Always make AAC available

A crucial step in the Augmentative and Alternative Communication (AAC) process is setting up environments. We need to make AAC is always available.

This ensures that AAC users have access to their communication devices. It also means that teams can provide modeling and support on the AAC.

For AAC users, access to their AAC system is essential. If they wish to communicate what they want, when they want, they must be able to reach that AAC system. AAC should not be in the cupboard or left in a bag - it is too hard to get. AAC users cannot communicate if the battery to their AAC device is dead. If AAC system is only available during morning circle or at McDonalds, this is not useful. Having access to their AAC system is crucial. Everyone should be responsible for making AAC available. And there should always be a plan for when AAC is not available.

If a person has a physical impairment, we do not take away their walker when they need to walk. If a person has a hearing impairment, we do not take away their hearing aids when they need to hear. So why do we take away a person’s AAC system when they need to talk?

This article will cover 7 strategies to ensure that AAC is always available for users. Some specific topics will include:

1. Allowing access to AAC for multimodal communication
2. Giving AAC users a way to ask for their device
3. Giving everyone access to the AAC system
4. Keeping the AAC system turned on and charged
5. Paper-based AAC options
6. Utilizing whiteboards and tv screens, and
7. Considering accessories to keep AAC accessible

1. Multimodal communication

Keeping AAC available is often complicated for many AAC users. Often they have multiple ways to communicate their messages. In addition to their AAC system, they may use a combination of vocalizations, word approximations, gestures, and sign language. Sometimes, in our fast-moving world, it can be faster and easier to rely on their vocalizations and gestures. We should value and respond to all methods of communication.

But what happens when that communication fails, when we cannot understand what the individual is trying to tell us? What if the individual has far more to say, than they can communicate with the sounds and gestures alone? Many AAC users need all the words and language in their AAC system all the time. It needs to be there and ready for them to use as soon as they need it.

For example, Matthew, is an excellent at multimodal communication. He communicates very effectively using some words and vocalizations, combined with a great repertoire of signs. He uses these methods of communication all day. Often, they give him a fast way to get his message across. However, these things do not work so well with unfamiliar people. Nor does it help him to tell the teacher what he has learnt from the lesson on recycling. It also doesn’t help when Mum has no idea what he is trying to tell her about what happened at school that day. This is when Matthew uses his AAC system. There are many, many times in the day that he uses it because his vocalizations and signing are not always enough!

Just like in Matthew's case, we should all consider all the different ways we can communicate.

2. A way to ask

In some situations, an AAC user does not have their communication device. Do they have a way to ask for it?

Some strategies that can give a person a way to ask for their AAC, include:

• Wrist bands or symbol cards to indicate that they need their AAC.
• “Calling out” or vocalizing to get the attention of their communication partner.
• A single-message button recorded to say “Please get my AAC system”.
• A laminated information page that the person carries to share how they communicate, and asking someone to get their AAC system.

3. Everyone needs access to AAC!

But it is not enough support the communicator to access their AAC system. All of the team need fast and instant access to AAC as well!

A key strategy when we start using AAC is modeling. Modeling means people in the environment point to the words on the AAC system while talking to the AAC learner. When the learner sees people in their environment using the AAC system to communicate, they will learn how they can also use their AAC to communicate. This modeling is more likely to happen when AAC is available and easy to access.

Read how Erin started wearing PODD to make it available for her daughter.

We cannot model if the AAC tool is in the cupboard or out of charge. So strap on AAC and be ready to pick it up and model at any time. Think of how many moments there are in our day where you can model. In Matthew’s case, his team keeps the AAC system out all the time, so they can model words and sentences. They do this whether Matthew is choosing to use the AAC system or not.

Remember it is always important to ask the AAC users permission if you are going to model on their communication device. If possible, keep access to your own AAC and model on that.

4. Turned on and charged

Put systems in place to ensure that AAC devices are always turned on and charged. Sometimes the AAC system may need to sit in an easy to access location while it is plugged in to charge.

It is good to work with the communicator so they can become more independent in this area over time. Teach them how to turn the device on and off, including how to enter a password to unlock the iPad if necessary. Show the AAC user how to tell if their battery is low and how they can charge it, or ask for help charging it.

5. Paper-based AAC options

Another great way to have consistent access to an AAC system is to use light-tech, paper-based options. We can take screenshots of key pages and then print and laminate them. This can be a great way to have access to the AAC system all the time, especially if something happens to the iPad. It is also helpful in messy, wet or bright situations where the iPad is difficult to use.

You may even wish to create a book based on the AAC system. For more information, see this blog post on how to create a paper-based book from Proloquo2Go, step-by-step.

You can print our Proloquo2Go Crescendo quick communication boards. These give 4 pages of key vocabulary, useful in many situations.

You can print Proloquo2Go Crescendo 7x11 core word boards and posters. Posters can be attached to walls, outdoor surfaces or anywhere that is easily accessible. Posters are very visible and make AAC constantly available for all to use throughout the day.

If you are working in an environment with only one iPad, it can be very useful to make some paper-based boards or posters. Some people can model on the iPad while others use the boards.

If you are using the PODD communication system, then a printed PODD book is an important paper-based solution. Our simPODD app has simple printing capabilities from within the app, so that you can print PODD books easily.

6. Whiteboards/TV screens

If the environment has whiteboards or TV screens, we can also use these for AAC. We can mirror an iPad screen onto these larger screens. This is just one more way to make AAC a highly visible part of the environment.

7. Accessories can help to keep the AAC system accessible

We should not restrict or limit access to AAC to keep devices “safe”. There are ways to protect devices, so they can be left available to an AAC user. There are also options to help active users keep their AAC devices within reach.

• Cases: Seeing a video of an iOS device being dropped down the stairs or bounced off cement without breaking can reduce anyone's fears. There are so many cases available these days, it is impossible to keep up with all of them. And that’s a good thing. AAC users have a variety of choices. They can select a case based on their unique needs and even favorite color! Cases range from soft and squishy to military-grade hardshells. One of the best places to view a wide variety of cases is Lauren Enders’ Pinterest board.

• Straps: For users without mobility limitations, carrying their own device so their voice is with them wherever they go provides ideal access. Some users wear their device with a strap or harness to keep both hands free when not communicating. Other users find using a protective case and a camera strap provides a workable option.

• Harnesses: Younger users might benefit from wearing a harness that holds the device. Harnesses can be more comfortable and distribute the weight of a larger device more evenly.

• Belt-clips: AAC users who use smaller devices can consider a case that fits into a holster that attaches to a belt or a case with a belt-clip.

• Mounts: AAC devices can be mounted on a desk, the counter, or a wheelchair.

The next step

We communicate all day, so we need to ensure that we make AAC always available. Setting up the environment for this is essential for success in the AAC journey.

Another step in setting up is getting the team on board and planning for AAC throughout the day.

Links & References

• Goossens, C., Crain, S., & Elder, P. (1992). Engineering the preschool environment for interactive, symbolic communication. Solana Beach, CA: Mayer – Johnson Company.
  
• Hartmann, Amanda. Making a paper-based AAC book. [Blog post]
• Hartmann, Amanda. Do's and Dont's of AAC - Access to AAC. [Blog post]
• Ahern, Kate. (2013). Bringing AAC home. [Presentation slides]