PrAACtical Suggestions: How to Get Started with A New AAC Client

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This is the first week of a new semester for us, and that means we get the pleasure of introducing a new crop of student SLPs to clients with AAC needs. We’ve been busy looking at lesson plans, discussing goals and objectives, listening to ideas for therapy activities, and helping to develop plans for data collection. With those recent conversations buzzing in our ears, here are some thoughts about getting AAC therapy sessions off to a good start.
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1. Connect with the client and family before the first session. Take some time to plan out questions that will help you get to know their expectations, family culture, and daily routine.

2. Know the history. Go beyond the diagnosis and device. Take time to research what’s been done before, how that worked out, and, if you can, how that was perceived. Knowing where the client has been on his/her AAC journey will help you plot out the next steps more thoughtfully.

3. Suspend judgement. You may find out some things that you don’t agree with or approve of, but force yourself not to judge. The reality is, we have no idea what it is like to live their lives. Judging your client’s family is not a right you’ve earned but more importantly, it will do nothing to make you a good clinician.

4. Activate your background knowledge. From your coursework, prior experiences, reading, and networking, you already know a lot about AAC, language intervention, and clinical processes. We’ve noticed that many times, though, clinicians don’t put into practice the knowledge they’ve gained. Our suggestion: Make a conscious decision to go back to course textbooks and notes that relate to your new client’s needs. Skim through the relevant parts and make notes as to how to operationalize this in your therapy.

5. Make practice a priority. Sure, you know about aided language input, recasts, and least-to-most prompting. But how are your actual skills with these things? It takes time and effort to get good at implementation, and until you are good at implementation, your data is meaningless. Find someone to practice with and role play until you are fluent with the strategies you’ll be using in therapy.

6. Learn to triage. Focus your efforts on pivotal AAC skills and practices that will make your therapy effective in a variety of clinical situations. Sure, it is tempting to spend part of your evening making a new board game with Pixons but how much bang will you get for that buck? If you’re already a good interventionist, that may be fine. But if you’re still developing the fundamental clinical skills you’ll need in the session, perhaps that time is better spent in other ways.

7. Start with the client’s AAC goals and objectives. Most beginning SLPs tend to spend most of their time thinking about what activities they’ll do in the session. Then, when they get into the session, they aren’t very effective at eliciting the target behaviors. Often, that’s because the activity is not a good fit for the target skills. If you start by focusing on what behaviors you want the client to learn and demonstrate, you can then brainstorm a variety of activities that will target that skill and select the most appropriate ones for your session.

8. Know the difference between assessment and intervention. Sounds simple, but this is tough for many beginning SLPs to put into place. Looking at pictures and asking questions like ‘What is he doing?’ is a great way to find out what your client can do with his/her AAC system. But…It. Is. Not. Teaching. The only way a client can learn something new in that situation is by trial and error. They respond and you correct them. Learning by being corrected is not very efficient and it feels awful. Would you do well in a class that consisted primarily of tests and quizzes or would you achieve more if the professor taught the content? Focus on teaching, with some assessment and you will help your AAC clients achieve better outcomes AND have a great time doing it.

9. Take initiative. Search out experiences that will make you a better practitioner. Adequate student clinicians wait for those experiences to be brought to their attention. Good ones take the initiative to do this on their own. Find out where you can watch good clinicians in action or read their reports, articles, etc. Check out therapy interactions online. They aren’t all good, but you can critique them as you watch and that’s a good exercise in clinical reasoning.

10. Manage your expectations. No one gets to be a great SLP without time, effort, and practice. It’s a process. Your therapy will feel awkward at first, but be patient with yourself. If you’re one of the ones who really cares, you’ll get there.

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Welcome to the new semester, folks. We have lots of prAACtical fun ahead of us!
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