Augmentative and Alternative Communication at the University of Washington, Seattle

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Home > Vocabulary Selection > Emerging Communication

Vocabulary Selection
for Emerging Communication

As you saw in the Communicative Independence Model the emerging communicator is an individual who:

1) does not have any RELIABLE method of symbolic communication [G]; and
2) can only rely on gestures, facial expressions, body postures and other "non-symbolic" methods of communication.

Remember, the fact that an individual does not have more sophisticated communication is not necessarily an indication of a cognitive impairment or developmental delay. The limited communication could be due to many other factors:

Hidden hearing impairment
Hidden vision impairment
Reliance on an unreliable method of communication
Device doesn't match motor capabilities, so unreliable.
Low expectations of other people, so no AAC trials.
Lack of opportunities to communicate
Lack of AAC services

In fact, if an emerging communicator has severe motor impairments, I would argue that you cannot know the underlying cognitive abilities until he/she has a way to communicate. There is no way to test cognition without good motor control and/or reliable communication. We simply cannot know until we finally establish expressive symbolic communication [G].

What is the purpose of vocabulary selection for the Emerging Communicator? The goal should be only one thing:

To identify the first, reliable method of symbolic communication

But that goal does not mean that we have to make the interaction a dull, stimulus-response activity to prove that symbolic communication has been established. In fact, that would be the worst way to proceed because it may make the individual unwilling to participate in your attempts. Instead, with emerging communicators (or "re-emerging" adults), you must select the vocabulary that will empower the individual through communication. You want vocabulary that will:

let a young child get exactly what he has wanted (i.e. request preferred object)
let a child control what game you play together (i.e. request an action)
allow an adult in ICU to convey information to his wife that is important to him (i.e. provide information)
allow a teen to refuse to do a task that is too hard (i.e. protest) BEFORE he resorts to inappropriate behavior, etc., etc.

Identifying those truly POWERFUL concepts is no easy task. This is particularly true with emerging communicators who cannot, by definition, tell you what they want to be able to say. Here are some strategies that you may find helpful in your work with these individuals.

Strategy #1: Likes and Dislikes Checklist

This technique is used to determine what the child or adult really likes and really dislikes so communication can focus on those things. Here is a form that can be used to keep track of likes and dislikes in a variety of modalities (e.g. sounds, sights, touch, etc.) for some individuals: Likes and Dislikes Checklist.

You can see that this method is best at identifying objects or actions that the individual wants to request or to reject. Typically, I use this list to interview family members and caregivers who usually already know this information. In some cases, we use it in planning actual trials with the individual to determine likes and dislikes. If I were to use this with an adult in intensive care, I would modify it to requests that can be made in that context (e.g. ice chips, fan, etc.)

Here are some other resources for preference inventories:

Dattilo (1986)
Houghton, Bronicki, and Guess (1987)
Mason & Egel (1995)
Wacker, Berg, Wiggins, Muldoon, & Cavanaugh (1985)

Strategy #2: Observation of AAC User in Communicative Contexts

Another technique is to observe the non-speaking individual in order to see what interests him. For example, if you observe a child during snack, you may find that he never eats his snacks and that he is more interested in something to drink. But you may also notice that he needs help getting the milk carton open. If you give him a symbol for the pretzels or chips, he may not use them. But if you give him a way to ask for "milk" and "help open" he may show successful (and more complex!) communication in that context.

Here is an observation form that I use during this type of observation: Observing Communication in Context

Too time-consuming to observe? Here are some potential solutions:

a) make frequent, short observations over many weeks
b) teach an assistant or family member to observe for you
c) help the team learn to make such observations as part of their everyday work with the individual, and agree on a way for them to communicate their observations (maybe not this form).

Strategy #3: Communication Breakdown Diary

If setting aside time to observe is impossible, we then recommend that team members keep notes only when communication is problematic. For this we use a "Breakdown Diary" like the one shown here:
Communication Breakdown Diary

Too little time or hard to carry the form? Here are some solutions:

a) jot down notes at the time a breakdown occurs on anything handy.
    (compile the notes later, perhaps on this form.)
b) at break time, record your memory of any breakdowns
    (use a tape recorder or a notebook at your desk)
c) each evening, jot down what you remember that day,
    (even if you cannot recall everything)

When you analyze this type of diary, don't look just for the specific vocabulary that would have prevented that breakdown; look instead for a class of words. For example, let's say an individual wanted to hear a particular song on tape and it took 5 minutes of yes/no questions to identify it. You wouldn't want to just put that song title on a communication board; you'd put all the favorite songs, leaving room for new songs as they are identified.

Strategy #4: Analysis of Inappropriate Behaviors

Some individuals have problem behaviors, such as tantrums, kicking, scratching, damaging property or self-injurious behaviors. There is considerable evidence that some of this behavior can be replaced with functionally equivalent alternative communication. Studies have identified specific communicative functions that are crucial for many individuals with problem behaviors. According to Lloyd et al (1997), these are:

· getting attention
· getting or keeping objects or actions
· getting pleasant sensory input (e.g. sounds, etc.)
· escaping from an unpleasant task, sensation, demand

Here are some excellent resources on this topic:

ASHA's Online Module: AAC in the Schools
Autism Society: See the information on Challenging Behaviors.
Institute for Applied Behavior Analysis: This website has many resources for you to browse through and consider.
Wacker, Berg and Harding (2002)
Sigafoos, Drasgow, Reichle, O'Reilly, Green, & Tait (2004)

When you select the initial vocabulary for an emerging communicator, be sure to concentrate first on

a) concepts the individual cannot already convey in another way.
(replacing a gesture that is already working for him might actually increase frustration)
b) concepts that can be used the most frequently.
(this will improve the individual's learning because she'll have more practice)
c) concepts that can be acted upon and are pleasant (positively reinforcing). This is not an absolute rule (see next point) but in general this will keep the new communication method positive for the individual.
d) a few concepts that are unpleasant or neutral (negatively reinforcing) for the individual can be used as foils to make sure the individual is not making random selections.