Alternative and Augmentative Communication Solutions for Children and Youth with Autism

Why use AAC Support communication Augmentative/ Alternative Receptive language Support e.g., -Routine Strips - Social Stories Expressive Language Support Words to express choices, ideas, feelings - Words to replace behaviours

What is the Clinic for Augmentative Communication (CAC)? Expanded level AAC clinic accredited by Assistive Device Program (ADP). Sees clients with complex clinical and/or technical needs. Can authorize full range of communication devices approved by ADP. Team includes SLP, OT, Technician, Program Assistant, and Admin Support Provides assessment, consultation and prescription of augmentative and alternative communication (AAC) systems Located primarily at Thurston site, with one SLP at Renfrew site Service may be provided at other OCTC sites or in homes/schools as required

Types of AAC There are many different ways to communicate: Unaided modes Aided modes Exchange systems (e.g. PECS)/pointing system (e.g. communication book or VOCA) Light tech/low tech/high tech

Unaided Modes No external devices is needed to send the message (natural means) The child communicates using movements or sounds he can make on his own Examples: sign language, vocalizations, pointing, facial expressions, body language Cheaper, more portable, always available/accessible, require less set-up/preparation time, may seem more natural, allow for eye contact with partner, may be faster

Aided Modes An object or a device is used to communicate the message Examples: communication book, theme board,picture exchange, topic board, pen and paper, electronic device, etc.) Requires less motor control, are usually understood by a wider range of partners, may make fewer demands on memory

Picture Exchange Communication System (PECS) vs Pointing System PECS provides an essential step in learning to engage in social interactions (e.g. giving a picture of desired item for that item). However, a pointing system may be useful if child demonstrates the following: - communicates directly with a partner - has “more to say” Example

Light tech systems Light tech: communication boards, books, themeboards, topic/alphabet boards - cheaper than technology - requires less maintenance (e.g.: cleaning, battery charging) - more portable/light weight - never breaks down - may be considered less obtrusive (e.g.: users who are very sensitive about appearing different)

Low tech/high tech devices Low/High tech allows for: greater independence increased flexibility in communication due to voice output (e.g.: can get attention, talk to someone at a distance, talk in a group, interrupt and be better able to control conversation, talk to people who can’t see or understand visual symbols etc.) user may be viewed as more competent if has technology

Themeboard example (light tech)

Topic Board

What type of AAC system is the most appropriate for an autistic child? It is the same for any other child - There is no one system that is best for all ASD clients It is important to determine the child’s: Communication needs Skills and Abilities The child’s communication partners The contexts within which communication occurs

AAC needs Needs can be related to a number of variables: Who are the client’s partners? Potential partners? Where and when does the client need/want to communicate? What does the client need or want to communicate about? Specific patterns of skill and disability – e.g. , Literacy? Motor skill? Client’s personal preferences Individuals with ASD tend to learn to request first. BUT do not stop there. Individuals with ASD can learn to communicate for other reasons. When they have limited speech we often only provide vocabulary and practice to make requests. At higher levels, PECS starts to address commenting, e.g., I see; I have – again, the vocabulary choice is often limited to the teaching task and not extended to life experiences and what the individual may WANT to say.

Skills and abilities How does the individual communicate now? Why – what reasons are important? Motor skills – can the individual: - point, gesture, make signs, turn pages of a book. Cognitive skills: attention, world knowledge, understanding of language, cause and effect, communicative intent, joint attention, categorization Does he use behaviours?

Skills and Abilities Symbol skills: recognition and use - what kind of symbols does he/she understand - how quickly does he/she learn to use a symbol/sign to communicate - what strategies are effective Sensory skills Vision and hearing Are there specific ways we need to design symbol layouts to ensure the client can find and select symbols?

Skills and Abilities Device trial? - is it motivating to the client? - is it motivating to the Team? - high or low tech? - what are the vocabulary needs? - can the client navigate a high tech device? Consider communicative need first – I.e., in what contexts would “out loud” speech be advantageous?

Resources Community SLP’s Individual Authorizers All About AAC Referral to the Clinic for Augmentative Communication

How to make a referral to CAC? Call OCTC Intake Services at 613-737-0871 ext. 4425 to initiate a referral A CAC referral will be sent for you to complete. It must be signed by the parent/guardian. Questions or unsure if referral is appropriate? Call CAC program administrator at 613-688-2126 x4319