AUGMENTATIVE & ALTERNATIVE
Speech development is affected in children diagnosed
as being on the autism spectrum, which includes autism and Asperger's
syndrome. Some may remain mute throughout their lives, though possibly
communicating in other ways - images, visual clues, sign language,
or typing on a keyboard. Augmentative and alternative communication
is the use of visual language systems to assist children with communication
skills. It is commonly referred to as assistive technology as well.
Research, information and support has been very slow in many aspects
of autism and Asperger's syndrome, and it is certainly true in communication.
Augmentative and alternative communication has long been available
for people whose communication was affected by a disability, but
it has only been adapted for autism in recent years.
Augmentative and alternative communication can
help a child to learn the basics of communication before speaking.
It can be a great help to parents too, who can bond better with
their child, even if communiation is only possible through assistive
technology. Parents should note that the use of non-verbal communication
systems is not giving up on your child's verbal skills. Assistive
technologies can form the foundation of communication skills that
may allow verbal communication at a later point.
why Augmentative and alternative communication works
The typical development of a child anticipates
that communication will happen in a certain order: listening, speaking,
reading, and then writing. Children on the autism spectrum have
a different blend of strengths and weaknesses and can be left behind
when their development may happen in a different sequence. Children
with autism or Asperger's syndrome usually demonstrate strong visual
processing skills, so a focus on visual strategies, reading, writing
and using a keyboard may be more important than verbal communication
to begin with.
The need for assessment
If parents is thinking about using augmentative
communication, they should start with an assessment of:
• Current and future communication needs
• Communication techniques in current use
• Other types of communication styles that could be used.
This will often have a multidisciplinary approach
as different specialists look at educational, physical, mental and
social abilities of the child.
finding good therapists
A good start is to look for a speech therapist/pathologist
and ask questions. A professional will always have time to answer
parents' questions and understand their desire to seek the best
therapist for their child. You should be able to ask about their
qualifications and work experience. They should have particular
experience with Autism Spectrum Disorders and how they affect
Check to see if they provide a comprehensive service
in terms of augmentative and alternative communication, and who
the other members of the team will be. There should be a full explanation
of how a program will be developed, monitored and amended as required.
They should have a range of assistive technologies available, and
suggestions on the ones most appropriate for the child after assessment.
Ideally you should be able to speak to other parents
they have worked with, as parents using assistive technology are
usually keen to help other parents new to the area.
Unfortunately, some parents are unable to afford
therapists or may be geographically isolated. Parents often ask
whether they can conduct their own interventions, and the answers
are usually mixed. Click here to read the Do-it-yourself
early intervention fact sheet.
Types of augmentative and alternative communication
As the title suggests, a child who cannot communicate
verbally can use an alternative form of communicating, or augment
their existing abilities with other strategies.
Picture Exchange Communication System (PECS)
This form of augmentative and alternative communication
is typically used as an aid for children with autism who are non-verbal.
PECS can be used in several ways to aid communication. PECS are
typically introduced using pictures of desired objects (such as
food or toys). This can be a hand drawn illustration, photo or computer
clip-art printed on a sheet of paper. A website at do2learn.com
provides free resources for PECS.
When the child wants one of these items, he gives
the picture to a communication partner such as a parent, therapist,
caregiver, or another child. The communication partner then hands
the child the food or toy, thus reinforcing communication. Ultimately,
the pictures can be replaced with words and sentence strips (for
example; I want cookies).
Many people believe that PECS can also be used
to create visual schedules for children this is however factually
incorrect. the term PECS does not refer to the individual pictures
or icons. PECS is the exchange of the icon as a form of communication,
not the picture itself. The same icons that are used for PECS are
frequently used for creating visual schedules, but this is not PECS,
it is simply using icons to create a visual schedule.
The introduction of PECS can be a long and drawn
out process taking months to complete. For a family facing a lifetime
with a non-verbal child who is not grasping sign language either,
these can definitely be a relief for the lack of communication.
PECS typically moves through six stages:
• Teaching the child to spontaneously request
an object or activity
• Generalize this skill to other objects and activities, and with
other people involved
• Teach the child to disciminate ie. 'what would you like to do?'
• Start to encourage use of setences ie. using the symbols for "I
• Extension of sentence with adjectives ie. "I want" "blue"
• Encourage the child to comment about things ie. using symbols
to say "I can smell dinner cooking".
PECS thus starts with a basic request and eventually
forms the basis for conversation, which provides an ideal foundation
for verbal skills at a later point.
Interactive language board
Language boards assume the child has some degree
of literacy but is not yet speaking. A language board can can be
made for different purposes. A common starting point in one for
meal times, as food is a good reinforcement
for learning new skills. The necessary words are chosen for the
activity, in this case, eating and drinking. Words are also needed
that allow the child to say 'yes', 'no' or make a comment.
Vocabulary is chosen which drives the activity,
that is, gets it started, moving and completed, as well as the objects
required for the actual activity and descriptors for giving the
child expressive options for commenting, acceptance or refusal.