Amanda and I met while working at a special education charter school as an Assistive Technology specialist and special education teacher. Somehow, several years later, we have both ended up working in EI. Amanda currently works as a Speech-Language Pathologist providing EI services and AAC evaluations in DC and I am a Developmental Therapist in Arlington County.
As EI providers, we know that communication creates the opportunity to learn about and understand the world around us. Yet, often children wait until they receive school services before they have consistent access to robust AAC (Augmentative and Alternative Communication) systems. When working with toddlers who are not using verbal language to communicate functionally throughout their day, it is important to offer information and have conversations about the benefits of AAC with the family.
Figuring out your role in these conversations as an EI provider, as well as how to support a family with their AAC journey, can be challenging. Below, we have listed a few common myths and misconceptions about AAC as well as examples of toddlers we know who have started their journeys with AAC. We hope you can use this as a resource as you continue to expand your knowledge about AAC as a primary provider.
Myth #1: Toddlers Are Too Young
We are never too young for language exposure. Most AAC relies on a different language system than what we are exposed to from birth. If children are going to use AAC functionally, they need to hear everyone in their lives use the same system to talk to them. Waiting to provide children with the opportunity to use AAC until they are “old enough” can deprive them of months and years of language input that is necessary when learning to effectively communicate. The earlier a child has access to language, the faster he or she will learn to use it and be able to engage more with the world (American Speech and Hearing Association, n.d.). There are no prerequisites to begin using AAC. While there are considerations as to the mode of access and system used, these are determined as part of an evaluation.
Amanda: Earlier this year, I had a conversation with the parents of a 15-month-old with limited vocalizations. We had an honest discussion about his diagnosis and the likelihood that he may not verbally speak for a while. Within the month, several low tech AAC systems (paper-based choice boards) and a GoTalk32 (recordable, fixed 32 cell device) were introduced. Before he was two, he started using a high-tech dynamic display (digitized display changes based on user actions) device and by two he was using phrases to communicate. By providing AAC from an early age, this child has the chance to continue his expressive language development at a rate similar to his typically developing peers.
Myth #2: AAC is for Speech Language Pathologists (SLPs)
While it is always challenging to talk about something that feels like it’s out of your area of expertise, the conversation about language development and ACC can come from any knowledgeable provider! SLPs are great resources about AAC, but remember that all providers can talk about communication. This is especially important when we think about babies and toddlers with complex bodies, who may also have complex communication needs. These children are much more likely to see a motor therapist as their primary service provider due to family priorities. Within their role, the PT or OT is also engaging in discussions and ongoing assessment in all areas of development with a family. This is the perfect opportunity to offer information about options for communication for a child who may not begin to develop verbal language in the same way as their peers.
Lauren: A few years ago, I began as a secondary service provider for a family, when the PT working with them began this very discussion. Due to his diagnosis, this child was not likely to begin speaking within his toddler years. Although his parents were concerned about his future communication, they did not know that there were options for him to begin using words at the same time as his peers. This PT provided the family with information about an AAC clinic hosted by the local infant and toddler program. Through this process, insurance covered a high-tech device that allowed the child to communicate using eye-gaze.
Myth #3: High-Tech Comes at High Cost
This statement is both true and false. Dedicated, high-tech AAC devices (those with digitized displays that change based on user actions) can cost tens of thousands of dollars. It is false that these devices always come at a high out-of-pocket cost. In fact, public and private insurance will cover a variety of devices. It is important to have a knowledgeable specialist provide a thorough AAC evaluation and report. This website from a device company provides some additional information about funding.
Amanda: I’ve been doing AAC evaluations for EI in Washington, DC for the past three years and have had many AAC devices covered by insurance including mid tech, high tech, eye gaze, and mounting accessories. Though coverage varies by insurance plan (some private insurances require a copay or deductible, but Medicaid and Medicare typically cover AAC at 100%), there are also grants and programs available to help cover the cost of AAC.
Lauren: Just this month, one of the toddlers I see received a device through insurance just in time to use it on his family trip to Disney World!
You do not need to know everything about AAC to begin the conversation. Before you talk with families, though, make sure you have some knowledge of AAC. If you are interested in learning more general information about AAC, there is a fantastic Talks on Tuesday as well as a free AAC 101 Course to get you started. We have only covered a few of the myths and misconceptions about AAC here. You can find more information and the supporting research through the American Speech-Language-Hearing Association. Another great step is becoming knowledgeable about the resources for ACC evaluation in your area. Begin by reaching out to local children’s hospitals, rehab centers, and speech therapy clinics in your area to find out if they offer AAC evaluations. Where are they? How can a family contact them? What public or private insurances do they accept? With this information, you’ll be better prepared to help families begin to explore AAC options and boost communication.
What are some of the strategies or resources you have used in your professional journey with AAC?
Share your strategies in the comments below!
American Speech-Language-Hearing Association. (n.d.) Key Issues, AAC Myths and Realities.
Lauren Lamore-Chen has worked in EI in the Northern Virginia area since 2016 and currently works as a Developmental Therapist with the Arlington Parent-Infant Education Program. She has a master’s degree in special education and worked as an instructional coach and special education teacher where she developed her passion for all things AAC. You can reach Lauren at firstname.lastname@example.org
Amanda Soper specializes in working with individuals with complex communication needs who use AAC systems. She works at a special education school and for the early intervention program in DC. Amanda is an adjunct professor at Gallaudet University and has a private practice, providing therapy services for children using AAC. You can reach Amanda at AmandaSoperSLP@gmail.com