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After speech is acquired, we use verbal and nonverbal communication to manipulate our environment. We communicate to give and receive information, to express intentions, beliefs and feelings. We communicate to solve problems, to entertain and to interact. How can we communicate when we cannot speak or understand speech? The solution is called Augmentative or Alternative Communication (AAC), a broad field that teaches alternative forms of communication to enhance the lives of the disabled. AAC is the refinement of communication modes that are not widely used in our society to individuals whose disabilities prevent them from speaking or writing as effectively as the norm.
Essentially AAC can be described as any system, method, or device that improves the ability for interaction, expanding the boundaries defined by nonverbal communication learned in the classroom. For young children, it has been named YAACK (AAC for Young Kids). (Bailey p. 4) Although AAC is often used to refer to formal communication systems and devices such as sign language, communication boards, or voice output communication aids (VOCAs), it can include less sophisticated means of communication such as facial expressions, non-speech vocalizations, or specific gestures. AAC is used when a child does not develop communication in the normal fashion or experiences significant delay in its development. Ideally it will consist of more than one mode of communication, with the child learning to adapt communication modes according to environment, people, and activities at hand. With AAC, communication occurs with at least one other person to serve several functions: to obtain or reject something, to express emotional interactions, to receive and send information and ideas. (American p. 6) A child needs AAC when his or her speech is not developing in the normal range, is temporarily unable to speak, or is unlikely to develop normally due to preexisting conditions. Candidates conditions for AAC include cerebral palsy, mental retardation, deafness, blindness and autism.
Even Lou Gehrigs disease and Parkinsons may require some form of AAC. Certain temporary conditions like concussions and intubation's will demand the use of some communication. (American pp. 12 - 14) AAC is so important because much of a childs cognitive, social, and academic progress depend on communication. A child with severe disabilities is often unable to learn the early cognitive and social skills on which conventional communication is based. Caregivers of disabled children are often unable to interpret the early attempts at communication. This results in a distorted relationship between caregiver and child and stops further attempts at communication by the child.
Because the adults do not expect the child to relay his or her needs and wants, they anticipate and often misinterpret the childs needs. As a result the child becomes extremely passive. Occasionally, the child will become frustrated at the lack of communication and resort to problem behavior to get needs met. AAC is a good combatant of this problem by opening the communication channels and offering socially acceptable alternatives. (Reichle pp. 6 - 9) A child with a lower level learning capacity is further stunted by the misinterpreted attempts at communication. When a child is brought into the classroom to learn these new techniques, the process is slow. Most children will have formed a vocal noise or gesturing technique to confirm or dis confirm the choices in front of them.
It starts with showing the child an object, say a ball. The teacher will then show the child a photograph of a ball, explaining how they stand for the same object. Once the child can accept that the physical object and its picture are the same, the teacher introduces a line drawing. He or she will explain again that the object, the photograph and the drawing all stand for the same item. If the child is mentally able to progress further, the teacher can progress to words. The more a child can graduate the better.
Pictures are more portable than physical objects, line drawings more portable than pictures, and so on. The importance of teaching these vital steps is not progressing too quickly. If the child becomes frustrated because he or she is shown a ball alongside a word-labeled line drawing that he or she can not grasp, the child will reject the system. The forms of AAC cover a broad base divided into two categories: aided and unaided. Aided systems use an external device like a voice output communication device (VOCAs), computers, and communication boards. Unaided systems are systems independent of a device, such as speech, vocalization, gestures, or sign language.
There are advantages and disadvantages to both systems. Aided systems have the advantage of flexibility. They are highly flexible and can be designed to take advantage of a childs strengths and skills, and to compensate for disabilities. They can be approached in a variety of ways, their output can be visual or auditory, and can be used with different symbol (line-drawing, photograph, or word) systems. In addition they are excellent for children who have severe motor impairments, since they can be switch-activated. Aided systems also have the advantage of using recognition memory.
The child is presented with several message choices and has to choose the correct one, as opposed to recall memory where the child has to remember how to produce the message in the first place. Aided systems are beginning to be used more and more with kids who have cognitive disabilities, even though they may be capable of sign language. In addition, VOCAs, which are considered a new class of AAC, have the advantage of being readily understood by others that may not understand augmentative forms of communication. This helps the child monitor his or her own communication and expand the boundaries of communication for each child. Positioning is very important when working with aided systems. A poorly positioned computer screen or picture board can give the child unwanted reflexes (twitching and ticking), fatigue, eye problems, and in more severe cases can cause permanent physical damage.
The disadvantages of aided systems are the cost and inconvenience. Portability is an issue because they usually have to be mounted on wheelchairs. In addition, they must be specially constructed and purchased. Their content is limited to what is programmed or added by an adult, which decreases the independence of the child. Some doctors feel that using a device for social interaction reduces the feeling of closeness and intimacy. It is important that these children get as much intimate one-on-one as possible, due to the probability of a stunted relationship with the parents during infancy. (Bailey p. 54) Unaided systems have the advantage of convenience since they dont depend on anything external.
The child is never without this mode of communication, and it is not susceptible to lack of availability, loss, or breakage. Unaided systems have an unlimited vocabulary potential since they are not limited by the characteristics of the device or what someone else has programmed on it. In addition, the intimacy involved lets a child have a secret language with his caregivers, if you will, as it is easy to forget that behind all the equipment and impairments there is a child who wants and needs to play. Unaided systems have the disadvantage of depending on recall memory.
The child has to independently remember how to communicate a particular message. This is considered more difficult than being able to choose correctly from a set of messages presented on a device, especially for a child with severe and profound disabilities. A further disadvantage for the severe and profoundly disabled are the motor requirements involved. Children who dont have the capability for fine motor skills are not candidates for these systems. Physicians recommend that children learn at least one unaided system if their abilities can allow it, even if only for emergency situations. Aided systems can be stolen, lost or otherwise unavailable.
If anything happens to the childs aided system he or she may be unavailable to communicate for a long period of time. (Bailey p. 54) Facilitated communication is a technique where the adult acts as the communicator. The child guides the adult who then writes, types, or uses an AAC device for the child. One example would be a child who points or gestures at an object or picture. Training the adult is necessary to make sure the child is initiating the direction and not the adult. If the adult were to project an idea on the child, the child would see that his or her needs were no longer being communicated correctly and scrap that form of communication altogether. This is a fairly controversial form of communication in the medical community for that very fact. (Reichle pp. 142 - 3) Switches are very important for children with motor impairments because they let the child control a device.
Sometimes the child will only have one consistent move that can elicit a number of outputs. Upon talking to Marylin Wood, a special education teacher with G. L. A. S. S.
for three- to five-year-olds, I was informed of a swing in her classroom that each child could operate, despite their abilities. One girl with cerebral palsy uses the sip and puff technique, where she blows through a straw to elicit a response. Other children push a button to elicit a response. Upon pushing the button or blowing through the straw, Marylins voice is projected from a machine saying, Push me, please!
Each child has enjoyed the over-sized, padded swing so much that each child has learned a technique to be pushed. The more switches a child can use, the faster and more efficiently he is able to communicate. Even a single switch user can become an effective communicator. Some switch systems allow a child to scan through a number of switches until the picture, line drawing, or word appears. Then the switch is hit again and the computer stops and chooses the item that the cursor is on. Eye gaze techniques, where the childs partner pinpoints what the child is looking at, is an excellent form of communication during an early childhood with severe motor impairments.
There are eye gaze switches which track what the eye is looking at and then produces the message. For example, a child may look at the drink drawing on a picture board. The switch will be hit after a certain amount of time, usually one second, and will produce an auditory or visual request for a drink. The more primitive version starts with the child looking at objects in the environment and then graduating to the picture board. Spacing and organization becomes very important with this system. The advantage of the computerized system is the independence of another person.
With the basic version, the child is completely dependent on the attention and accuracy of their partner. Another problem is how to signal a person who is not paying attention. (Reichle, pp. 139 - 40) Augmentative and alternative communication provides systems that enhance peoples lives. It uses techniques that the average person may not consider viable communication. Until you have visited a classroom of the severe and profound, it is unfair to demean these systems as elementary.
When visiting Mrs. Wood after class I was greeted at the door by a student, about three years old and with an adorably large head, who held up his arms and cried into my coat like he had missed me. When I told her that I felt flattered, she said, Dont. This is how he manipulates the ignorant to take him to the hallway. He heard Marylins comment, walked away in a huff, and ran to push a button across the room. It said, Push me, please!
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Research essay sample on Studies On Augmentative Or Alternative Communication
