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Topic: AAC and students who can speak?
Initial Post:
I have had several situations surface where different SLPs in my school district want me to issue Aug Com devices to students who have intelligible verbal speech. In two of the cases, the students are so language impaired that they are having difficulty expressing their thoughts in a logical way that others can follow. (I think the difficulty lies in severe syntax and vocabulary deficits.) The other student is a high school student who is not really motivated to interact with people in his environment (at home or school), but can read, write and speak when he chooses to. In all three cases, the students are able to use their voices and produce intelligible speech. I'm wondering if other AAC people are facing this dilemma? My initial reaction is to reserve the limited number of aug com devices that we have for students who don't have any other way to express themselves. Is my thinking too narrow in this respect? It is a philosophical question, I suppose, but I want to know how others are thinking. Thanks, in advance for your input.
Salem OR
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This can be a controversial topic in IEP meetings and is certainly based upon one's personal philosophy. That being said, I have had to advocate for students to obtain AAC devices that have intelligible verbal speech for a few reasons:
1. Many students can produce verbal speech that is scripted, but are unable to produce novel language especially in times of high task demand.
2. Not all verbal speech is communicative in nature (e.g. self-stimulatory speech).
3. Some students can formulate novel language, but are unable to initiate independently.
I have seen many students dramatically improve their overall communication with the addition of assistive technology whose necessity was determined by the individual IEP teams.
Oceanside CA
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I agree this topic can be very controversial. In my experience there are other factors to consider.
1- Is the device scaffolding the person's communication skills whereby it is augmenting the person's ability to communicate?
2-With the advent of smart phones, IPADs/IPODS, families believe that these devices believe that the device will improve/normalize the student's communication abilities. This may or may not be true. So the question, does the device facilitate interactions or is it the latest gadget.
3-The use of these devices are now being expanded to not simply be a dedication communication device but an educational tool as well.
3-A two to three month trial of a device and appropriate software/APP's has a way of teasing out whether a device is helpful or ultimately be abandoned.
4-The price point of many of these devices is cheap. Often times they are purchased for children as presents. Talking about these devices with the family and teachers to assess their commitment to use also needs to be considered. Access and Opportunity Barriers may be eliminated through this dialog.
Westfield NJ
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It is a valid question. We have obtained AAC devices (mid to high tech) for a few students who have understandable speech. Two were apraxic (understandable but with compromised intelligibility) and one who only used 2 word utterances at most to express himself. Our "barometer" for justifying devices were whether or not, given an emergency or medical situation, the student could effectively communicate and actively participate in an exchange to get help. Some scenarios you have to take into account are ones where the referent isn't necessarily available (medical distress in a restaurant, at a ball game, etc) as well as one where the information has to be given in a fast manner, perhaps even in a chaotic environment. In all of those possible scenarios, our students would be very hard-pressed to provide a clear message. Of course, there are a million other daily social communication scenarios where you could apply the same questions to help you make that decision, but for Medicaid purposes, you have to look at a medical justification, which is a strong justification for a device in and of itself.
In a real life example, I had an adult client in a day program during my graduate work that had a fracture to his leg. He could say clear enough to be understood, "My leg hurts." He repeated this sentence on and off, for 3 days straight, but when asked where exactly or how much it hurt, he could not be specific.. He continued to walk on it throughout the week. On day 4, he was given an Xray, which is when the extent of is injury was revealed and his leg was casted. If he had an AAC way to be more specific (not even necessarily a high end device) would his medical attention have occurred sooner? Given my added 20 years of AAC experience, my answer would be yes.
SLP-NY
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I would encourage you to consider the possibility. Do an evaluation to see if trying something on a trial basis would be beneficial. If the evaluation process reveals some benefits, try something out and take data! If you see improvements in communication skills comparing verbal vs. use of AAC strategies, you will have solid information upon which you can base your recommendation.
Tinley Park IL
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Why does the automatic assumption for AAC have to be high tech? Sometimes a low tech option such as core vocabulary provides enough structure for an individual to organize words so he/she can initiate, create novel phrases etc.
Pampa TX
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