Before discussing the use and needs of Augmentative and
Alternative Communication, it will be best to define these
terms for those who have had no experience with people who
have difficulty in communication.
Augmentative communication is an addition to natural speech.
We all use augmentative techniques at some time or other, in
gestures, body language and facial expressions. A smile, a
frown, a shake of the head or a nod are all very definite and
accepted forms of communication.
Alternative communication is an approach which is clearly a
substitute for natural speech and/or handwriting. A symbol is
something which stands for or represents something else.
These may be pictures, symbols, sign language, gestures or a
speech sound.
An assistive communication device refers to any non-
electronic or electronic device which provides external
assistance for conversational speech. The two terms,
augmentative and alternative communication, are generally
combined and referred to as A.A.C. Readers are advised that
this term has no bearing whatsoever on Facilitated
Communication [used with autistic, brain- damaged people
etc.], about which there has been so much controversy
lately.
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This article is about children and not adults, and will
discuss the advantages or otherwise of the use of A.A.C.
Who needs augmentative or alternative communication?
A child with a severe hearing loss or one with verbal
dyspraxia or aphasia [see Ross's article from Parshas Bo] may
become very frustrated at being unable to communicate
effectively. The older the child, the greater the
frustration. We have all heard of Anne Sullivan who helped a
seven-year-old little savage grow into an educated,
articulate human being. Helen Keller published several books
in spite of being deaf and blind and became a most sought-
after public speaker.
Communicative competence means that someone has to have the
skill, knowledge and judgment to communicate. Normally
speaking children develop skills of conversation naturally.
They learn turn-taking, how long to wait before speaking.
They learn what is appropriate to say in a given setting.
They learn how to repair mistakes and gaps in the
conversation, and how to request information. There are
literally hundreds of bits of information and knowledge that
we acquire naturally, as we learn to speak. All this, of
course, with a conversational partner.
Besides having to acquire all these skills, the A.A.C. user
needs operational competence, too. He has as much need of a
conversational partner as a person using normal speech, but
these partners do not always have the patience to listen. A
person with physical disabilities has the additional
challenge of restricted abilities in exploring and
experiencing his surroundings. However intelligent he is,
communicative competence is very hard to come by. About
twelve years ago, an 18-year-old boy who was unable to speak
and had been considered severely retarded, was given a
sophisticated computer, purposely built for him, as he also
had limited use of his limbs. One day he typed out, "What is
the use of this * * * * machine if nobody bothers to read
what I have written?"
Natural speaking partners often have a low expectation of
A.A.C. users. They often anticipate their needs and wants,
until conversation is no longer necessary. If objects are in
view and in reach, there is no need to request them. When
partners prompt before the A.A.C. user can initiate a message
of his own, either by giving a choice, by questioning or
supplying the words, they prevent the child from speaking. He
will take the easy way out until, once again, there is little
or no conversation. Thus, communication skills do not
develop.
There has often been controversy about the use of A.A.C.
because people tend to think that once a child has been given
this prop to facilitate his communication, he will never
learn to speak naturally. With ordinary language-impaired
children, this does not seem to be the case. Children with
severe speech disorders tend to use gestures which are often
misunderstood by the conversational partner. Studies have
shown that A.A.C. boards do not inhibit the use of speech. On
the contrary, once communication is established, in whatever
form, the child uses as much verbalization as he is capable
of producing. The same applies to computers and synthesized
voices. The child will use as much of his own voice as he is
capable of using but will meanwhile have the satisfaction of
being able to share his life with others.
Deaf children, however, who learn to use sign language,
report that this is their `mother tongue.' They feel most at
home in this language. Unfortunately, there are not too many
people who speak or understand either B.S.L. (British Sign
Language) or A.S.L. This limits a deaf person's social life
considerably. I personally have worked with deaf people and
find that those who are taught to speak normally at a very
early age, grow up to feel most at home with natural speech.
For Jewish children, this is a distinct advantage. There are
some teachers who fiercely defend the right of deaf children
to be taught sign language, and others who are just as
strongly against it.
To summarize: Augmentative and Alternative Communication is a
wonderful tool if used correctly and if suited to the child.
Simple aids are best where possible, and the same aids should
be used in the classroom and at home. Speech should be fun
and no child should be pressured into using equipment which
is too difficult for him to use. With modern ideas and
technology, children with a speech problem, especially those
with normal intelligence, have a wonderful chance of
achieving equality with their peers.
