Supporting Young Children with Augmentative and Alternative Communication Needs

This module expands on the ECPC curriculum modules for the EI/ECSE Standards. The learning resources provided are designed to be used in both pre-service and in-service to facilitate the integration of the knowledge and skills addressed by this topic. The learning resources specifically address the augmentative and alternative communication (AAC) needs of young children, criteria used to evaluate for AAC, and effective evidence-based strategies used for supporting young children with high-intensity communication needs and their families.

The following EI/ECSE Standards and components are addressed in this curriculum module.

  • Standard 3: Collaboration and Teaming, Component 3.1
  • Standard 4: Assessment Processes, Component 4.2
  • Standard 6: Using Responsive and Reciprocal Interactions, Interventions, and Instruction, Component 6.7

Purpose

The purpose of this module is to (a) introduce augmentative and alternative communication (AAC) fundamentals, (b) discuss strategies and tools for supporting children who have AAC needs and (c) describe important evidence-based techniques for implementing AAC intervention and supporting communication development. The learning resources provided are designed to be used in both pre-service and in-service to facilitate the integration of the knowledge and skills to support young children with autism spectrum disorder and their families. It is designed to be used flexibly for preservice and ongoing professional development.

Objectives

After engaging with these resources, learners will be able to:

  • Define augmentative and alternative communication
  • Identify myths and misconceptions about AAC
  • Describe a continuum of augmentative and alternative communication (AAC) tools, strategies, and techniques
  • Describe the criteria used to identify children who can benefit from AAC tools and strategies
  • Plan for supporting AAC in home, educational, and recreational environments
  • Demonstrate understanding of the factors impacting AAC access including parental perspective and communication, interdisciplinary collaboration, public policy and use of evidence-based practices
  • Describe the benefits of AAC for children with diverse communication skills

PowerPoint Presentations:

This sample syllabus provides ideas for resources, activities, readings, and assignments, aligned with the EI/ECSE standards.  Consider state and university policies and add them as appropriate.  This is a sample only and is not a complete syllabus.

What Learners Should Know and Be Able to Do

Learners Who Have Mastered this Component/Topic Know and Understand:

  • Definitions of AAC
    • Aided and Unaided language
    • No technology, Lite technology, and High technology solutions
    • Multimodal communication
    • Aided language modeling
    • Core and Fringe vocabulary
    • Dedicated and integrated speech-generating devices
  • Developmental milestones to consider in AAC decision making
  • That AAC tools and techniques are not mutually exclusive
  • Evidence-based practices for identifying and supporting young children who can benefit from AAC
  • Resources to support young children and their families who can benefit from or already use AAC.

Learners Who Have Mastered this Component/Topic Are Able To:

  • Work together as a team to plan and implement supports and services to meet the unique needs of each child and family.
  • Work with families and other adults to identify each child’s needs for assistive technology to promote each child’s access to and participation in learning experiences.
  • Work with the family and other adults to acquire or create appropriate assistive technology to promote each child’s access to and participation in learning environments.
  • Gather and use data to inform decisions about individualized instruction.
  • Work as a team with the family and other professionals to gather assessment information
  • Use a variety of methods, including observation and interviews, to gather assessment information from multiple sources, including the child’s family and other significant individuals in the child’s life.
  • Work together as a team to plan and implement supports and services to meet the unique needs of each child and family.

Multimedia Illustrations

This section includes short videos, video vignettes, TED Talks, and webinars that relate to the topic. The majority addresses the evidence-based practice for adult learners of illustration.  Some are informational and relate to the practice of introduction.

Component and Title Key Content Duration Link
4.2 Introduction to AAC The video presents how AAC can be a solution that helps people effectively and efficiently communicate. 15:38 View
6.7 Aided Language - AAC A conversation about using aided language to enhance AAC. 8:39 View
3.1, 4.2 AAC in Everyday Routines This video helps learners understand how to embed AAC in everyday routines. 18:26 View
3.1 AAC Partner Strategies An overview of strategies used to enhance communication. 13:32 View
4.2, 6.7 AAC: Modeling, Prompting, and Responding In this video, the child is making choices with a high-tech AAC device while the teacher models the use of the device. 3:38 View
6.7 Respond to AAC In the video, the instructor teaches a child to respond to her peer’s communication attempts with his AAC device using a token system. 10:03 View
4.2 Five Common AAC Myths A quick overview of common myths about using AAC. 2:19 View

Learning Activities

The projects or assignments below require learners to apply the practices/skills related to Supporting Young Children with Augmentative and Alternative Communication Needs.

  1. Needs assessment (Standard 3, Component 3.1; Standard 4, Component 4.2)

Consider a child on your caseload or someone you’ve met who does not use speech as a primary means of communication. Describe their present needs (list communication functions, environments, partners, types of messages, and AAC options available / needed). Estimate future needs in six months and in one year. Given the needs you’ve identified and the skills you know them to have, what stage of language development do you suspect the individual is at? How would you introduce alternative language symbols to help them move to the next stage (or closer to) of language development? Describe behaviors (typically from observational assessment) that influenced your decision.

2. System design activity (Standard 3, Component 3.1; Standard 6, Component 6.7)

One of the biggest differences in working with children who have complex communication needs versus other children is that you must think about symbols to communicate information. Children need a variety of modes for communicating information to allow them to be independent across a wide variety of environments and times of the day. You are tasked with developing two different systems for a child (see case studies provided below, or you may use your own). Include body-based communication and lite technology options. As you are planning consider the child’s needs and the communication situations and partners that may impact your decision-making. Make sure your AAC options provide as much communication coverage as possible (e.g., be thoughtful about core and fringe vocabulary.

Case Studies

Sheila is a 4-year-old girl who has autism. Her expressive vocabulary is around 50 words with few two-word combinations in highly structured interactions (e.g., lunch request; arts /craft activity). She has some vocalizations and a close approximation of speech sounds, but primarily uses her communication notebook to generate basic 1–2-word utterances. She appears to understand more than she can express and benefits from having directions given in one or two steps. She appears to have an interest in interacting with some of her peers but has trouble engaging with them. How might you help Sheila have more interactions with her peers? Are there scriptable routines you might introduce for her and her peers to engage in?

Jim is a 5-year-old boy who has cerebral palsy. He attends a regular education preschool classroom with a 1:1 aid who assists by dictating for Jim. He is an adept user of his AAC system and language software. He is highly social and often organizes group activities (e.g., games) with his peers. Jim has expressed a desire to learn to read and write. How might you help Jim develop literacy skills using his language system and peer engagement? How might you utilize his 1:1 support for his literacy goals?

  1. Which App for that? activity (Standard 3, Component 3.1; Standard 4, Component 4.2)

The purpose of this activity is to give you exposure to, and experience with, searching for, critiquing, and selecting appropriate technology resources (i.e., applications for mobile devices) that have become ubiquitous. Many applications are marketed as targeting specific populations and skills. For the purpose of this activity, it is okay to presume competence in linguistic skills (i.e., symbolic considerations are not required) when selecting application / assistive technology to review for this assignment. Select two applications based AT programs to review and compare. You are welcome to use these examples but are not required to do so. In fact, encouraged to explore other options available (they change regularly). For both apps: Your group will generate a “fact sheet” that offers a description of the program itself, population(s) targeted, skills required to be able to use the program, skills the program intends to build/support, cost and limitations. Compare features/aspects/capabilities of both applications and determine your interest in which app you would purchase for your clinical practice and why. Be prepared to offer a 5-minute, description/demonstration of application software.

  1. Intervention planning activity (Standard 6, Component 6.7)

Using the same child as you selected for the system design activity (or another just be clear about indicating this) consider the following:

    • What is the child’s potential?
    • What barriers do you anticipate to more independent communication?
    • Will your intervention focus on language learning, literacy, social communication, etc.?
    • Generate a script for an activity that you could use to address the focus you select.
  1. Scripting activity (Standard 6, Component 6.7)

Select an activity that is routine for young children you work with. Identify core vocabulary that is used in that activity and identify key/motivating fringe vocabulary that also corresponds to that activity. Think about how to incorporate core words throughout the activity. For example, if making cookies think about how you can incorporate the use of “more” “less” or “soft” and “dry” as well as motivating fringe vocabulary like “chocolate chips” and “cookies”. Once you have identified the vocabulary you want to focus on for your activity decide what you can do and say to create opportunities for the child to practice using those words as well as for the child to see you modeling those words. How will you scaffold success?

Websites

AAC Language Lab

The AAC Language Lab offers real-life solutions in support of language development.

AAC Learning Center

The AAC Learning Center is a free educational resource on augmentative and alternative communication (AAC) and provides presentations by persons who use AAC, short lectures by AAC researchers, and links to information on AAC.

AAC Learning Center Moodle

This site provides resources for learning about augmentative and alternative communication (AAC), and is a joint offering of the RERC on AAC and the AAC program at Penn State University. Topics include AAC for Children (an Introduction), Developing AAC for Children, Family Centered Skills, Funding AAC for Children, and Literacy. For free modules, registration is required.

AAC Specialist

Free products and resources from a respected speech-language pathologist.

American Speech and Hearing Association (ASHA)

The professional organization for speech-language pathologists.

 ASHA’s Practice Portal for AAC

The goal of ASHA's Practice Portal is to facilitate clinical decision-making and increase practice efficiency for audiologists and speech-language pathologists by providing resources on clinical and professional topics and linking to available evidence.

Assistiveware

A leading pioneer in the field of augmentative and alternative communication (AAC) and assistive technology software for iOS and macOS. This website includes videos demonstrating software and technology.

Link Assistive Technology: Choosing a Communication Device

A resource to use when feature matching a child with a communication device.

 National Joint Committee for Persons with Severe Disabilities (NJC)

The purpose of the NJC is to advocate for individuals with significant communication support needs resulting from intellectual disability, that may coexist with autism, sensory and/or motor limitation.

 PrAACtical AAC

Supports a community of professionals and families who are determined to improve the communication and literacy abilities of people with significant communication difficulties.

The Communication Matrix

This nonprofit project is devoted to improving outcomes for individuals with complex communication needs around the world. It offers a free assessment tool to help families and professionals easily understand the communication status, progress, and unique needs of anyone functioning at the early stages of communication or using forms of communication other than speaking or writing.

 The International Society for AAC

A parent organization of USSAAC that works to improve the lives of children and adults who use AAC. ISAAC’s vision is that AAC will be recognized, valued, and used throughout the world. This website includes a video of individuals using AAC systems.

 The United States Society for AAC

An organization dedicated to supporting the needs and rights of people who use Augmentative and Alternative Communication (AAC). This website includes a video of individuals using AAC systems.

Learning Modules

Modules from other sources that relate to the topic. They can be used in their entirety or by selecting sections or content that support the objectives of an IHE course or PD content. The evidence-based practices for adult learners will vary based on the module selected.

Learning Modules

Augmentative and Alternative Communication (AAC): This website describes AAC and includes video examples.

Explore AAC: This module is a brief introduction to augmentative and alternative communication (AAC). The module will define AAC, talk about who uses AAC, describe AAC systems and address the question of when to begin AAC.

Power: AAC: A training series developed by PaTTAN with Gail Van Tatenhove, CCC-SLP. These brief modules support individuals who are supporting young children and students with complex communication needs and who need or use AAC.

Glossary

Term Definition Reference/Resource
Coaching A cyclical process designed to support practitioners, primary caregivers, or other adults to implement interactional or instructional practices with fidelity. Primary components include needs assessment, goal setting, action planning; observation; reflection, and feedback. DEC RP Glossary:

National Center on Quality Teaching and Learning. (2014). Practice-Based Coaching: Collaborative Partnerships. Retrieved from https://eclkc.ohs.acf.hhs.gov/professional-development/article/practice-based-coaching-pbc

Culturally and linguistically responsive and affirming Approaches that empower individuals intellectually, socially, emotionally, and politically by using cultural and historical referents to convey knowledge, impart skills, and change attitudes.

Such approaches involve consciously creating social interactions to help individuals meet the criteria of academic success, cultural competence, and critical consciousness and include creating individual-centered learning environments that affirm cultural identities; foster positive learning outcomes; develop children’s abilities to connect across lines of difference; elevate historically marginalized voices; empower children as agents of social change; and contribute to individual child engagement, learning, growth, and achievement through the cultivation of critical thinking.  These approaches challenge norms (e.g., expectations regarding language, behavior, and social interactions) in order to be responsive to marginalized children and families and work towards greater equity.

Project READY: Reimagining Equity and Access for Diverse Youth

DEC RP Glossary:

Barrera, I., Corso, R., & Macpherson, D. (2003). Skilled dialogue: Strategies for responding to cultural diversity in early childhood. Baltimore: Paul H. Brookes.

Ladson-Billings, G. (2014). Culturally relevant pedagogy 2.0: Aka the remix. Harvard Educational Review, 84(1), 74-84.

Evidence-based practice Used as a Noun - Practices that are based on the best available empirical research that documents the practice’s efficacy with young children and families; the wisdom and knowledge of the field; and the core guiding values, beliefs, and theoretical approaches of EI/ECSE.

 Used as a Verb – The process for selecting and implementing practices that weigh research evidence; family and professional wisdom and values; and the individual characteristics, strengths, and needs of a child.

Odom, S. L., & Wolery, M. (2003). A unified theory of practice in early intervention/early childhood special education: Evidence-based practices. The Journal of Special Education, 37(3), 164173.

Buysse, V., Wesley, P. W., Snyder, P., & Winton, P. (2006). Evidence-based practice: What does it really mean for the early childhood field? Young Exceptional Children, 9(4), 2-11.

Family A child’s consistent (i.e., primary) caregiver(s) who have responsibility for the child’s well-being and development and who are partners in the child’s education and intervention. This may include a variety of individuals, including, but not limited to, the child’s biological, adoptive, or foster parent(s), legal guardians, siblings, grandparents, other relatives, and others within the child’s primary support network. Mapp, K., & Kuttner, P. J. (2013). Partners in education: A dual capacity-building framework for family-school partnerships. Austin, TX: Southwest Educational Development Lab.

Turnbull, A. P., Turnbull, R., Erwin, E. J., Soodak, L. C., & Shogren, K. A. (2015). Families, professionals, and exceptionality: Positive outcomes through partnerships and trust. Upper Saddle River, NJ: Pearson.

Inclusive environments Settings that facilitate inclusion.  For infants and toddlers, natural environments represent a broad array of contexts and activities that are typically available to children without disabilities and their families.  For children 3 through 8 years, inclusive environments may include a variety of organizational contexts (e.g., public school, private community-based centers) and ECSE service delivery models (e.g., co-teaching/team teaching, itinerant/consultant). Division for Early Childhood/ National Association for the Education of Young Children. (2009). Early childhood inclusion: A joint position statement of the Division for Early Childhood (DEC) and the National Association for the Education of Young Children (NAEYC). Retrieved from https://www.decdocs.org/position-statement-inclusion Love, H. R., & Horn, E. (2019). Definition, Context, Quality: Current Issues in Research Examining High-Quality Inclusive Education. Topics in Early Childhood Special Education. Retrieved from https://journals.sagepub.com/d oi/pdf/10.1177/027112141984 6342

US Department of Health and Human Services & US Department of Education (2015). Policy statement on inclusion of children with disabilities in early childhood programs. Retrieved from https://www2.ed.gov/policy/speced/guid/earlylearning/joint-statement-full-text.pdf

Instruction A set of practices that are evidence-based, intentional, systematic, and support development and learning for all young children across developmental and content domains. Instruction includes the intentional structuring of children’s environments and learning experiences as well as methods used to teach a curriculum. Instruction is used across natural environments and inclusive settings in collaboration with families and other professionals. Wolery, M. (2012). Voices from the field. Young Exceptional Children, 15(4), 41-44.

Boat, M., Dinnebeil, L., & Bae, Y. (2010). Individualizing instruction in preschool classrooms. Dimensions of Early Childhood, 38 (1), 4-10.

Division for Early Childhood. (2015). DEC recommended practices glossary. Retrieved from https://divisionearlychildhood. egnyte.com/dl/facKSfYlFI/

Intervention A set of strategies that are evidence-based, individualized, and support specific individualized developmental and learning objectives across natural environments and inclusive settings in collaboration with families and other professionals. Wolery, M. (2004). Using assessment information to plan intervention programs. In M. McLean, M., Wolery, & D. B. Bailey, Jr. (Eds.), Assessing infants and preschoolers with special needs (pp. 517-544). Upper Saddle River, NJ: Pearson.

Division for Early Childhood. (2015). DEC recommended practices glossary. Retrieved from https://divisionearlychildhood. egnyte.com/dl/facKSfYlFI/

Natural

Environment

Home and community settings (e.g., childcare programs, libraries, parks) in which children spend time participating in activities and routines regardless of their ability or needs, and are typically available to children without disabilities. DEC/NAEYC. (2009). Early childhood inclusion: A joint position statement of the Division for Early Childhood (DEC) and the National Association for the Education of Young Children (NAEYC). Chapel Hill: The University of North Carolina, FPG Child Development Institute.
Strengths-based Approaches that concentrate on the inherent strengths of children and their families. It is a philosophy and a way of viewing children and their families as resourceful, resilient, and self-determined. Green, B. L., McAllister, C. L., & Tarte, J. M. (2004). The strengths-based practices inventory: A tool for measuring strengths-based service delivery in early childhood and family support programs. Families in Society, 85(3), 326-334.

References

Beukelman, D. & Light, J. (Eds) (2020). Augmentative & alternative communication: supporting children and adults with complex communication needs. 5th edition, Brookes.

Blackstone, S. W., & Hunt Berg, M. (2002). Social Networks: An assessment and intervention planning inventory for individuals with complex communication needs and their communication partners. Monterey, CA: Augmentative Communication.

Cress, C., & Marvin, C. (2003). Common questions about AAC services in early intervention. Augmentative and Alternative Communication, 19(4), 254-272.

Davidoff, B. E. (2017). AAC With Energy—Earlier: Research shows that children with communication challenges do best when introduced to augmentative and alternative communication as early as 12 months. The ASHA Leader22(1), 48-53.

Erickson, K. (2003). Reading comprehension in AAC. The ASHA Leader8(12), 6-9.

Light, J., & McNaughton, D. (2013). Putting people first: Re-thinking the role of technology in augmentative and alternative communication intervention. Augmentative and Alternative Communication, 29(4), 299-309.

Millar, D. C., Light, J. C., & Schlosser, R. W. (2006). The impact of augmentative and alternative communication intervention on the speech production of individuals with developmental disabilities: A research review.

Nigam, R., Schlosser, R. W., & Lloyd, L. L. (2006). Concomitant use of the matrix strategy and the mand-model procedure in teaching graphic symbol combinations. Augmentative and Alternative Communication22(3), 160-177.

Schlosser, R. W., & Wendt, O. (2008). Effects of augmentative and alternative communication intervention on speech production in children with autism: A systematic review.

Soto, G., Zangari, C., Beukelman, D., & Reichle, J., (Eds.) (2009). Practically speaking:  Language, literacy and academic development of students with AAC needs. Brookes.

Waddington, H. (2018). Meta-analysis provides support for the use of high-tech speech-generating devices for teaching a range of communication skills to children with autism spectrum disorders. Evidence-Based Communication Assessment and Intervention, 12(1-2), 7-11.

Blueprint

ECPC Course Enhancement Modules E-Learning Lessons, Practice Guides & Resources 
CONNECT Modules CONNECT Modules and Courses
Faculty Forum - The Chronicle of Higher Education Archived Zoom Call: Faculty Resilience and the COVID-19 - Week 2
Frank Porter Graham Toolkit of Resources TOOLKIT: resources for early childhood faculty and instructors
Association of College and University Educators Online teaching toolkit
The Chronicle of Higher Education How to be a better online teacher advice guide
SCRIPT-NC Shifting to Online Instruction and Faculty Webinars
Openstax Open access to high quality textbooks online -free
CEEDAR Center Virtual Toolkit: Easing Faculty Transition to Online Instruction​
FREE RESOURCE: Poll Everywhere for Higher Ed. Faculty Create unlimited questions for up to 40 students
CEC Webinar and Resources Teaching Special Education Online During COVID-19
IRIS Center Planning for Distance Learning: Resources: Modules, Case Study Units, Activities
The Chronicle of Higher Education, Michelle D. Miller
Going Online in a Hurry: What to Do and Where to Start
The Chronicle of Higher Education, Kevin Gannon 4 Lessons from Moving a Face-to-Face Course Online
The Chronicle of Higher Education, Heather R. Taft, March 17, 2020 How to Quickly (and Safely) Move a Lab Course Online
The Chronicle of Higher Education Coping With Coronavirus: How Faculty Members Can Support Students in Traumatic Times
The Chronicle of Higher Education, Flower Darby How to Be a Better Online Teacher (Advice Guide)
Ohio Developmental Disabilities Council Video Series: Use of Technology with Evidence Based Early Intervention
National Center on Deaf Blindness
Open Hands, Open Access video learning modules
Coursera Child Development Courses

 

Activity Bank

*New* Tip sheet: Enhancing Family-Provider Partnerships During COVID-19  Enhancing Family-Provider Partnerships
Tips for Providers: Providing & Coordinating EI Remotely Tips for Providers: What to say to Families
Tips for Providers: Providing & Coordinating EI Remotely (What will it look like?) Tips for Providers: What will a Remote Visit Look Like?
Tips for Families: Receiving Remote EI Services Tips for Families Flyer .pdf What is Remote EI

Consejos para Familias .pdf What is Remote EI? (Spanish)

Tips for Families: How to prepare for a Remote EI Visit Tips for Families: .pdf Preparing for the Visit

TConsejos para Familias: .pdf Preparing for the Visit (Spanish)

ECPC Course Enhancement Modules E-Learning Lessons, Practice Guides & Resources 
CONNECT Modules CONNECT Modules and Courses
Virginia Early Intervention Professional Development Center Framework for reflective questioning / The Coaching Quick Reference Guide - .pdf
Virginia Early Intervention Professional Development Center Tools of Trade
OCALI (Ohio Center for Autism and Low Incidence Disabilities) (note: you must login but it is free) Suite of Resources for Early Childhood Professionals
Public Consulting Group Use of telehealth in early intervention (IDEA Part C)
Protecting Student Privacy

U.S. Department of Education

Student Privacy 101

FERPA and the Coronavirus Disease 2019

FERPA and Virtual Learning

Edelman, L. (2020). Planning for the Use of Video Conferencing for Early Intervention Home Visits during the COVID-19 Pandemic Planning for the Use of Video Conferencing for Early Intervention Home Visits during the COVID-19 Pandemic
CEC Hosted Webinar with Resources Teaching Special Education Online During COVID-19
National Center for Hearing Assessment & Management Utah State University Welcome to the Tele-Intervention Learning Courses
Lisa Dieker & Rebecca Hines UCF - Podcasts for Part B/619 Coordinators Series of Podcasts: teaching online, inclusion, etc.
National Center for Pyramid Model Innovations - May Newsletter Pyramid in the Time of COVID-19