AAC - Teen and Young Adult

Practical advice for AAC learners – Teens and Young Adult

Learning AAC (Augmentative and Alternative Communication) is like learning a second language – it takes time and lots of consistent practice to use it independently. It’s helpful to consider this when thinking of expectations for an AAC learner to become proficient with a symbol communication system.

One of the key things to remember is that the AAC system, whether this is a low-tech board or a high-tech device (or any other system), is that the system must always be available. A user MUST see what AAC communication looks like in order to learn how to eventually communicate on their own. We must show an AAC user where words are, and how words can be combined to create phrases. Read below for ABCs of daily practice.

A) How do we learn AAC?

It can feel difficult and clumsy at first for a parent or caregiver - that’s okay! It is more important to get started than to worry about picky grammar and sentence structure. If the AAC user is just starting, then they are likely only using 1-2 words at a time, anyways. Let’s begin!

Best practice says modelling is a key teaching strategy (also known as ALS: Aided Language Stimulation), which is done in the learner‘s natural environment. Modelling means communicating with the learner and others using the AAC system to immerse the learner in this language of symbol communication. You need to use it at home, school, during holidays, and any community setting. Modelling will be most effective if the learner sees communication with AAC in real situations, all day, every day. Here’s how you can give good models:

o   Model 1 or 2 words beyond the student’s current language level. For example: If they are a brand new user and not comfortable using it independently, you can model with 1-2 words at a time on the device. If the student is using one word at a time to communicate more comfortably, you would put together short phrases of 2-3 words.

I.e. Student uses : “outside”, teacher/caregiver validates this and says “yes! Outside!” and can model: go + outside

o   Model target vocabulary and grammar. It is okay if they just follow you when learning new targets. A learner typically needs at least a few dozen exposures to new words in different activities in order to generalize and use words by themselves.

o   Model at a rate slow enough for the student to follow you. Take your time.

o   Don’t worry if you make an error! Let them know: “Oops, I made a mistake. Let’s fix it” and let them see you correcting it. For example, returning to the home page to start again.

o   Think aloud and talk about what you’re doing while modelling for the user. I.e. “Hmm, I want to ask for tea… I need to find the “DRINKS” page. Oh! “Tea”, “drink + tea”

o   Remember that LOTS of exposure is needed before the learner can produce similar messages on their own. Be persistent!

B) What should we teach?

As much as possible, incorporate it in all daily activities – practice makes progress! Typically developing children have heard verbal language modelled for them thousands of times before they are expected to use words. We should expect that an AAC learner, young or old, needs to see and hear the device being used a lot in order to understand its effectiveness as a communication tool. AAC is NOT just for requesting. It should be used for a variety of functions: to request, to comment, to refuse, to share thoughts, ideas, and feelings, and for social conversation.

C) Can you give me examples?

Here are some suggestions to include AAC modelling in routines for teens and young adults:

Meal time:

How to request: find a button for their preferred food and/or drink, press it. If the user is at a more advanced level, you can use “eat + sushi”, or if that is already being used independently, go even further and model “I + want + to eat + sushi”.

How to comment: find a Describe page, press “yummy”, “good” to describe it. If at phrase level, use “I + like + ____”. For emotions, find buttons for “hungry”, “thirsty”, “full”

How to refuse: “all done” “finish”, “I + don’t + want + it”

Night time routine:

How to request: I + want + books/blanket/tea or other preferred routine items. When their usual bedtime arises, model “sleep” or more advanced “I + want + to sleep.” Remember that the vocabulary and models must be relevant to the user. If they require support for night time routines, your modelling on the device should reflect that.

How to comment: use “go + bed”, find buttons for “blanket”, “pillow”, go to a clothing page and find “pajamas”. Use core vocabulary for dressing routine, try “on” and “off”, or “put + on” and “take + off” (Remember to show them and model it; don’t force them in using it or withhold things from them – they are still learning, we can show them!) Use buttons for places such as “bathroom”, “bedroom”. For emotions, find and press “tired”.

How to refuse: use “stop”, or use “I + don’t + want + it” to help them refuse help or refuse part of the routine they don’t want (i.e. they don’t want a drink before bed).

*see if you can apply some of these to a morning routine, too.

Favourite activities:

How to request: watch + TV, read + book, go + outside, take + pictures, listen + music, play + cards/game/soccer. If they are now able to make longer phrases, try using phrases such as “I + want + to watch + Youtube + please”

How to comment: “on” or “turn + on/off” for electronics and TV, use emotion words such as “happy”, “excited” when playing. If the student is upset when the activity must be finished, i.e. you must leave the soccer field to get ready for dinner, you can validate their emotions by showing and pressing “sad”, “disappointed”.

How to refuse: can use general refusals of “stop” and “no” if they don’t want you to take turns in their favourite activity. Can use “I + don’t + want + it” or the other suggestions for refusal if they don’t want to add new objects in a game (or a different book they don’t like: offer, and let them refuse it - the power of choice!)

Getting ready to go out:

How to request: “help” is a useful button for those who need help dressing or with shoes, zippers. Try “put + on” with various clothing items: jacket, shoes, hat, boots. Before leaving, try “go” or “go + outside” to request the walk.

How to comment: comment on the weather before leaving, can also add time of day comments. ie. “the weather is + sunny.” Look outside, comment the time of day with “morning”. For emotions, use “happy” “excited” if they like to walk; if they don’t like uncomfortable boots or don’t like the rain, use “frustrated” or “uncomfortable”. Perhaps they had a bad sleep and don’t want to go for a walk; model a comment on this with “tired”

How to refuse: use “stop” “no” or phrases such as “no + walk”, or show them locations they’d like to go instead , ie. bedroom, home, etc.

Can you think of some more ways to add practice during the day? Get creative and get started!

**As always, this blog post does not replace an assessment or individualized recommendations for speech-language therapy by a certified SLP. Contact a speech-language pathologist to ensure that your family member is receiving the right supports to help them grow.