connection and, therefore, communication!

Don’t hesitate to contact me!

Sonja McGeachie

Early Intervention Speech and Language Therapist

Feeding and Dysphagia (Swallowing) Specialist The London Speech and Feeding Practice

The London Speech and Feeding Practice

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.

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    Parent Child Interaction Coaching

    This is an amazing way to help children with the following difficulties:

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    Speech Sound Disorders, Verbal Dyspraxia, Phonology and Articulation

    Speech Sound Disorders, Verbal Dyspraxia, Phonology and Articulation

    I love working with children of all ages on developing their speech sounds. Whether your child has a lisp, or a couple of tricky sounds they simply cannot produce quite right, or perhaps your child is really unintelligible because he/she is having lots of different sound errors, making it really hard to understand them. I typically work on getting “most bang for your buck” , meaning I address the sounds that cause the most problems and, therefore, when they are fixed your child/person’s speech becomes that much clearer fairly quickly.

    Feeding and Swallowing Difficulties

    Feeding and Swallowing Difficulties

    Having worked for over 20 years in NHS Child Development Clinics and Special Needs Schools I trained and worked with feeding and swallowing difficulties early on in my SLT career. I later trained as a Lactation Consultant and so I am well placed helping and support all types of Infant feeding, both breast or bottle, as well as toddler weaning. I aim to ensure that your little one swallows the right kind of foods and drinks for their abilities. I am experienced in managing and supporting children with physical needs and mobility problems, Cerebral Palsy, Down Syndrome or any other type of syndrome or presentation.

    What does a speech therapy session look like?

    All sessions differ slightly depending on the age of the child and the nature of the difficulties.

    However, mostly our sessions look like FUN! After arrival and washing hands we tend to start off with the tricky work straight away whilst our child still has energy and the will to engage. So, for speech work we will focus on the target sounds first: this could be sitting at a table doing work sheets together, playing games using the target sound and really any type of activity that gives us around 70-100 repeats of the target pattern. For example, a child who is working towards saying a ‘K’ at the end of the word I will try and get around 100 productions of words like: pack/sack/lick/ pick/bike/lake and so on.

    Then we often play a fun game where I might try for a ‘rhyming’ activity or other sound awareness type activities, for perhaps 10 minutes and within that time I aim to trial the next sound pattern we need to improve on; I will test which sound your child can do with help from me. During he last 10 minutes we might look at a book, again listening to and producing whatever sound we are working on. If I did not get 100 sounds earlier on in the session I will try and practice them now as part of the story. In total I aim to have about 40-45 minutes of activities, all aimed at the target sound we are working on.

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    During a Parent Coaching Session we meet online for about an hour and we discuss how the week has been for you trying out the strategies. Typically parents start off recalling what went well, what progress was made and what had been more tricky. We work through it all, and then follow on to the next strategies: I will show you examples and demonstrations of each strategy and I will get you to think about how you can use this with your child and in what situation you might use it. I will explain what we are doing and what the purpose is. You might want to write down what you are going to work on for the week. Over the course of about sessions we can cover all the major strategies that are proven to help kickstart spoken language and/or help your child to connect more with you. Through that connection spoken words most often develop.

    Research Papers on the Efficacy of Parent Child Interaction Coaching

    Research Papers on the Efficacy of Parent Child Interaction Coaching

    • The It Takes Two to Talk Program has been shown to be effective in changing how parents interact with their children, and that children’s communication and language skills improve as a result.
    • Baumwell, L.B., Tamis-LeMonda, C.S. & Bornstein, M.H. (1997). Maternal verbal sensitivity and child language comprehension. Infant Behavior and Development, 20(2), 247-258.
    • Beckwith, L. & Cohen, S.E. (1989). Maternal responsiveness with preterm infants and later competency. In M.H. Bornstein (Ed.). Maternal responsiveness: Characteristics and consequences: New directions for child development (pp. 75-87). San Francisco: Jossey Bass.
    • Bronfenbrenner, U. (1974). Is early intervention effective? (Publication No. (CDH) 74-25). Washington, DC: Department of Health, Education, and Welfare, Office of Child Development.
    • Girolametto, L. (1988). Improving the social-conversational skills of developmentally delayed children: An intervention study. Journal of Speech and Hearing Disorders, 53, 156-167.

    Sonja has been a real help for my 5 year old daughter. Due to her support, my daughter is now able to clearly and correctly enunciate ‘th’ ‘f’ and ’s’. She was also helpful in making positional changes to her seating to help her concentrate better and kept her engaged throughout all the lessons which is a feat in itself on zoom!

    Helen, Mother of Catherine Age 5.

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    Cued Articulation involves using specific handshapes and placement cues to guide the speaker’s articulators, such as the tongue, lips, and teeth, to produce accurate sounds. It was originally conceptualised by Jane Passy, a speech-language pathologist. But it is important to know that we can, and often do, also use other speech cues which help our student visualise what they need to do. In other words, we can mix and match our cue pictures depending on what works best with each student.

    In the beginning of my speech therapy practice I would stick religiously to Jane Passy’s method but over the years I have learned and used many different visual hand cues which all have worked with individual students.

    It is important to remember that this is not an exact science, rather than an art! The art is to find the key to each individual student’s understanding and inspire motivation to try out a sound which they find hard to do.

    As an example, the hand signs used by Caroline Bowen’s method, an Australian Speech-Language Pathologist, are quite different to Jane Passy’s signs but they can equally work very well. Caroline Bowen’s visual for the /r/ sound is the ‘rowdy rooster’ — a crazed rooster on a motorbike — and the hand signal is that of revving up the motor bike engine with both hands whilst trying out the /r/ sound! I have a good handful of students who really loved this rooster image and were able to eventually produce a good /r/ using this cue.

    So, it is horses for courses with many things, and visual images and hand cues are no exception!

    Sound picture cards:

    Again, there are a host to choose from and I tend to collect a number of different images for each sound I want to practise with my student. As an example, below are a couple of different examples I use for the sound /p/:

    The Nuffield Programme suggests to use this popper card, which works well with a student who knows these poppers and perhaps has one on their trousers.

    As an alternative, and especially for younger students, I like using the Popper Pig Card – which I also have in my room so I can quickly show how it pops. Or we can have a popping game in between saying the /p/ sound at times. (The popper card is great as I can use the real toy to help with conveying the /p/ sound as it pops.)

    Each card has its own merit and I choose the right card for the individual student.

    How I use cued articulation and the visuals in Speech Therapy

    1. Cueing and practice: I introduce the appropriate card and handshapes for the targeted sounds. We then practise producing the sounds.
    2. Reinforcement and feedback: Positive reinforcement encourages progress and builds confidence.
    3. Fading out the cues: Once my student is able to say the sound more easily, we can gradually fade out the speech cues.

    Benefits and effectiveness

    Using Cued Articulation and Speech Image Cards has been shown to be effective in improving speech production for individuals with various speech and language disorders, including:

    • Articulation disorders: Difficulty producing specific sounds accurately.
    • Apraxia of speech: A motor planning disorder that affects the ability to sequence and coordinate movements involved in speech.
    • Phonology disorders or delays: Confusion and delays in how sounds are organised in categories to convey meaning, errors in sound patterns, for example front sounds are produced at the back, or long sounds are produced as stops.
    • Stuttering: A fluency disorder characterised by interruptions in speech, such as repetitions and prolongations.

    Tips for parents and student speech therapists

    Parents can play a crucial role in supporting the implementation of cued articulation at home and in therapy sessions. Here are some tips:

    • Collaborate with your SLT: Good feedback and communication with the Speech and Language Therapist creates consistency and progress..
    • Practise Regularly: Encourage consistent practice of cued articulation at home to reinforce learning.
    • Use Visual Aids: Use the same visuals that your therapist uses in the speech clinic to help your child at home with recall and practice.

    Feel free to contact me if you need help with your child.

    Sonja McGeachie

    Early Intervention Speech and Language Therapist

    Feeding and Dysphagia (Swallowing) Specialist The London Speech and Feeding Practice

    The London Speech and Feeding Practice

    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.

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