Using AAC all day and

every day
Charlene Cullen
Speech Pathologist
Speech Language and AAC Consultant
[email protected]
Twitter: @chacullen
Today’s Outline
9 – 1pm
• Good practice in AAC
• Apps for AAC
• Additional supports to good practice in
AAC

30 minutes morning tea

What is AAC?
• Augmentative and Alternative Communication (AAC): An area of
specialised clinical and educational practice that provides
communication options and interventions for people with complex
communication needs. The term augmentative in this context means
supplemental or additional to speech. Augmentative techniques (e.g.
gestures, and facial expressions) are commonly used when
communicating and interacting with others.
• The use of the term alternative acknowledges that there are some
individuals whose speech is sufficiently impaired that they must rely
completely on standard and special augmentative techniques, which
do not augment speech but are alternatives to speech
(Vanderheiden & Yoder, 1996).
(Speech Pathology Australia AAC Position Paper 2004)
AAC System
• AAC system: An integrated group of
components, including the
symbols, aids, strategies and techniques used
by individuals to enhance communication. The
system serves to supplement any
gestural, spoken, and/or written communication
abilities
(American Speech and Hearing
Association, 1991).
AAC System
Unaided and Aided AAC
• Unaided AAC: All techniques that do not require any
physical aids (e.g. gesture, sign, facial expression).
• Aided AAC: Techniques where some type of physical
object or device is used (e.g. object
symbols, communication boards, books, wallets). Aided
AAC is often divided into high technology or low/light
technology systems.
(Speech Pathology Australia AAC Position Paper 2004)
AAC Myths and Legends
• Introducing AAC will stop someone from
developing speech
• Low tech before High tech
• Has a little speech so doesn’t need AAC
• Too cognitively impaired for AAC
• AAC will fix all communication difficulties
• Too young for AAC
• Doesn’t need AAC as they can express
basic needs
AAC Myths and Legends -
Resources
• Romski, M.A. & Sevcik, R.A. (2005).
Augmentative communication and early
intervention: Myths and realities. Infants &
Young Children, 18:3, 174-185.
• YAACK http://aac.unl.edu/yaack/
• DynaVox Implementation Toolkit
http://www.dynavoxtech.com/implementati
on-toolkit/learning-paths/list/?id=7
AAC Myths and Legends -
Resources
AAC Myths and Legends -
Resources
So how do we introduce AAC?
Good Practice Approaches to
AAC
• Aided Language Displays (ALDs)
• Engineering the Environment
• Chat Now
• PODD
• Core Vocabulary
Additional AAC options to
support good practice
• Small Talk
• About Me Books
• Yes/No ++++
• Social Scripts
• Partner Focused Questions
• Storytelling
High Tech AAC
• Custom Speech Generating Devices
• Mainstream Technology
• iPod touch/iPad
• Android Phones/Tablets
• Laptops
Communicative Competence
• Light (1989)
• Linguistic Competence (mastery of the
linguistic code)
• Operational Competence (access methods,
on/off)
• Social Competence
• Strategic Competence (make the most of the
vocab they have)
Aided Language Displays
Aided Language Displays
• Prospective users must be provided with
frequent examples of interactive, generative use
to acquire any semblance of proficiency.
• No one would dispute the fact that it would be
very difficult to become a fluent speaker of
French, if your instructor seldom used French in
your presence.

Goossens’, Crain and Elder (1988); Goossens’

(1989)
Aided Language Displays
• Likewise, it is difficult for a nonspeaker to
become a proficient AAC user if other
people never model interactive use of their
system during all aspects of the day.
Aided Language Displays
• Aided Language Displays are NOT choice
making boards.
• Choice making boards supplement ALDs.
• E.g. in music time a choice board of songs
is followed by boards for singing the
songs.
It is critical for an individual to not only have
symbols, but also to have experience with
those symbols in a symbol rich
environment / print rich environment. The
typically developing child will have been
exposed to oral language for
approximately 4,380 waking hours by the
time he begins speaking at about 18
months of age.
If someone is using a different symbol set
and only has exposure to it two times a
week, for 20-30 minutes each, it will take
the alternate symbol user 84 years to have
the same experience with his symbols that
the typically developing child has with the
spoken word in 18 months!!!
The typically developing child will
demonstrate language competency
around 9-12 years of age having been
immersed in and practicing oral language
for approximately 36,500 waking hours.
For 9-12 years that child has been using
and receiving corrective feedback while
practicing with the spoken word.
At twice a week, 20-30 minutes each time, it
will take the alternate symbol user 701
years to have the same experience

Jane Korsten (2011) QIAT Listserv 4th

April
Aided Language Displays
• If children are to gain proficiency in using
their aided AAC systems, others must
begin to use the children's AAC system to
communicate with them.
From “Being a Model Communicator,” ComTEC, 2010
Aided Language Displays
• By modelling how to use a display to
initiate and maintain communication, you
show a student how to initiate and
maintain – not just respond!
Aided Language Stimulation
Aided Language Display Design
Aided Language Display Design
Aided Language Display Design
Aided Language Display Design
Aided Language Display Design
• If you (as a person proficient in language)
cannot use a communication system or
display throughout an interaction then how
can you provide Aided Language
Stimulation?
• If you cannot use it, is it designed well?
Exercise
• In pairs: Design an Aided Language
Display for making things from
pipecleaners.
• Remember to include vocabulary such as
names, actions, positions, requests,
commands....
Boardmaker Software Family
• Boardmaker
• Boardmaker Plus
• Boardmaker with SD Pro
• Boardmaker Studio
www.boardmakershare.com
Engineering the Environment
Engineering the Environment
Engineering the Environment
Storing displays
• Must be stored in close proximity to where they
are needed
• Must be stored in a way that helps with quick
access and set-up
• E.g. in dress-up box, on back of bookshelf, on
walls, in plastic bucket, inside game box, with
props, in eye gaze arrangement
Engineering the Environment
Week 1
• Figure out how to make the display(s)
available everywhere.
CHAT-Now
CHAT-Now
• Developed by Gayle Porter (Cerebral
Palsy Education Centre) and Marnie
Cameron (Communication Resource
Centre)
• Children’s Aided Language Tools
• Consists of aided language displays for
early childhood settings and general
interactive board(s)
CHAT-Now – Book
CHAT-Now – Music play
CHAT-Now – Music play
CHAT-Now General Interactive
CHAT-Now
• A series of ALDs for different activities.
• Designed for early childhood but suits
many special education settings
• Also includes a general interactive board
for use throughout the whole day
Special School Project
• Approx 80% of students in school with
CCN
• A few have individual systems – generally
not being used
• Lots of visual supports in place – all staff
carry key caddies and all classrooms use
visual schedules, first then boards etc
• Commonly used AAC is all adult focused
language
Key Caddies
Special School Project
• Baseline observations and videos end of
2010
• No spontaneous AAC use by students
Term 1 2011
• Every student establish yes/no
• Begin using CHAT-Now
• Introducing general interactive board
• Then aided language displays
Week 1
• Problem solve how to make general
interactive display available in every
situation
Week 2
• Model more and finished all week
Week 3
• Add I like this
Week 4
• Add I don’t like this
 Week 5
• Use whole board

•Made up in Tap Speak Choice, AAC App

Weeks 6 - 10
• Consolidate use of whole board
• Ensure all students have yes/no
Special School Project
• Repeat observations and videos end of
term one
• 10 spontaneous uses of AAC by students
observed
• Next term introducing ALDs for a range of
activities
• Term 3 introducing multi-page generic
displays
CHAT-Now
• General interactive multi-level
Yes/No
• Need to watch the number of yes/no
questions we ask AAC users
• BUT
• Every AAC user needs to develop a good,
clear Yes/No response
Yes/No
Yes/No
Pragmatics
Pragmatics
• Pragmatics – social use of language
• Using language for different purposes,
such as greeting, informing, demanding,
promising, requesting
• Changing language according to the
needs of the listener
• Following conversational rules
www.asha.org
Pragmatics
• Need to ensure AAC users have access to
and know how to use a range of pragmatic
skills
• Dewart and Summers “Pragmatics Profile”
(1998)
• http://wwwedit.wmin.ac.uk/psychology/pp/
Pragmatically Organised
Dynamic Displays (PODD)
PODD

• PODD is a way
of organising whole word
and symbol vocabulary in
a communication book or
speech generating
device to provide
immersion and modelling
for learning.
PODD
• The aim of a PODD is to provide
vocabulary:
• for continuous communication all the time
• for a range of messages
• across a range of topics
• in multiple environments.
PODD
• PODDs can have different formats,
depending on the individual physical,
sensory and communication needs of the
person who will use it.
PODD
• PODDs have been developed over the
past 15 years by Gayle Porter, a speech
pathologist with the Cerebral Palsy
Education Centre (CPEC) in Victoria.
Each PODD format has been shaped by
the experiences of both children with
Complex Communication Needs (CCN),
and their communication partners.
Let’s have a look....
Core Vocabulary
• Using common English words on an AAC
display to enable a user to construct their
own sentences.
• Approach used in lots of high tech
systems but not used as much in low tech
due to difficulty of arranging vocabulary for
access.
Core Vocabulary
• CORE VOCAB • FRINGE VOCAB
• High frequency • Low frequency
words words
• Can be combined • Only useful in one
to get your or two situations
message across in • Often related to a
lots of different specific topic
situations
Core Vocabulary
 Core Vocabulary

•WordPower 24 in TouchChat, AAC App

Pixon
• http://www.vantatenhove.com/showfolder.
php?id=57
Core Vocab to supplement ALDS
• From the Disability Services Commission
WA

http://www.boardmakershare.com/Activity/969086/Core-Vocabulary-Display
The Language Stealers
Technology
High Tech and Light Tech
• Both are just tools
• Both need good vocabulary design and
good modelling to ensure success
• High Tech can be less forgiving but can
offer more access options
• Some students more motivated by high
tech and some don’t like it!!
• Most people need both – for different
situations
Speech Generating Devices
• STATIC DISPLAY • DYNAMIC DISPLAY
Static Display
• May be more durable
• Generally cheaper
• Often run off AA or AAA batteries
• Overlay based - require Boardmaker or
other tool
• Need to work out system for storing and
changing overlays
• Need to ensure vocabulary is updated
• Harder to maintain in many ways
Dynamic Display
• May be more durable
• Usually rechargeable
• Tools for generating pages in device – and
sometimes in free software too
• Can change vocabulary on the spot
• Can change pages and levels easily
• Generally offer a wider range of access
options
Access Options
• For a user who need alternative access,
SGDs can offer:
• Large range of access options
• Flexibility
• Complete control over device and other
software
Scanning and Eye Gaze
High Tech Scanning
Scanning
Low Tech Scanning & Eye Gaze
• Add movie file here
Eye Gaze
Eye Gaze
Mainstream Mobile Devices for
AAC
There’s an App for that!
Over 100 AAC Apps
www.spectronicsinoz.com/article/iphoneipad-apps-for-aac
It started with Proloquo2Go...
• How do I choose?
• Are they worth the
cost?
• What do they offer
that traditional
speech generating
devices don’t?
• What don’t they
offer that traditional
SGDs do?
iPad
Media, Stories, Opinion
 Media, Stories, Opinion
http://socialtimes.com/iphoneipad-app-helps-autistic-children-
communicate_b10778
 Media, Stories, Opinion
www.spectronicsinoz.com/blog/resources/2011/04/aac-apps-
speaking-appropriately/
Media, Stories, Opinion
•Apple iPad2 launch
 Media, Stories, Opinion
•http://www.wired.com/geekdad/2011/03/ipads-are-not-a-miracle-for-
autism-geekdad-opinion/
Apps with Symbols/Pictures
Apps with Symbols and Text-to-
speech
My Voice
Apps with text only
Traditional SGDs
 Research

http://aac-rerc.psu.edu/index.php/pages/show/id/46
Accessories
Access
Other mobile devices
Resources
• www.spectronicsinoz.com/blog/apple
• http://a4cwsn.com/
• iTeach Special Education – iDevices in
Special Education (Facebook group)
• Assistive Technology (Facebook Group)
Expertise
Case Study
Additional AAC options to
support good practice
• Yes/No ++++
• Small Talk
• About Me Books
• Storytelling
• Social Scripts
• Partner Focused Questions
• Introducing yourself
• Taking non-obligatory turns
Social Communication
• Social communication is a BIG part of our
day.
• We use different forms of social
communication – small talk, storytelling,
greetings, wrap ups and farewells.
Social Communication
• Social communication is more than 50% of our
daily conversation.
• Light (1998) found that reasons for
communication between adults were (in ranked
order)
• Social closeness
• Social etiquette
• Information transfer
• Wants and Needs
Small Talk
• A type of conversational exchange used for initiating and maintaining
conversational interaction.
• Some conversation never progresses beyond small talk e.g. at a cocktail
party.
So…. Let’s get more social!
Small Talk
Small Talk
• Small talk is used as a transition between the greeting
and information sharing stage, especially when people
don’t know each other well or don’t possess a lot of
shared information.
• Small talk is often the first step towards social closeness.
• A quick check at Amazon showed 16 books aimed at
helping people improve their small talk skills. Including
“How to get people to like you in 90 seconds”.
• There are even websites to teach you how to small talk!
e.g. www.ehow.com, www.englishclub.com,
www.ivillage.co.uk and many more!
AAC Users and Small Talk
• Many AAC users use little or no small talk
• This can be because
• They don’t have access to small talk in their
communication system
• They don’t see the need for it
• They think it is a waste of time.
• Light and Binger (1998) found that AAC
users were seen as more intelligent,
valued and competent communication
partners if they used small talk.
Generic Small Talk
• Generic small talk is small talk that people can use with a variety
of different conversational partners because it doesn’t refer to
specific shared information.
• Particularly effective for many AAC users as it has many
different uses.
Generic Small Specific Small
Talk Talk
How is your How is your
family? wife?
What’s What are you
happening? doing?
Don’t you look Nice haircut.
nice!
She’s great. She’s a great
teacher.
Generic Small Talk
• Several groups of researchers at the University of
Nebraska-Lincoln looked at the frequency and types of
generic small talk used by speakers of various ages
without disabilities.
• 3 – 5 year olds - 48% of all utterances at both home and
pre-school/school were generic small talk
• 20 – 30 year olds - 39% of all utterances were generic
small talk
• 65 – 74 year olds – 31% of all utterances were generic
small talk
• 75 – 85 year olds – 26% of all utterances were generic
small talk
Generic Small Talk
• Most of the age groups used continuers as
the most common form of small talk.
• Really? Yeah? Great! Cool!
• Go to aac.unl.edu for more detailed
information.
Differences in Small Talk
Vocabulary
• The small talk vocabulary lists showed that
some words were used more frequently than
others e.g. OK
• Some words were common across all age
groups e.g. great
• Some words were specific to certain age groups
e.g. “bummer” was used by the 25 – 35 year age
group but not by the others.
• Small talk also differs based on your friendship
groups, your geographical location, your
interests and life experiences.
Small Talk and Mealtimes
• Balandin and Iacono (2000) found that it was
nearly impossible to script the content-specific
vocabulary needed for mealtimes for an adult in
the workplace (although there was a good
chance on Mondays and Fridays that footie
would be the topic during the footie season).
• In this situation, the only predictable thing was
small talk.
Pre-school Generic Small Talk
Adult Generic Small Talk
George’s Small Talk
George’s Small Talk
• 21 year old male with athetoid cerebral
palsy
• Attends a day centre for young adults
• Uses a Dynavox 3100 but only uses the
spelling page
• Controls communication device with a
head switch
George’s Small Talk
• Over 20 other people with disabilities and 6 staff
attended George’s centre, most of whom talked.
• George rarely used his device during the day.
• Staff requested a review of his device because
he didn’t “ever” use it.
• George had previously had a setup with core
vocabulary on his device but found it frustrating
to find words he wanted when he could just spell
them.
George’s Small Talk
• A speech pathology student observed him in two
sessions. He “used” his device constantly but only
spoke with it twice.
• George was accessing his device with a head switch and
block/row/column scanning. She observed that by the
time he had formulated a message the conversation had
moved on and he erased and moved onto a new
message.
• A two pronged approach was used. Firstly, a
conversational topic was established before each group
e.g. “What are your favourite films?”. This allowed
George to compose messages in advance.
• A small talk page was programmed and George
practiced using this in one-to-one and then small group
conversation.
George’s Small Talk
• At the end of 8 weeks the same speech
pathology student observed George in the same
two sessions.
• George used his device 46 times. Five of these
were topic setters, 41 were small talk continuers.
• Several other people in the centre commented
spontaneously that “George was much cleverer
than they thought” or that “They enjoyed talking
to George much more”.
• And….he’s still using it!
Sequenced Social Scripts
Sequenced Social Scripts
• Sequenced social scripts can really help a
user to
• Get a 'feel' for the anatomy of a conversation
• Develop turntaking skills
• Learn to interact with a variety of partners.
What are Social Scripts?
• They support students in learning to claim,
start, and maintain turns in a conversation.
• Much of the information in this section is
taken from “Can We Chat? Co-Planned
Sequenced Social Scripts: A Make It /
Take It Book of Ideas and Adaptations” by
Caroline Musselwhite and Linda Burkhart
• Also called Participation Scripts
What are Social Scripts?
• Social Scripts are interactions such as
joke-telling, sharing life stories and general
conversations.
• They help persons using augmentative
and alternative communication (AAC)
move beyond wants and needs to using
'real' communication for conversational
purposes.
• Often give developing communicators a
sense of the power of communication.
Anatomy of a social script
• Attention getters
• Starters
• Maintainers, holders and interjections
• Turn transfers
• Closings
Attention Getters
• These are the phrases that start an
interaction and make sure that someone is
ready to listen.
• Creative attention getters can motivate a
listener to be interested in hearing more.
They can also change perceptions of
others about the child who is using the
script, by conveying, humor, age
appropriateness, and initiative.
• AND they can be very motivating to use!
Hey, you guys
Waz up
Dude
Yo
Helloo
Come here
Let’s talk
Starters
• Starters are used once attention is gained. They
set the stage for what the child will be talking
about.
• Setting the context further prepares the listener
and allows the child to take charge of the
conversation.
• Like attention getters, creative starters pique the
interest of the listener and often get a natural
response that encourages the child to go on and
tell the story, complete the joke, etc.
Guess what I did?
I have a secret!
Wait till you hear what I heard!
You won’t believe this
Did you see the game?
I’ve got something to show you
Wanna hear a joke?
Maintainers, Holders and
Interjections
• These are phrases such as "Shall I give you a
hint?", "You know what happened next", "You
will never believe what she said after that", "It
was so awesome", It was really scary", etc.
• They allow the child to add interest to the basic
story line while maintaining control of the
conversation.
• They also prompt the listener to make comments
and naturally encourage the child to tell the rest
of the story.
And then
It was so funny
Guess what happened next?
Wanna hint?
I hate that!
Can you guess?
I’ll give you a clue
It was so embarrassing
And then it got even worse
Turn Transfers
• After the child has communicated his story, or
sometimes in the middle of a longer story, turn
transfers invite the listener to comment or give
their opinion.
• They give the child the power of turning the
conversation over to a partner, without ending
the conversation.
What do you think?
Isn’t it amazing?
Can you believe it?
You won’t tell anyone will you?
How about you?
Is that amazing or what?
What did you see?
Closings
• Closings allow the child to take the initiative of
ending the conversation. This helps the listener
and also avoids that awkward feeling of “well is
that all?”
• Again the child’s personality and humor comes
through in the choice of closings used.
• Often several closings in sequence are
appropriate, because people typically take
several turns when finishing a conversion.
Nice chatting with you
Enough about that
What have you been up to?
Catch you later
Can you find someone else for
me to tell about this?
Hasta la vista baby
Exercise
• In pairs pick a topic e.g. Joke, prank,
gossip, message
• Generate a sequenced social script
• Find another pair and try your script out
Anatomy of a social script
• Attention getters
• Starters
• Maintainers, holders and interjections
• Turn transfers
• Closings
About Me Books
• Communication Passports
• Personal Photo Stories
Communication Passports
• Template available from CALL Centre
Scotland
• www.communicationpassports.org.uk
• iPhone App coming soon
• Also from SCOPE UK at
http://www.scope.org.uk/help-and-
information/publications/scope-
communication-passport
Communication Passports
• Useful for exchanging information about
an AAC User between others
• Often not a tool used by the AAC user
directly
Personal Storytelling
• As we get older the percentage of small talk
decreases and the percentage of storytelling
increases.
• Older adults, in particular, use stories to
entertain, teach and establish social closeness
with their peers.
• As individuals lose their spouses and move to
retirement and care facilities the need to socially
connect with individuals their own age becomes
important and storytelling becomes a vehicle for
this.
Personal Storytelling
• Schank (1990) discussed story formulation,
refinement and storage in detail. He found a few
different “types” of stories in common use:
• First person stories
• Second person stories
• Official stories
• Fantasy stories
• Marven et al (1994) found that for preschoolers,
9% of their communication at home and 11% at
preschool involves fantasy of some sort.
AAC and Storytelling
• Storytelling with AAC systems has
become practical and possible with
improved technology.
• However, we must be careful that the
stories are ones which the person would
choose to tell.
• Storytelling is very personal and must be
individualised.
John’s storytelling
John’s “chat” cards
• John is an 11 year old with autism spectrum disorder.
• John uses words (which are mostly intelligible to familiar
people), signs and a multi-page communication book.
• John also has some challenging behaviour.
• Five years ago, John had challenging behaviour every
night when he got home from school.
• His mum felt that this was due to his frustration over
trying to tell her about his day.
• His team decided that “chat” cards about his day would
help.
• They setup a process to write a sentence about each
day.
John’s “chat” cards
John’s “chat” cards
John’s “chat” cards
John’s storytelling
• Many of John’s old chat cards are in a milk crate in his
room.
• John began spontaneously using them with new people
a couple of years ago.
• He selects a few cards and then brings them to the new
person. They read them with him and if they show
particular interest in one topic e.g. playing basketball he
will go and get more things around this topic.
• He brings out fewer chat cards as people become more
familiar with him and understand more of his speech.
Ted’s Storytelling
Ted’s Storytelling
• Ted is a 78 year old who had a CVA when he was 72.
• Following the CVA he regained some spontaneous
speech, mostly small talk. He can understand
everything that is said and can read the paper and
magazines. He cannot speak (apart from small talk) and
he cannot write.
• Prior to the stroke he was president of his local RSL
Club. His wife and his friends miss his storytelling.
• His wife was able to work with him and write out many of
his stories. These have now been stored in a Macaw,
with one of his friends doing the recording.
• He and his wife are delighted as he is once again able to
tell stories and delight his family and friends.
Personal Photo Stories
• A series of photos about a person to give
the “listener” a sense of who the person is
• Can be used to let them have a
“conversation” with their “listener”
Sarah’s Storytelling
Sarah’s Storytelling
• Sarah is a woman in her sixties who lives in her own
house.
• In her forties she was in a motor vehicle accident and is
now a quadriplegic.
• She has a good understanding of spoken English but
very limited expressive communication, including very
little facial expression.
• She has control of a single switch with her left thumb, but
tends to fatigue quickly, although her stamina is
increasing.
• She has a multi-level communication book which she
accesses with eye pointing.
Sarah’s Storytelling
• She has a range of in-house care staff
who tend to stay around for between 5
months and 3 years.
• Many of these staff assume she doesn’t
understand what is said to her because
she doesn’t give body language feedback.
 Sarah’s Chat Book
Inside this book are some of my photos. The writing tells you
about them. The questions are things I am interested in about
you. Please read out the writing and the questions and we can
find out about each other together - but be warned - it might
take more than one visit!

Sarah
•I was born in 1943, but this is the first decent photo of me -
sitting at the piano when I was 11 like a good girl! You won’t
see that often.
•Did you learn an instrument? If so, what was it?
•Me and my cat in 1955. I’m the one on the right.
•Did you have a pet as a child. If so, what was it?
•What was its name?
•This is me in 1957 with my family. My brother and I are up
the back, my mother and sister are in the middle and my
father is at the front.
•Who is in your family?
•And here starts the party girl era….
•20 years old and ready for anything
 •Party, party, party.
•Are you a party person?
 •Recognise me? I’m one of the goddesses at this toga party.
•Have you ever been to a toga party?
•There’s me (left), Bob, Delilah, Juno, someone’s back and Helen.
•And here we are - Peter and I in late 1978 just after we’d
met.
•And here’s the wedding invite. It all happened very quickly
- we were married less than a year after we’d met, in
October 1979. It was a wonderful time.
•The wedding day - myself and Pete.
•Peter loved sailing. This was a fantastic day. It would have
been sometime in 1984.
•Have you ever been sailing? Do you like it?
•On the 12th of July 1985, Pete and I were hit by a car as
we were walking to a restaurant for dinner.
•My life completely changed after that. Pete died as a
result of the accident and I am now severely physically
disabled.
•Pete and I had over six wonderful years together. I still
miss him very much as you can imagine.
•Luckily, I have many great friends and they, and my own
determination, have helped me to keep going.
•And in 1991, getting familiar with the options in
communication technology at the time.
•And on to 2002 - some things never change. Recovering
from a party and Melbourne Cup day.
•Do you enjoy a flutter on the cup?
Sarah’s Chat Book
• Sarah’s chat book has completely
changed the way staff see her.
• Each new staff member sits down and
goes through the book with her over a few
different sessions.
• They realise how interested Sarah is in
them and they gossip with her more.
• It also gives them topics to talk about that
they think will interest her.
Maggie’s Storytelling
• A series of photos about a person to give
the “listener” a sense of who the person is
• Can be used to let them have a
“conversation” with their “listener”
http://sheldonhickey.com/maggie/All%20about%20me/index.html
Just how important is social
communication?
• In Building Communicative Competence
with individuals who use Augmentative
and Alternative Communication Light and
Binger (1998) looked at just three different
social communication skills.
• 1. Use of an introductory strategy when
meeting new people
• 2. Use of nonobligatory turns to increase
participation in social interactions
• 3. Use of partner-focused questions to
demonstrate an interest in the partner.
Use of an introductory strategy
when meeting new people
• Teaching a 35 year old with a closed head injury to use
an introductory strategy to explain his use of AAC and
his communication resulted in much more positive
interactions with unfamiliar people, with fewer
breakdowns and made the new partners more at ease.
• Teaching a 44 year old with cerebral palsy to use an
introductory strategy allowed her to be more confident
and assertive with new people. Twenty adults with no
previous experience of AAC viewed tapes of Maureen
meeting new people pre and post. 100% of them
reported she was a more competent communicator when
she used an introductory strategy.
Use of nonobligatory turn taking
• Teaching a young (4½ year old) child with cerebral palsy
to use non-obligatory turn taking via AAC meant that the
child was initiating more frequently and was more eager
to participate in group activities. One of her peers said
she was more fun to play with. Her speech improved and
she acquired 30 new words.
• Teaching a 14 year old with autism to take non-
obligatory turns also resulted in a increase in initiating
and turn taking. There was a decrease in his
inappropriate behaviours and he was less disruptive in
class. 20 adults who were not familiar with AAC rated his
pre and post videotapes and rated him as a much more
competent communicator in the post tapes (although
they didn’t know which were pre or post).
Use of partner focused
questions
• Teaching a 13 year old child with developmental
disability to use partner focused questions
produced a change in the focus of his
interactions. His partners began to see his
communication as more appropriate.
• Teaching a 24 year old with athetoid cerebral
palsy to use partner focused questions meant
that he became a more valued communication
partner with those he regularly communicated
with.
So how do I decide what’s
important in an AAC system?
• Beukelman (2004) wrote that
“vocabulary selection in AAC can be
viewed as the process of choosing a
small list of words or items from a
pool of all possibilities”
Choosing vocabulary for pre-
literate individuals
• For people who are pre-literate those designing
an AAC system face a hard task. Generally we
consider there are two forms of vocabulary for
this group – vocabulary that is needed to
communicate essential messages and
vocabulary to develop language (which includes
small talk and narratives).
• Many people like to make this decision around
core vocabulary ie words and messages which
are commonly used and occur frequently. Small
talk vocabulary fits well within these criteria.
Choosing vocabulary for non-
literate individuals
• Aim to meet their daily, ongoing
communication needs in a variety of
environments.
Choosing vocabulary for literate
individuals

• For literate individuals, they may need

some phrases or words which need to be
pre-stored for quick access either so they
can participate in the conversation in a
timely way or so they can reduce fatigue.
What do we know about aided AAC
use?
Many people who use AAC

• (Kraat, 1985; Light, 1989; Muller and Soto, 2002)

• Play a passive role

• Rarely initiate interaction
• Express a limited number of speech acts
• Use restricted linguistic forms
• Limited opportunities to interact with
other people
Communication board use is
frequently less than one might
expect.
When the communication board is
used, it is often used primarily to
provide information requested by
the facilitator.
The range of communicative
functions produced is typically
restricted.
Functionally non-speaking partners
tend to assume a respondent role
using primarily yes/no answers and
other short provisions of
information.
Patterns of turntaking, initiation and
conversational control tend to be
asymmetrical in nature ie the
speaking partner dominates the
conversational exchange.
Speaking partners are frequently
observed a) to ask closed-ended
questions and specific Wh-
questions and b) to repeat and
rephrase previous turns, often
initiating topics without expecting a
response from the child.
In the classroom setting, AAC
users tend to communicate
predominantly with the adults in the
class, not their classmates.
AAC should be…
Used frequently, interactively and
generatively to express a wide
range of communicative intents;
 Occurring during at least 80% of
ongoing classroom programming
(as speech or manual sign use is);
 Being used to mediate
communication with classmates as
well as personnel (ie teachers,
aides, therapists, clinicians);
Being designed and implemented
in as time and cost effective a
manner as possible.
What we know
• Communication displays and devices are
often not used
• AAC users are typically responders not
initiators
• Interaction patterns focus on “closed”
questions such as “What do you want?”
• Conversational partners control interactions
(turn taking is unequal)
• Peer interaction is minimal

(Kraat, 1985)
Four main issues
• Lack of Modelling
• Lack of Access to Vocabulary
• Communicative Competence
• Passivity/Learned Helplessness
We know how to fix this...
• We just need to do it!

• And model, model, model