I know it’s been forever since I posted…and I apologize. I’m currently working on a post about PROMPT and whether it’s EBP or pseudoscience and I suspect I’m
avoiding delaying working on it because I’m afraid of what I’ll find.
However, I wanted to post something…and this has been laying rather heavily on my heart lately, so I thought I’d post it here. Go on…click on it, it’s not personal.
I read an article recently from Speak for Yourself AAC on The Myth of Augmentative and Alternative Communication (AAC) Pre-Requisite Skills.
The post talks about myths: low cognitive skills, behavior problems, needs to be more verbal…etc. And it really made me think. I’ve had exactly two kids I’ve considered for AAC of any kind here in my current school (going on 7 years – yes, it is utopia, but that’s another post!).
With both of those kids, we implemented PECS. One is now completely verbal and doing great (not even on an IEP anymore). The other moved away halfway through and I’m not sure of the outcome.
Like most school-based SLPs, over the years I have had a few kids that don’t fit nicely into any particular mold…preschoolers who weren’t in a language rich environment and encouraged (okay forced) to communicate to get wants/needs met, or kids with known problems but no label, etc.
I’ve often wondered what criteria I should use before suggesting AAC…and I really hope I’m not the only one who isn’t 100% sure.
When the child comes to me and has a total of 20 words at age 3 – do I automatically consider him an AAC candidate or do I try to teach him language first? If he doesn’t have 200 words after 3 months of therapy do I do it then?
What’s the magic rule? Is there one?
I’m curious what everyone’s views are on this subject.
What things do you look for before questioning whether AAC is something to be considered? For instance, would you consider it for the 3-4 year old who is highly unintelligible or do you wait until school age in hopes of that magical language burst?
What about the kindergarten student with suspected ASD who is highly echolalic and can’t answer yes/no questions with any sort of intent, but the echolalia has some functionality…occasionally? He might be able to say he hurts – but when questioning him, he couldn’t reliably tell you if his head/tooth/ear/stomach hurt. He would benefit from AAC – but is it necessary? How do you, as a school-based SLP, make that pitch to the educational team? What if the parents or caregivers can’t afford it – won’t carry through with it – don’t want it? Then what?
Is AAC something you even consider? What would you start with? I’d really like to hear your thoughts.
Until then…Adventure on!