There are three basic AAC modalities: vocalization and speech, graphic-based communication aids (e.g. communication boards and voice output communication aids), and gestural and sign languages. (See The main categories of AAC and Aided vs. unaided systems.) In general, different teaching techniques will work with any type of AAC. There are, however, a few issues that are specific to the mode of AAC.

The main issue in teaching speech and vocalization is that a child has to be able to imitate, since it is not possible to use physical guidance to assist the child. (See Prompts given by another person.) While this makes teaching more difficult, vocalization and speech are such efficient methods of communication, that is worthwhile putting in time and effort if these skills can be advanced.

Indeed, it is possible to teach a currently non-vocal child how to begin to imitate sounds (Reichle, York, & Sigafoos, 1991).

Help me—and everyone who reads this site—by mailing your suggestions, criticisms and personal experiences to Ruth Ballinger at yaack@iname.com

This is done by first increasing the frequency with which a child vocalizes, and then teaching the child to imitate sounds made by an adult. To increase the frequency of vocalization the child can be reinforced (ideally with attention) every time he or she produces any sound.

Once the child is vocalizing on a regular basis, he or she can be taught to imitate. At first the adult starts by imitating sounds produced by the child. This encourages the child to repeat the sound, which the adult can, then, repeat again. The adult continues this sequence of imitating the child's sounds, and eventually begins to lengthen the time between the child’s output and the adult’s repetiton. When this delay is very long, and if the child is continuing to take his or her turn relatively quickly after the adult's turn, it can seem as if the adult is initiating the sound with the child imitating the adult.

In teaching a beginner how to use a communication board or voice output communication device (VOCA), initially the simplest setup—a single picture or symbol—may be used (Reichle, York, & Sigafoos, 1991). It is, however, often useful to add a "distractor," that is another choice, but one which is blank and does not result in anything. This prevents the child from thinking that the objective is simply to inidcate any symbol on the board, or to indicate the board itself. In addition, it helps to periodically change the position of the two choices so that the child is not always indicating the same location on the board. This is can be more cricital with communication boards which lack the verbal feedback of voice output communication aids (VOCAs).

Other issues with graphical AAC is that, in addition to understanding what the message symbols mean, the child must learn how the messages are organized, and how to locate them, and the child will have to learn either direct selection or scanning techniques (Reichle, York, & Sigafoos, 1991).

OTHER RESOURCES:

• Mike Gregory 's Nov. 6, 1997 e-mail posting under "Communication Boards" describes issues in conversing with a communication board on the ACOLUG listserv archives at listserv.temple.edu/cgi-bin/wa?A2=ind9711&L=acolug&F=&S=&P=5764.

Graphic AAC users (e.g. communication board or VOCA users) have vocabulary selection issues because what they are able to communicate depends on the vocabulary that is available to them on their device. Vocabulary has a tremendous impact on whether an AAC device is used or not. If the vocabulary on a device is not motivating or useful to the child, he or she will most likely seldom use it. Therefore, what the child wants to say should rank as the most important factor in determining what messages to put on a device.

It is easy to fall into the trap of emphasizing only vocabulary that adults would like the child to say in order to increase the child’s independence, cognitive or academic standing or self-help abilities, or to foster other well-meaning skills. Nevertheless, if the vocabulary does not at least partially encompass what the child wants to say, the AAC device may simply not be used, and the adults may never know why (Mirenda, & Iacono, 1990).

Here are some rules of thumb in vocabulary selection:

• Use vocabulary that is age-appropriate. For example, include phrases like "Cool," or "Gross."

• Include greetings and a self-introduction that feels comfortable to the child. Being able to initiate a greeting appears to make a noticeable difference in generating positive attitudes towards the user, particularly among persons unfamiliar with AAC.

• Keep the vocabulary up-to-date. This can be very time-consuming but is extremely important. It allows the child to participate in new activities or curriculum and to talk about the latest events, all of which are important to the child’s academic and social status.

• Vocabulary that others use may be programmed into the child's device as well so that partners may also be able to use the device. When others use the child’s AAC, the child is able to learn through imitation. (See Simultaneous communication.)

• Provide a wide variety of types of words to assist the child in progressing towards increasingly sophisticated sentences. For example, a child may initially use single words, mostly nouns. Later verbs may be added, and then pronouns, etc. as the child is able to string more words together and to produce more complex sentences. (See Teaching sentence structure.)

There are several methods used in deciding what vocabulary to put onto a device. Frequently more than one strategy is used (Beukelman, & Mirenda, 1992; Fried-Oken, & More, 1992; Goossens', 1989; Goossens' & Crain, 1987; Marvin, Beukelman, & Bilyeu, 1994; Marvin, Beukelman, Brockhaus, & Kast, 1994).

• Vocabulary based on the routines and activities in which the child is or will be involved. (See The ecological approach: Focusing on participation.) This is one of the most recommended approaches. Essentially, it involves analyzing the vocabulary that the child needs in order to participate more fully in the routines and activities that make up his or her day. For example, the child needs certain messages during mealtimes, other messages while playing with siblings, others during school activities, etc. Often these messages are organized so that all the vocabulary that the child needs for a specific activity is located on a single page. This means that words used in a variety of activities will be duplicated. However, it offers tremendous advantages in terms of speed, which is considered extremely important in normalizing conversation among AAC users. (See Organizing vocabulary for speed and Conversational control vs. conversational efficiency.)

• Preselected vocabulary already available on commercial AAC devices or symbol sets.

• Word lists based on research in child language usage among children with and/or without disabilities.

• Categories based on grammatical usage, such as nouns, verbs, adjectives, etc.

OTHER RESOURCES:

Help me—and everyone who reads this site—by mailing your suggestions, criticisms and personal experiences to Ruth Ballinger at yaack@iname.com

• "Functional Language Instruction for Linguistically Different Students with Moderate to Severe Disabilities" by Elva Duran at www.cec.sped.org/digests/e501.htm. Although this focuses on children who are culturally and linguistically different, much of it pertains to AAC users who can, in effect, be considered culturally and linguistically different.

• "AAC Messaging and Vocabulary" lists vocabulary words and phrases used by preschool and school-aged children at home and at school at aac.unl.edu/vbstudy.html.

• "Augmentative and Alternative Communication Messaging: Vocabulary, SmallTalk, and Narratives" compiled by David R. Beukelman is a comprehensive bibliography on vocabulary selection issues at aac.unl.edu/VSRef.html.

Organizing vocabulary is necessary only on communication boards, voice output communication aids (VOCAs), and other graphical AAC systems. The main purpose of organizing vocabulary is to increase the speed at which communication can take place. Speed is one of the main factors in normalizing the conversation between an AAC user and his or her partner. (See Conversational control vs. conversational efficiency.)

The following are techniques used to organize vocabulary (Beukelman, & Mirenda, 1992; Goossens', 1989; Goossens' & Crain, 1987).

• One symbol can be used to represent a complete concept. For example, a picture of a cup can mean "I want a drink."

• A highly recommended method of organizing vocabulary is the thematic approach in which vocabulary is grouped by activity. Every page or overlay of vocabulary contains words used in a single activity. When a new activity is begun, a new page or overlay is used, complete with the vocabulary for that activity. Using this method, the child does not have to access different overlays to find vocabulary. This also means that commonly used vocabulary words, for example "I," "want," "yes" and "no," must be repeated on each overlay. (See The ecological approach: Focusing on participation.)

  Help me—and everyone who reads this site—by mailing your suggestions, criticisms and personal experiences to Ruth Ballinger at yaack@iname.com

• Two types of symbol organizational systems that are widely used on VOCAs today are Minspeak and Dynamic Display. (See Minspeak vs. Dynamic Display.)

OTHER RESOURCES:

• "Creating communication boards and displays" by Patricia Dellacecca, Joyce Hignett, and Kerri-Lee Turcotte at www.closingthegap.com/cgi-bin/lib/libDsply.pl?a=1009&b=4 describes the issues in issues dealing with organizing a communication board display.

• "Minspeak Conference Proceedings" by Semantic Compaction Systems at www.lti.cs.cmu.edu/scs/procs.html.

When obtaining a device, whether by borrowing, rental or purchase, it is essential to get a complete set of operational manuals in order to be able to use it correctly and efficiently, and to be able to troubleshoot if problems occur. Some companies also maintain telephone or e-mail help lines which can be extremely useful. In addition, contacting other users is another invaluable way to get help and support. (See Finding answers to specific AAC questions.)

OTHER RESOURCES:

• "AAC Device Tutorials and Checkouts" offers several AAC tutorials at aac.unl.edu/AACTU/tutoring.html.

• "Tutorials" under "Print Resources" are tutorials on how to use various AAC devices at www.aten.ocps.k12.fl.us/printres.html.