Redefining AAC as a Standard of Care
Only a small percentage of people with complex communication needs get the AAC support they need. Though AAC is becoming more widely accepted, the huge gap between the people who need AAC and those who get adequate AAC support is longstanding and pervasive across service delivery standards. There are many fine people who work tirelessly to make changes to this unfortunate reality, and we are deeply grateful for their work. They are exhausted, hard-working, frustrated, and represent various stakeholder groups.
Still, there are far too many professionals who fail to provide AAC support to those they work with who need to use other means of communication. How can we change their perspective in ways that will steer them in the direction of providing AAC support?
How we talk and write about AAC matters. It’s only a small piece of this challenging conundrum, but one that, nonetheless, can contribute to systems change over time.
We propose talking about AAC as a standard of care.
Standard of care is a legal term with a very specific meaning. It refers to “the watchfulness, attention, caution, and prudence that a reasonable person in those circumstances would exercise. If a person’s actions do not meet this standard of care, then their acts fail to meet the duty of care which all people (supposedly) have toward others.”
While the medical model of disability is not the best fit for most situations in which AAC could or should be provided, it is ubiquitous here in the US, and, as such, plays a role in this discussion. The National Institutes of Health defines standard of care as “treatment that is accepted by medical experts as a proper treatment for a certain type of disease and that is widely used by healthcare professionals.” They note that this is also called best practice, standard medical care, and standard therapy.
In education, it refers to “the level and type of care that a reasonably competent and skilled professional, with a similar background and in the same setting, would have provided under the circumstances The standard of care is measured by the judgment, knowledge, experience, training, perception of risk, and skill that a person in the capacity of a professional would have.”
There are some situations, such as an individual who has completely lost their speech abilities due to disease, when the role of AAC is so blatant and critical that few would argue against it being a standard of care. Most situations, though, are less clear-cut.
- What about people with some residual speech?
- How about those who failed to develop spoken language in early childhood?
- Would it include those who speak easily and well under some circumstances but find that their speech is inaccessible in some situations?
- Should it include people who can speak but do not, due to selective mutism or severe anxiety?
Let’s open up a discussion on when and for whom AAC is a standard of care. As a field, AAC has always been driven from the bottom up. The AAC community is a creative, determined, and powerful one. Let’s do this.
Do you have thoughts on this matter? We’d love to hear from you.
Quotes were retrieved from the following websites.
This post was written by Carole Zangari