Children with Autism Spectrum Disorder (ASD) have become a large part of my practice as an SLP. I am always surprised, however, that even with all that we know about the social and communication challenges facing these kids in the short and long term, many will reach school age having minimal to no exposure to a reliable AAC system. Communication and social interaction begins for all children at birth and these early foundations are what successful relationships and learning experiences are built upon. All children with ASD will struggle to talk to some degree throughout their lives. Some won’t talk at all, some will be slow to learn to talk, while others may talk more freely but be difficult to understand. These children will also struggle with the overfall process of learning language, understanding others, engaging in important interactions, and realizing that communication makes the world go ‘round! The struggles and triumphs of ALL children with ASD are best supported when we offer the tools needed to access the world. One of the most important tools that we currently have to offer is AAC- here are a few reasons why:
1. AAC breaks down barriers
Communication is not just talking and in fact, all children-including those without ASD- will use forms of AAC to communicate as they learn to speak. Speech is a motor skill that requires the coordination of many systems in the body with planning that occurs in the brain. This skill is a complex one that works in partnership with language to form verbal communication. Language, however, is not a motor skill but a cognitive skill that can be learned and expressed with or without speech. Many children with ASD struggle with the motor planning skills required to produce consistent and clear verbal speech-a condition often described as apraxia. By providing frequent, motivating opportunities to learn and use language through AAC strategies, we allow language and overall communication to flourish without restricting opportunity in the presence of challenges with speech (motor) skills.
2. AAC improves access to learning opportunities
Research has shown that the use of AAC has a positive impact on other areas of academic and social development. By providing a supportive system to improve receptive and expressive communication, children with ASD who use AAC are more able to access the classroom curriculum and participate in the daily routines enjoyed by their classroom peers. Think about the learning opportunities that occur during a social (communicative) activity like circle time or show and tell that would go otherwise unrealized without a reliable means of communication.
3. AAC provides opportunities to build relationships
Communication plays a large role in social interaction and building relationships. AAC strategies provide a child with ASD the tools to use communication for purely social purposes, rather than just to request wanted items or activities. Using AAC, a child can gain the attention of another by calling his name, tell a joke, ask a question, or share information about himself with a new friend-acts which may be otherwise difficult or impossible with his current speech skills.
4. AAC makes spoken language visible
All children-especially children with ASD-learn through experiencing with their senses. Visual learning and visual thinking have emerged as relative strengths for children with ASD. AAC makes spoken language- an auditory message which is here one second, and gone the next-more visible and longer lasting. With visual language provided by AAC, a child with ASD has more success understanding what is being said and more access to the vocabulary, language structure, and communication function needed to communicate his own message.
5. AAC provides tools to manage challenging behavior
Many challenging behaviors emerge in children with ASD as a means of communicating with others in the absence of another way. By providing a child who may be struggling to speak an alternate means of expressing such messages as discomfit, fear, or disagreement, we are able to offer tools to replace many challenging behaviors.
6. AAC provides opportunities for accidental communication
"Accidental" communication shapes verbal language for children from birth. As a baby plays with sounds he hears in the speech of his parents, he stumbles upon a few gems like "ma" and 'da' and is enthusiastically rewarded by his excited parents' reactions ("He said mama!") That praise and encouragement leads to more and more repetition of these sounds which then leads to first words, and then to sentences and so on. Children with ASD who struggle to speak and to engage in imitation and interaction with caregivers have minimal opportunities for such accidental communication. AAC provides these kids with a way to "babble" and in doing so, to stumble upon a powerful word that results in enthusiastic reward and leads to more and more over time.
7. AAC supports spontaneous and novel communication
Children with ASD often encounter restrictions when it comes to saying exactly what THEY want to say when THEY want to say it. When a child has limited speech, we find ourselves asking many yes/no questions rather than open-ended ones, prompting for a request rather than allowing it to naturally occur, or anticipating needs and telling stories from our own perspectives. AAC offers the building blocks for us as partners to model the language around important experiences as they occur and to provide each child with a menu of sorts for accessing that language later on-when THEY want to talk about THEIR experiences.
8. AAC reduces frustration and improves communication success
Most of us don't particularly like doing things we don't feel good at and aren't particularly excited about being asked to do things we don't like to do! AAC empowers children with ASD to communicate because it allows language to be more easily accessed. With access, successful interactions with others, and a feeling of "I can do this!", we see children with ASD become more excited and less frustrated about the prospect of communicating.
9. AAC teaches language skills
Sure, AAC is a tool for actually communicating but in addition to this important purpose (if not even MORE SO), AAC is a tool for LEARNING language. What better way for a visual learner to learn word meanings, how to combine words into sentences, and how to use different words for different reasons than to present such lessons in pictures? AAC provides kids with ASD a language roadmap that offers consistency, structure, and longevity in the frenzied world of spoken language.
10. With AAC there is nothing to lose and everything to gain!
In short-AAC does not prevent or decrease speech! in fact, research has shown that the use of AAC either has no effect on speech or improves speech-so what have we got to lose? Using AAC can be clumsy and it is certainly hard work for each child and everyone who supports him. BUT, we certainly have so much to gain if we are up for the challenge!
What does your child with ASD gain from his AAC tools? Please share comments and questions below!