We have AAC: now what?

image of an iPad screen with Speak for Yourself, and a list of animals in the message bar: banana, cookie, cat, dog...

Access to AAC is a fundamental human right, but it’s one that tends to be forgotten and overlooked in many spaces still today. October is AAC awareness month, which means lots of people are hearing about AAC or gaining access for the first time. The first few steps can feel overwhelming to families and professionals new to this journey. There is a fear about “doing it right” and “doing it enough”. I promise that you can do it. You can do it. You must do it. And it will be worth every step. 

Get excited. It can be really easy for AAC to be seen as a chore or “another thing to do”. It can seem like that to families, to professionals, and to AAC users themselves — especially when drilling methods are used to teach its use. It’s really important for all of us that we don’t associate AAC with “work”. We need to stop seeing on AAC as a way to drill our students on all the things they already have a way to say. We need to see AAC as a tool that allows our students to express all the other things they have to say. This isn’t to say that learning a new language isn’t hard (it is) or that magic moments happen every single day. Learning to read and to write and to speak a new language — all of these things can be challenging at times. But they are all things we see as worth it, because of the long-term benefits. We find the joy in all of the moments along the way. The first time our child spells a word by themselves, the first time they “read” their favorite memorized picture book, the first novel we pick out. AAC is like that. Sometimes easy, sometimes hard, and always worth it. 

Make sure the system is available. This is the first thing I always tell families or new teachers to do. Spend the first few weeks getting into the habit of always having the system. Problem-solve what you need to make it happen, whether it’s straps, a Post-it note on the door, a different case, etc. Assign staff members who get systems out of backpacks. Figure out a plan and space for charging if it’s high-tech. This shows your student that you truly value their AAC system, that you believe in its importance, and that you want to hear what they have to say. It’s also really hard to model on or use an AAC system if it’s not there. 

Assume intentionality. Please, please, please, please, whatever you do, please never say “I don’t think they meant it” in front of a student. I wish you wouldn’t even think it, but please don’t say it. Always respond as if your student meant it. There is no harm in this assumption, but there is so much harm in telling kids’ that you do not believe their words. If you don’t understand, be honest. Ask. “I don’t understand what you mean, can you try telling me another way?” or “Hmm, I have to think about that, can you tell me more?” These are not hard things to say. 

Encourage exploration. Treat a talker like a voice. Do not take it away. Do not remove it or block it. Do not put it on the teacher’s desk to be used later or when it’s appropriate. You cannot do this with speech, and so you cannot do this with a talker. Exploration is wonderful. Exploration is learning. Exploration is ownership. There’s a million reasons for children to babble and stim and enjoy their systems. They could be learning the locations of words — how else will they find them, especially if they are not yet reading and spelling. They could be playing with sound and exploring words and language, just as young ones do when first learning how their mouths can make different shapes and noises. They could be engaging in self-talk. They could just be having fun with sound, and that’s fine too. They have a right to autonomy with their AAC systems, the same autonomy that they would have with their speech, the same autonomy they should have with their bodies. 

Familiarize yourself with the language system. Adults often complain about not being able to find words or finding systems not intuitive. I’ve found the hands-down best solution is to explore the system. Find a picture book and comment on all of the pages — with the AAC system. Watch a favorite TV show or movie, one where you know all the best parts already, and do the same. Think about words you might want to use on a daily basis — search for them. It truly comes down to practice. There’s a reason so many adults tend to prefer the system they know the best… Once you’re familiar with it, it becomes easy. If you don’t have access to the system itself, see if you can get access to a low-tech version, watch videos of people using it online… Give yourself time and grace to learn something new, but keep learning it. 

Model, model, model. And then — start modeling. Modeling is a fancy word for saying “talk with the talker”. Don’t overthink it. When you talk, highlight one or two of the words you say on the talker. If you’re wondering what your child could be thinking, highlight one or two possibilities on the talker (“I wonder if you’re tired? Sad?”) Start with modeling just a couple words or modeling at meals or spending some 1:1 time with your student’s AAC system and their favorite toy. Yes, you can start that small. Yes, you can start by modeling 3-4 words as the opportunity arises during the day. Yes, you can start modeling by talking all about food and drink and favorite TV shows, or other likes or dislikes at the dinner table. Just don’t make it work for them or for you. Don’t make it “say this right now”. Think of your goal less about “doing it right” and more about “getting comfortable with AAC”. I’ve seen fear of being wrong all too often lead to no modeling. And I promise some modeling, modeling with mistakes, modeling slowly, all of it is better than no modeling. 

Yes, there can be more to AAC. Yes, there are other things to think about, amount of modeling and vocabulary and recasting and probably some other fancy terms. I’m not denying that. But it all starts here. Don’t overwhelm yourself with dozens of articles and stress about doing it right. This is the foundation. This is what everything else is built upon. Make this strong. Become so reliable about having the device that you feel naked the one time you forget it for 5 minutes. Get so comfortable with responding and modeling with AAC that your child or student never, never, not for one second, ever doubts how important you see their system and how valued you see their words. Everything else comes later. 

How We Do It: Visual Schedules

yellow clipboard with velcro picture symbols showing a student's day (circle time, art, tech, eat)

I tend to write about the philosophy behind my teaching and the culture more than the practical. This is because nothing else matters until our classroom cultures shift. Visual schedules are a fantastic example of what I mean.

There are plenty of people who use visual schedules as a compliance system. This is on your schedule. You must do this. Or they use visual schedules because someone once said they should, but they sort of just sit around and have little meaning for the students using them. If that’s how they are being used, then it’s not a student accommodation. It’s a teacher tool.

We use visual schedules to increase predictability, visual supports for conversation about our day, and to assist students to know where they are going and when they are going there. They are a support system. I understand this deeply because I need a schedule.

How do we do this?

yellow folder on top of a yellow clipboard

We design the schedule to be easily accessed.

I often see schedules on walls. I’ve made this mistake in the past. But it’s not very useful on a wall if you’re in the cafeteria, on the playground, or even on the other side of the room. Asking a student to leave a preferred activity to go across the room to check their schedule to come back across the room seems like a lot of response effort for a time that may already be challenging. Transitioning, shifting attention, and now moving too? We keep our schedules on our clipboards. The front has a folder for data, notes, or individual student items. The back is the schedule. We also bring the schedule to our students. Older students could carry their schedules with them by placing them in their binders or backpacks.

We design the schedule for understanding.

We currently use primarily picture symbols, but not only picture symbols. We have used songs, objects, photographs, and written text, all dependent on the child’s needs. We’ve also mixed them all up — maybe a student uses a picture schedule for all of their work activities, but uses a spoon to transition to meal time. We currently don’t use times on our schedule as we are in preschool but I’ve used them with older students. It’s not about the tool. It’s about matching the tool to the student needs. Ask your students: will this lead to more or less understanding? More or less frustration? If they cannot tell you with speech, watch their nonverbal language. We always want to decrease frustration.

We use visual systems to support their use for transitions.

image of a filing cabinet with an "art" picture attached to the side, with 8 velcro dots below

One thing that has invariably helps my students when learning routines and schedules is to have a match in another location. They don’t just have a random picture of a table that means “work time”. There is a matching picture on the actual work time table as well. If we’re using a space that serves multiple purposes, that picture is attached by velcro. I don’t like spaces to have multiple visible pictures showing; it gets confusing. We know what the schedule says because we can read text. If our students are not yet able to read, how do we make sure they understand? This matching system helps so much.

We refer to the schedule throughout the day.

The schedule is not just a decoration or a transition cue. It’s something we talk about throughout the day. We talk about changes to the schedule in our morning meetings. When students go to their backpacks during the day, we show them their schedule to help them know when we go home. If a student asks for a snack or iPad or some other item that we cannot access right now, we use the schedule to tell them when they can have it.

We don’t care about compliance.

Repeat after me: the schedule is not about compliance. It is about understanding. Not compliance. Not compliance. It has to be said so many times. One of our assistants is brilliant at being about cooperation instead of compliance, especially with schedules. When a student puts a picture schedule piece in the wrong place or on the floor, she says, “That’s one place you could try. But let me show you where I would put it.” If a student just won’t take their picture symbol to transition, then we say, “Oh I’d love to help you. Let me show you where we are going.” If a student needs to finish their current activity, because they’re mid-alphabet, we let them finish their current activity. If a student runs across the room to the next activity, ignoring their schedule, that’s fine. If they are already sitting and waiting at the table, that’s fine too. Because it’s not about “checking the schedule”. It’s about feeling safe, knowing what’s happening in your day, and having a way to help you get from place to place. That’s why we use them. That’s why we adapt them. That’s why they work.

The right to NOT talk.

image of an iPad screen with a grid of icons for voice output. the message bar reads: "I don't want to! Grumpy"We all have times where talking is not happening. We ignore questions. We don’t answer the phone. We flat out tell others that we don’t want to talk. Some of us have times where we simply cannot talk; I’ve had many conversations with my husband via text message. At other times, we may want to talk — just not about the subject at hand. Our partner may ask if we want hamburgers or grilled cheese for dinner, but we answer with complaints about something that happened earlier during work.

Yet, this is forgotten or completely thrown out the window when it comes to the students that we serve (and children, generally, in our compliance-driven society).

We ask students what they want (often within limits). If they begin talking about something else, then we take it as proof that they weren’t listening, that they don’t understand, or that they don’t have the ability to answer. They talk about Diego, because it’s their all-time favorite, and we say they “perseverate” or “only know one word”. They don’t use their talker on demand, and it’s written off as “inappropriate” or “not being used” or “they don’t know how to do it” or “too much”.

We need to ask ourselves: what is our goal? Is our goal for students to say what we want when they want? Or is our goal for student’s to have a voice? Because a voice means they get to say what they want when they want.

A voice means being able to talk about your passions, whether they are Diego or the alphabet or worms. A voice means being able to change the topic, interrupt, or ask for something that wasn’t on the menu.

A voice also means being able to NOT talk.

It means that I don’t have to answer your questions  — not when you want me to, and maybe not at all.

It means that I can go hours without talking, or days, or whatever, because it’s my voice and I can use it when and how I want it. I can be silent, and I won’t have people then try to take my voice away.

Autonomy isn’t autonomy if it’s only allowed at the convenience of adults and professionals in students’ lives. A voice isn’t a voice unless we grant the full range of freedom — freedom to use, but freedom to not use as well.

Silence is okay.

Silence doesn’t mean “doesn’t know”.

Silence doesn’t mean “doesn’t need”.

Silence certainly doesn’t mean “take my voice from me”.

Silence is just that — silence. And everyone has the right to it.

Me & My Headphones, or why we don’t need to outgrow accommodations.

image of smiling white woman with short dark pink hair, wearing cat ears and over the ear headphones
I went to my first convention of superfans this past week, and it was the BookCon with its 20,000 attendees. That’s a lot of people. Without anything else, that’s a lot. A lot of conversations, a lot of noise, a lot of unwritten social rules, a lot of social navigation.

It could have been a disaster for me, especially on that first day. I didn’t know where anything was. I didn’t know where I should be. I only knew that there were a whole lot of lines, sometimes with clear signs and sometimes not. Lights, sounds, smells, all of it. I would say “I almost ran away from it all” except it’s not almost. I did. I sat in a corner far from the show to eat my lunch in silence. Later, I totally quit the show floor and spend the afternoon listening to panels (a much more sensory-friendly experience for my body). There was lots of running away. There could have been more. I was always able to come back. I was able to find something that meant a lot to me. I was able to have a day that was beautiful and fun and memorable, despite any near breakdowns.

It’s because of accommodations.

I didn’t use any accommodations from BookCon… The one downside to the Con is that there really aren’t very many available accommodations. I created my own. Or, in some cases, my husband thought ahead and created them for me. He packed my headphones. I downloaded audiobooks and music that help me stay centered and calm. Oh, those headphones. They were everything. I could drown out the noise that was making my skin crawl. I could distract myself from the anxiety of losing personal space by listening to a favorite chapter in a favorite audiobook on repeat. I fiddled with wires as if they are a fidget toy. They kept people from talking to me when I was not in a place to chat. Those headphones were everything. It wasn’t all I used, but it was the biggest help. I took breaks! I found quiet spaces with no one around. I found the spaces with dim or natural lighting. I stepped out of line when I needed to. I came late or left early from panels, drop lines, autograph signing.

I share this list, these few examples of a much longer list, to say — I am nearing 34, and I make these adaptations to meet my needs. I was able to have this dream weekend, filled with my number one love, because I don’t feel shame about needing what I need. Yet, all too often, we treat accommodations as if they are something to outgrow. We celebrate when students no longer need chewies, when they don’t wear their headphones anymore, or when they decide to hand write rather than use speech-to-text dictation.

We are celebrating the wrong thing.

It doesn’t matter if someone needs to wear a chew necklace. It doesn’t matter if they need to sit at the table with their shoes off. It doesn’t matter if they need to wear a pressure vest or have a weighted blanket or use a rocking chair or wear headphones. It just doesn’t matter.

It matters if someone is living the life that they want to live. It matters if someone has autonomy. Can they do the things they most want to do? What can they access? What dreams can they pursue? What learning is able to happen? What environments are now available to them? What brilliance and beauty and talents are now able to be shared with the world?

This is what we celebrate. The celebration is not whether I was able to do the second dayimage of white woman with short dark pink hair against a rainbow book backdrop. she has white earbuds slung over her shoulder.
of BookCon with less headphone time… The celebration is this: I was able to access this event that meant so, so much to me. The celebration is not whether someone uses speech or a communication device or sign to convey their message. The celebration is that this person’s voice is now able to be heard in the world.

Accommodations don’t need to be outgrown, though they certainly may morph as people’s needs change. They may even morph from one day to the next. We need to focus our attention on the right things: helping our students have lives that they design and love. Accommodations and assistive technology are not things that leave us bound. They are things that help us fly.

 

On a final note, I was able to create my own accommodations this weekend, but that’s not the case for everyone. Some accommodations really need to be created and provided by the venue, whether it’s through universal design or access to specific needs. Most venues, restaurants, stores, even community parks need to do better. One of the ways that we can make that happen is to acknowledge that these needs exist. They are not signs of weakness or “less”, but valid needs.

Switch It Up: Meet Kids’ Needs to Solve “Behaviors”

We’ve had a couple of little “problem behaviors” pop up that have occurred across multiple students pop up in my class. Going into closets. Climbing on the counters. Dumping everything in the toilet. The instinct from grown-ups tends to be that whole “no means no” — repeat, day after day, ad nauseam. And we say, “Why aren’t they getting it?”

But we can look at it another way — these behaviors are the best tools that the students currently have to meet their needs. These students are telling us: I don’t yet have the skills to handle this exact situation on my own. I need supports; I need instruction. If we want the behaviors to cease, we can’t just say no. We need to create environments that support students to use the skills they have, while we teach the skills they don’t.

So that’s what we did this week.

Photo Mar 19, 2 51 48 PM (1)Situation 1: Climbing on the Counter

Above the counter are shelves — filled with all the things that we don’t allow free access to. Not because we are controlling and keep a “sanitized environment”, but things like Cheerios, Cheetos, glue, scissors… Things that just can’t be free access. They also tend to be things our preschoolers really, really want. Thus the climbing on the counter. All of our students have a way to ask for help or ask for those items. But in the moment, the impulse control, attention shift, and emerging communication skills just don’t line up for them to do so. Because they’re in preschool.

We added a Big Mac switch to the counter that says “I need help”. It’s LOUD. It’s easy — even our most emergent communicators can use it. Just leaning in to the counter as they think about climbing it often activates it, so that they can quickly learn the association. It also serves as a big visual support — a “STOP AND THINK” kind of moment. And it worked. Within just a few hours, multiple students were running to the button, asking for help, and then telling us what they need when we brought their talkers to them. Climbing fell off dramatically — and fast. So much faster than any “no means no” instruction could have done. Because we met the students need.

 

Situation #2 – Potty!

The toilet is a tempting playground. My own son went through the same phase; we hadPhoto Mar 19, 2 49 18 PM to call the plumber multiple times for all the things that were flushed down the toilet. It doesn’t matter that we have lots of sensory fun available throughout the room. It’s the TOILET. It flushes! It’s loud! It makes noise! The best way to help our students stay out of trouble is to help them stay out of the toilet.

We also have students who are just recently potty trained, who need to be able to run to the bathroom and gain access quickly. We needed to balance all of the competing needs.

Enter switch #2… It sits right above the door handle, and says “POTTY!” We can keep the door shut, because we are allowing students to have a quick and easy way to meet their need. Just like our counter switch, we positioned it for the easiest access for this particular group of kids. Like with help, they all have the ability to ask for potty on their talkers. But it’s hard. It’s new. We need a bridge until we get there, and this is it.

And once again, it works. We have students requesting the potty that I had under-estimated, that I had not been sure they were yet able to request. It’s not that I did’t think they ever could, but I wasn’t sure they were “ready yet”. But they have an awesome way of continually reminding me that “readiness” can be an arbitrary concept, one that is primarily used to limit them. Readiness is about accommodations as much as instruction. It’s about what I am doing  more than anything they are doing.

Meeting needs works. Again and again.