Let me preface this post by saying that *high-tech AAC is worth any and all technical difficulties that may come with it*… but as with all kinds of technology, stuff happens and we should always be prepared.

So, here are my top tips for getting started with AAC:

- Invest in a good screen protector and case. The AAC device is going to go along with the child in most (if not all) of their environments, so it's a good idea to plan for durability and provide additional support based on however the child is going to carry it.

- Enable guided access. This 'locks' the child into the AAC app and teaches them that the device is meant to *only be used for communication.* Games and videos can still be accessible to them, just on a separate device!

- Back up your vocabulary! All AAC programs will have methods for backing up your data (e.g., Dropbox, email, airdrop) and it's important to do that regularly! *When* (not if!) you run into tech troubles, you don’t want to lose all customizations you've made within the program!

Especially useful for GLPs and late talkers, declarative language offers a gentler approach to communication by *inviting children to act* as opposed to pressuring them to respond in a particular or expected way. 

Whereas questions and directives are a means to an end, declarative statements actually increase independence by giving the child the space they need to notice what’s happening in their environment, process what has been said to them, and then respond with their own thoughts and ideas.

In other words, declarative language helps to create space for connection and is a fantastic tool for child-led play. 

Here are some examples of declarative statements from Meaningful Speech:

• That's a beautiful picture.
• I'm so thirsty.
• We're doing it!
• The moon's out.
• I wonder if there's a different way…
• I'm thinking about a snack.
• That's really fast.

PSA: we can customize and modify language systems (such as high-tech AAC, as shown above) to support bilingual language learners. 

This child has an interest in learning animal names in Ojibway, and we can use AAC to support his expressive vocabulary in this language. While there are currently no AAC systems that have Indigenous languages programmed into them, programs like LAMP (Language Acquisition by Motor Planning) are easily customizable and allow for this addition. This child's motor plan is still kept consistent while navigating between the two languages. 

It’s an honour to support this child’s journey with his language!

This will likely be a *controversial* post, but I am not trained in (and will not be trained in) using PECS (the Picture Exchange Communication System) for my AAC users for a number of reasons.

PECS focuses heavily (!!!) on requesting, and this can often result in communication only being used as a source of extrinsic motivation (i.e., to get something). It doesn’t take into account all the other reasons to communicate (such as greet, negate, argue, comment, suggest, direct, etc) in order to build intrinsic motivation to communicate. Communication and connecting should be the reward! 

Teaching PECS often involves hand-over-hand prompting of the child, violating their bodily autonomy. This is not a necessary part of learning picture communication. Modelling for the student on their device with no expectation for the child to copy is an evidence-based way to teach picture/symbol communication, which allows for the child to regain this autonomy and express what they WANT to express. 

Furthermore, PECS doesn't allow a motor plan to develop as the symbols are always moving, which is an important part of communicating with a symbol-based system. Since PECS focuses on single words to start, it also is not the most appropriate for our gestalt language processors (and up to 85% of Autistic children are GLP!). We don't want our AAC to further contribute to our children being 'stuck' in their single-word or multi-word scripts. 

And lastly, PECS is not a robust language system that can grow with the child. Our children can learn much more competently if their communication systems are robust from the start, and not being 'upgraded' every few years. We need to presume competence right from the start. 

NOTE: This is in reference to the Picture Exchange Communication System and not all picture-based communication, such as low tech AAC and core boards.

​While PECS may have a been a gold standard in the past, and many well-meaning therapists have endorsed its use, it's important to listen to our Autistic community who have talked about the negative aspects of the system. Once we know better, we can do better.

As shown by this real-life example, it's important to do the detective work to figure out the meaning behind delayed echolalia and the gestalts that are picked up by your child naturally, because gestalts communicate!

In this example, the child is communicating with a gestalt that had been stored in his episodic memory. During the balloon exercise, he might *feel* the same excited way he felt watching the scene in the show, and is expressing that feeling with his gestalt.

Now that we recognize and understand why he is using this gestalt, where it came from, and what it means to him, we can validate his gestalt. 

We might also model something else that is a little easier to understand and mitigate, such as "it's a surprise"!

As mentioned in our previous post, the first stage of Natural Language Acquisition (NLA) is the use of delayed echolalia... aka gestalts! In other words, children in Stage 1 NLA are processing *all* incoming language as gestalts.

A gestalt is simply a word or phrase that a child has heard that they could then use (verbatim) after some time has passed (days, weeks, or even years later!). It is basically a "chunk" of language that gets stored in a child's memory for later use.

Your child's gestalts may be short, long, from media sources (books, TV shows, songs, or movies), totally nuanced or even unintelligible, but they are never *wrong*. So, before gestalt targets are chosen and modelled, always try to acknowledge their original gestalt.

When it comes to choosing gestalts, just remember: "We are not replacing the child's language, but merely offering suggestions of useful phrases based on our observations and detective work." — @meaningfulspeech

The families I work with are always SO creative in figuring out ways to translate our SLP goals into methods that work within their homes and dynamic lives!

There is no one-size-fits-all approach for parent coaching and the carryover of skills between SLP sessions, but the important thing is that each family finds what works for them.

This family uses a wall-mounted white board to show which Stage 1 gestalts we are working on modelling throughout the day.

This acts as an easy, accessible reminder for them (as well as any extended family members or childcare providers that they may have in their home), and as a bonus, it was SUPER helpful to me during the session as well!

I also love how they've recognized and included that we are targeting 'language modelling', and that the child doesn’t necessarily need to say the exact phrase. Rather, the goal is for *us* as communication partners to be able to readily model these gestalts in the child's everyday environment.

Suffice to say, I'm very proud of this family.

Why is being quiet when working or playing with a child *so difficult?*

Because as parents, teachers and clinicians, we want to help them, guide them, and feel useful!

Even though it can be challenging, silence has a very important place within speech therapy. For instance, silence:

• provides the child with time to process language that has been modelled,
• decreases auditory input (which can lead to better regulation for some children),
• allows time for the child to generate some thoughts and ideas to share,
• reduces prompt dependency, and
• provides time for initiation of communication and sharing of their actual thoughts

If you're finding it difficult to sit back and be one with the silence, Meaningful Speech suggests the following:

• Use this time to observe.
• Practice playing.
• Make notes regarding interests, listen for quieter gestalts or intonation that sounds familiar, and enjoy just *being* with your child.

"A greater connection will build as the child will note that their gestalt play and language aren't being interrupted, but honoured. They will realize their language isn't being ignored, stifled, rushed, or judged."

PSA: There's no right or wrong or better or worse way to communicate. 

As an SLP, one of my commitments is to honour *total communication* from the child I'm working with, no matter what that may look or sound like. Just as speaking individuals are not limited to just spoken word, 'total communication' includes things like gestures, facial expressions, body language, texting, writing, vocalizations, etc., and we should be taking it all into account.

In other words, honouring total communications just means that however the child communicates is valid, and we roll with it!

In this reel, I honour whatever way the child prefers to communicate with AAC, whether it's using symbols or the keyboard. Any method with which they can convey their ideas, opinions, requests, statements and desires is encouraged.

Communication is communication.

If you listen closely, you'll hear kids singing along to Oh Canada in Oji-Cree.

Regaining their language.

Indigenous language and identity was punished and oppressed for so long, and here, you can witness the youth reclaiming it.

It's my job to learn and listen to these voices when I'm providing services in remote indigenous communities.

Today a little girl asked me if I knew Oji-Cree and I said I didn't, so she asked if she could teach me. She taught me a few words including cat (my interpretation of the pronunciation was "boozh") and we laughed about my cats.

Kids just want to connect, and it makes my job as an SLP a whole lot easier.

It's an honour to hear them and learn from them.