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Fresh science and pioneering practice
134
JCPSLP
Volume 17, Number 3 2015
Journal of Clinical Practice in Speech-Language Pathology
Pariya Behnami
(top) and Sally
Clendon
THIS ARTICLE
HAS BEEN
PEER-
REVIEWED
KEYWORDS
AUGMENTATIVE
AND
ALTERNATIVE
COMMUNI
CATION
EARLY
INTERVENTION
LANGUAGE
This paper explores the appropriateness and benefits of
implementing augmentative and alternative communication
(AAC) for children under the age of five. Despite the
acceptance of the importance of intervening as early as
possible with children with disabilities, and the evidence
base supporting the use of AAC with individuals with
complex communication needs (CCN), a number of myths
have hampered the provison of AAC to young children.
These myths will be examined, and existing research will be
explored to identify what modes of AAC and supports have
been shown to be effective. Finally, the paper will provide
suggestions of where to begin with AAC intervention by
discussing implications for clinical practice from research
findings and advice from field experts.
AAC
AAC is a term used to describe “the use of non-speech
modes as a supplement to, or a substitute for, spoken
language” (von Tetzchner & Jensen, 1996, p. 1). AAC
systems can be no-tech, low-tech, mid-tech, or high-tech.
Examples of no-tech systems include sign language and
communication boards or books. These systems are
no-tech as they do not require a power source. Low-tech,
mid-tech, and high-tech systems do require a power
source and vary in terms of their programming complexity
and the amount of training required (Assistive Technology
Training Online Project, 2000–2005). High-tech systems
also differ from low- and mid-tech systems in that they can
store large amounts of vocabulary and therefore enable
more complex message generation. No-tech systems may
also provide access to a large amount of vocabulary.
When discussing high-tech AAC systems, it is important
to acknowledge the significant role that technology plays
in the lives we lead today and the crossovers occurring
between mainstream technologies and AAC. The advent
of mobile technology such as tablets and smart phones
has resulted in technology becoming pervasive, heavily
influencing areas such as social communication and access
to information. Recent evidence exploring the impact of
this for young children suggests that access to technology
facilitates the development “of a huge array of skills,
knowledge, and understandings about the world in which
they live” (Yelland & Gilbert, 2014, p. 2).
The increased availability of technology, particularly
mobile technology, has resulted in more widespread
use and acceptance of AAC. Light and McNaughton
(2014) recently re-examined Light’s (1989) model of
communicative competence for users of AAC. They
This paper explores the appropriateness and
benefits of implementing augmentative and
alternative communication (AAC) with
children under the age of five. It outlines a
number of myths related to the use of AAC
with young children and examines the
existing evidence base in order to identify the
modes of AAC that have been shown to be
effective. Finally, the paper provides
suggestions of where to begin with early
intervention involving AAC with reference to
key research findings and advice from field
experts. These suggestions include following
language progression models based on
typical language development, focusing on
highly motivating interactions to teach the
power of communication, providing
communication partners with robust
coaching, having high expectations, using a
multimodal approach, targeting operational
skills alongside communication intervention,
and providing extensive aided language input.
I
t is well researched and widely accepted across
education, medical, and allied health communities that
early intervention (EI) for children with disabilities results
in ongoing, significant positive outcomes. These include
improvements in important domains such as cognition,
communication, and motor skills (Landa & Kalb, 2012;
Miller & Guitar, 2009; Spittle, Orton, Anderson, Boyd, &
Doyle, 2012). The benefits also extend beyond children,
with positive outcomes for families including enhanced
parent–child interactions (Ciccone, Hennessey, & Stokes,
2012) as well as increased parental self-esteem, decreased
stress, and greater use of community resources (e.g.,
Benzies et al., 2014). Furthermore, effective EI allows for
more cost-effective service delivery which is critical in the
current financial market (Drager, Light, & McNaughton,
2010; Eapen, Crncec, & Walter, 2013). An understanding
of the benefits of effective EI provision is important
for a range of people and services including: families,
clinicians, educators, support staff, management, training
services, and fund holders. Alongside the importance
of understanding the benefits of EI is the importance of
knowing how to implement effective EI.
Early intervention
and AAC
Research and expert recommendations
Pariya Behnami and Sally Clendon