Overlooked AAC, Part 1

Whether you are a therapist, educator, or other professional there is a long list of things that people who use AAC need us to do so that they can communicate in ways that help them live their best lives. Today, we begin a series on some of the most overlooked areas that even veteran AAC practitioners often miss. Not because they don’t know about them. Not because they have a philosophical reason to avoid them. Not because they can’t figure out how to implement them. But because there are incredibly frustrating systemic obstacles to providing the kinds of support our clients/students need. 

In schools, caseload and classroom sizes stack the deck against us. In healthcare settings and private clinics, the funding streams steer us away from a best practice approach. And in almost every setting, the increasing paperwork and organizational demands draw our attention away from what we want to be doing: serving children and adults whose ability to communicate orally limits them. 

Anyone who has done this work for a while and done it well knows that supporting people who need AAC can be intense. For the most part, focusing on the immediate needs takes center stage. Ensuring that there is a means of functional communication, supporting language development, promoting self-advocacy, facilitating literacy learning, and helping the person move toward life goals are all we can manage. We have a laundry list of other things we want to do to support them, but those often get put on the back burner while we deal with the situation at hand. 

In this series, we hope to bring some of those ‘I-know-I-need-to-do-it-as-soon-as-I-can-find-the-time’ issues to light and inspire a few of you to take on these challenges. So if you are a provider of AAC services, please stay tuned. We hope to help you move in the direction of tackling one or more of the most overlooked areas in AAC support.

Overlooked AAC: Backups 

To start us off, we’ll look at something pretty basic: If your client or student doesn’t have access to their primary AAC tool when they wake up tomorrow, what would happen? Run down your AAC caseload, one by one. Is there a plan for each of them or would it be a big scramble to get a functioning communication system in place?

Here are some things to consider if you have one or more clients/students who will be hard-pressed to communicate effectively if their primary AAC tool becomes inaccessible.

For Those Who Use Paper-based Communication Boards and Books as a Primary Means of Communication

1. Create duplicates of the communication board, PODD book, or flipbook that the client/student uses. Ensure that the AAC user, family, and other key communication partners know where that is and how to access it.
2. Ensure that there are digital versions of these tools available to someone besides you. Could they lose their AAC tools while you are on vacation, out sick, or overwhelmed with other things in life? Murphy’s Law says yes.

For Those Who Use SGDs and AAC Apps as a Primary Means of Communication

1. Back up the software/app after any significant programming change. Each of the different companies has a different way of managing this process. Learn about the ones your clients/students use and commit to backing those up using cloud storage, external hard drives, and the like.
2. Develop a plan for regular backups once a month or so. Document those so that you can keep track of the last time a duplicate copy of each person’s personalized AAC software/app was created.
3. Teach AAC users and their primary caregivers how to back up the system. As professionals, our role in their lives is a temporary one. We may play a role in their communication journey for a few months or even several years but are rarely by their side for the long term. They need to be empowered to take care of this on their own so that things don’t fall apart when there is a change in schools, therapists, etc.
4. Teach AAC users and primary caregivers how to retrieve the current backup and install it on a loaner/temporary device, new device, or one that was reset to factory settings. Practice it with them if you can. Provide clear documentation on the process that they refer to if needed.
5. Outline a plan for who does what if a device breaks down, or gets lost, stolen, or destroyed. 
6. Ensure that everyone who plays a role in that plan knows their part and has the information they need to take appropriate action.
7. In some cases, the client/student has an older device that is still operational. If folks on your caseload have a previous device in a drawer or closet, see if that can be used as an interim solution. Check to be sure that any peripherals that are essential (e.g., keyguard, switch) and the charger are available and functional. 
8. Create paper-based versions of the AAC software/app, focusing on the most important words/phrases/sentences for the client/student. Include access to the alphabet for spelling and/or speech supplementation. (New to speech supplementation techniques? You can learn more about those here.) 
9. Teach the client/student how to use the paper-based communication tool, if it is not something they already know how to do. Practice this periodically so that they stay skilled and feel confident if they have to use this for a period of time.
10. Teach the key communication partners how to support the AAC user with paper-based AAC. Have them practice and provide them with guidance or coaching, if needed.
11. Create an easy way for the individual to tell people that they are communicating in a different way and provide partner instructions. For example, a single-message talking switch or information card can be used to explain why the regular AAC device/app isn’t there and what they should do to support communication with the temporary AAC tool.
12. If you have to put the backup plan into action, take some time afterward to debrief and refine the plan, if needed.

For Everyone with Complex Communication Needs

1. Consider how to maximize other modes of communication and/or other sorts of tools that AAC users already work with. As we all know, people communicate in all sorts of ways. Multimodal communication deserves more than just a passing nod and thinking about how we can harness the power of signing/sign approximations, vocalizations and speech approximations, gestures, writing, typing, texting, drawing, etc.
2. Realize that our clients/students are much more vulnerable without access to their regular AAC tools. This is a time to be highly observant and check in with them frequently.

A primary role of SLPs and others who serve people with AAC needs is to ensure that they always have access to a functional communication system. When things break down or go missing, having a plan to put a backup system in place as soon as possible can make all the difference.

We’ll continue the Overlooked AAC series to discuss other things we can do to strengthen our support for people who use AAC. Is there something that you think we should address in this series? Touch base via the Contact Form or add a comment. We’d love to hear about it.