In saying this, I emphasize symbolic communication because most of these individuals already use facial expressions, eye-gaze and gestures; some are also able to use mime or take the partner to see something. We want to expand this communication, so this individual can talk about things beyond the "here and now" with familiar and unfamiliar partners; this is done only through the use of "symbolic" language.
I emphasize reliable communication because there are too many situations where an AAC user is over-estimated or under-estimated when communication is not completely under their control. We do a tremendous disservice to an individual by giving them an unreliable method of communication and then judging his or her cognitive or academic skills.
Many emerging communicators are successful with a new method of communication only if it empowers them….allowing them to communicate what they want, when they want it. If we provide the wrong vocabulary, to communicate what we want them to say, or if we ask them to say it in an artificial interaction then AAC will fail.
There are a number of intervention steps that must take place before symbolic communication is designed and implemented for individuals with emerging communication. The most important are:
1. Hearing and vision testing:
Hidden hearing or vision losses are very common in non-speaking individuals who are not yet successful with AAC. These impairments can actually interfere with the use of AAC and the development of effective communication methods. This is true even if these the losses are minor or subtle. Hearing and vision testing is essential for all AAC users, particularly emerging communicators. The team must consult with professionals who are familiar with testing non-speaking individuals.
2. Improving current non-symbolic communication:
You must begin by improving the effectiveness of the non-symbolic communication, for example gestures, pointing, facial expressions. This may involve teaching some partners to recognize and respond to these attempts or it may mean teaching the individual to make clearer attempts in this way. According to Beukelman & Mirenda, here are the most important signals to focus on initially:
As discussed above, emerging communicators are most successful
with AAC if it enables them to communicate something they care about in
a natural interaction. To do this, we have to first identify what they
want to communicate. Here are some of the techniques that are used most
Technique #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. The checklist should consider both objects (e.g. things you give) and actions (e.g. things you do to or for the individual) in all the different sensory modalities.
Click here to see a form that can be used to evaluate likes and dislikes 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 for some trials with the individual to determine likes and dislikes.
Make sure you include dislikes in your vocabulary list. It is very important
that emerging communicators have experience rejecting or opposing what
they don't want along with requesting what they do want. True communication
includes both abilities. Just as speaking individuals have a large vocabulary
but only ask for what they want, so a non-speaker to should have a repertoire
that includes items they want to avoid asking for. Later, this vocabulary
can be used in sentences like "no + yogurt!" Initially, we only ask that
they recognize and avoid those symbols for things they do not want.
Technique #2: Observation of AAC User in Particular Activities
Another great technique is to observe the non-speaking individual in order to identify what interests him or her. For example, if you observe a child during snack, you may find that he never eats his snacks and that he is most interested in something to drink. But you 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 become a successful communicator.
Here is an observation form that I use during this type of observation: Observation Form
You can see that the biggest problem with this method is that it is time-consuming. However, if you make such observations routinely, even for only 30 minutes a week over many weeks, they can yield very important information. Ideally, you want the team to make such observations simply as part of their every day work with the individual, not really needing a form to do it. This will increase the likelihood that the communication you devise for an emerging communicator is appropriate and powerful.
Technique #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:
This particular form is not essential and some families find it quite cumbersome. In those cases, I recommend keeping paper handy in many different locations and just keeping notes on each episode.
When you analyze this type of diary, you don't look just for the specific vocabulary that would have prevented that breakdown, but 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. Instead, this observation should compel you to make a board with all the individual's favorite songs on it, leaving room for new songs as they are identified.
Technique #4: Analysis of Inappropriate Behaviors
Some individuals with "emerging" communication skills 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:
There are some excellent resources on this topic on the Internet. Check out the following sites:
In Summary: We've given you four techniques to identify vocabulary for emerging communicators. From the lists you generate, you should only consider the words or phrases that meet the following specifications.
There are also a number of activities that must be done while symbolic communication is being implemented:
1. Select appropriate symbols: We cover this in another section of the web-site. Be sure to visit: Customizing Symbols.
2. Verify that this method is reliable: There are many ways to assess the reliability of communication in the emerging communicator. One of the best references on this subject is:
3. Determine the best way to teach new symbolic communication: Beukelman & Mirenda (1998, p. 287-315) present an overview of teaching strategies for beginning or emerging communicators.
4. Make sure you continue to expand communicative purposes: All too often we give individuals a way to request, for example at snack time, then add ways to reject (as above) but stop there. It is important to give early experience with the following concepts too: