The Specific Language System First Approach to AAC
The year is 1999. The primary way to interface with a computer is with a mouse. Some people with disabilities have trouble accessing the computer using the mouse. A solution for many? Place a touch window over the monitor to allow the person to directly touch the screen. We call this technology touch screens.
The year is 2001. The primary way to read text is with your eyes. Some people with disabilities have trouble accessing the text using their eyes. A solution for many? Give them access to software that reads the text aloud so they can use their ears instead (or in addition to) their eyes to access the text. We call this technology text-to-speech.
The year is 2002. The primary way to produce text is to type letter by letter on a keyboard using a word processor. Some people with disabilities have trouble accessing the keyboard. A solution for many? Provide these individuals with software that predicts what they are trying to type and decreases the number of keystrokes necessary to produce the word. We call this technology word prediction and word completion.
The year is 2003. The primary way to produce text is still to type letter by letter on a keyboard using a word processor. Some people with disabilities have trouble accessing the keyboard. A solution for many? Provide these individuals with software that allows them to speak what they want to type and have the text appear in the document as they speak it. We call this technology speech to text or voice dictation.
The year is 2018. Touchscreen technology is the primary way people interface with computing devices. Text-to-speech is freely available on any computing device. Word prediction and word completion are default functionalities of text messaging and Internet search services. People talk to a variety of devices to control functions and produce text. Functionalities of technologies which were derived as solutions for a small population of people with disabilities are now used widely by the masses.
What if we took this same pattern and applied it to the consideration for an AAC device?
The year is 2004. Most individuals who are not using verbal speech as their primary form of expression are either using a picture exchange system or a static display device, like a TechSpeak. Robust language systems accessible on touch screen devices are available, but expensive. The fortunate individuals who have access to these systems are few and far between. Clinicians and educators who know how to teach others how to use a device are an even rarer resource. However, like so many other technologies that started with a small population of users, this changed.
Flashforward back to the year 2018. It’s becoming standard practice to introduce those not using verbal speech as their primary form of expression to robust language systems with thousands of words as soon as possible. More people are using robust language systems than at any other point in human history. No longer are these systems available only to a fortunate minority. Terms like Core Vocabulary, Aided Language Stimulation, and Motor Memory are becoming commonplace amongst clinicians working to support those learning language through the use of AAC.
However, a ghost from the past still lingers. A remnant from the earlier years of AAC selection and acquisition still haunts contemporary practice. In all the other examples, access to the technology is available to the masses without need for an initial assessment. Touch screens, text-to-speech, word prediction, word completion, and speech-to-text are readily available without the need for someone to determine if it should or should not be implemented. The fact that these functions are now available to anyone allows for anyone to try these functions of technology.
It is time to lay this specter to rest and consider a different way to allow students more immediate access to robust language.
In a Multi-tiered System of Support (MTSS) model, schools determine what interventions (including technologies) are made available to every student. These are called Tier One supports. Tier Two supports are those made available to small groups of students. Tier Three supports are made available based on the needs of the individual student. Currently, many AAC device selections are made through an assessment process and are supplied as Tier Three supports. But, what if they were made as Tier Two or even Tier One supports? What if any student over the age of three who came to a school who was not primarily using intelligible verbal speech as their primary form of expression was just issued an AAC device without doing an initial AAC assessment? What would the implications be?
Let’s call this method of AAC selection a Specific Language System First approach.
To determine which robust language system to put in place as a Tier One or Two support, a school district or other learning agency can look back upon its history of providing Tier Three supports. Based on the last three to five years worth of assessments, which system was recommended and implemented most frequently? Which system is used most prevalently? This evidence could be used as a primary consideration for which system to implement as the Tier One or Two support. For any student for whom it is obvious the selected system won’t work, an assessment could still be conducted.
Let’s look at the implications of a Specific Language System First approach.
Potential Pros
Increased Time for Training and Coaching - The amount of time a person has is finite. Every minute spent on assessment is one less minute spent on implementation, training, or coaching. There is an opportunity cost related to assessment that is difficult to quantify. If the number of assessments was decreased, what could those who were formerly doing those assessments create or accomplish? Would this free up time for ongoing coaching opportunities, professional development course creation, material generation or adaptation, and/or parent/family learning experiences?
Less System Confusion and an Increase in Modeling - A student stands a better chance of learning how to use an AAC system when communication partners also use the same system. This strategy is called Aided Language Stimulation (ALgS). When educators are conducting a lesson and those participating in the lesson each have a different communication system, it makes accurate and proficient modeling a greater challenge. The educators would need to fluidly know where the words are located on multiple systems. It can be difficult enough to learn one system, let alone multiple. Using one primary system helps reduce the learning curve, decrease the intimidation factor, and allows for greater modeling on that particular system.
Mitigate Impact of Transitions - Transitions can be the death knell for successful implementation. One might spend years or more coaching educators on how to implement a system. The educators then learn the system, become proficient modelers of the system, and the student reaps the benefits. Then, the student graduates and moves onto the next grade level. Depending on the school, the educators there might be starting from scratch, completely unaware of the system or how to implement it. Having one system which is used primarily within a school district helps everyone understand and learn how to use that particular system. When transitioning to a new school, the chances of that new staff being familiar with the system increases.
Students Aren’t Waiting - In a traditional assessment process, implementation of an AAC device is postponed until after the assessment is complete. Paperwork, procedures, and processes eat up valuable time where a student could be learning to use a system. Every minute a student does not have access to the robust language system is one less minute he/she has to learn how to use it. Opportunities to learn language on a good system might be flying by as the process works on selecting the perfect system.
Potential Cons
One Size Does Not Fit All - There is no one system that will work for every student. Individual needs vary. Although most users might access the device using direct selection by isolating a finger, there are others who require alternative access, such as switch scanning or eye gaze. Even if a Specific Language System First approach were to be adopted, customizations within that system would likely be necessary for individual students. Despite the idea that one system will never meet the needs of every individual, perhaps, one system might meet the needs of most.
What If We Get It Wrong? - There is a risk that the system used by most does not meet an individual’s needs but it was provided to that student anyway. An assessment might have produced a different result in system selection had it been conducted. What if the time spent learning to use the system selected as a Tier One or Two support wasn’t the right fit and it was provided anyway because of the implementation of a Specific Language System First approach? Although this might occur, the risk might be worth the reward.
The year is 2030 and beyond. What does the future of AAC selection and implementation look like to you? Does every student requiring an AAC device still sit in a queue waiting for assessment? Have AAC systems become so mainstream that general educators are overtly aware of how to use them to design educational experiences to teach language? Does every educator and peer know where the vocabulary is located so that everyone can be modeling on the device when communicating with an AAC user? Is teaching students how to use a robust language system something known by a relative few or has it emerged to take its place alongside the pantheon of other technologies that have grown to be used by the masses? What future do you want to see become a reality? What actions can you take to get there as fast as possible? Adoption of a Specific Language System First Approach expedites a vision of the future where learning language using a robust language system in a supportive learning environment is the norm rather than the exception.
Additional Resources:
A Flowchart Diagramming An Example of A Specific Language System First Approach to AAC
Talking With Tech Episode 11 - Erek Engar: A Specific Language System First Approach to AAC
Talking With Tech Episode 140 - David Moehn: Supporting Students More Universally with Technology
Bio:
Christopher R. Bugaj, MA CCC‐SLP is a founding member of the Assistive Technology Team for Loudoun County Public Schools. Chris co-hosts the Talking With Tech podcast featuring interviews and conversations about augmentative and alternative communication and has hosted The A.T.TIPSCAST; a multi‐award winning podcast featuring strategies to design educational experiences. Chris is the author of The New Assistive Tech: Make Learning Awesome For All, published by the International Society for Technology in Education (ISTE). Chris is the co-author of Inclusive Learning 365: EdTech Strategies for Every Day of the Year (which is available for pre-order now) and The Practical (and Fun) Guide to Assistive Technology in Public Schools both of which are also published by ISTE. Chris co-authored two chapters for a book published by Brookes Publishing titled Technology Tools for Students with Autism. Chris co‐produces and co‐authors the popular Night Light Stories podcast which features original stories for children of all ages. Chris has presented over 500 live or digital sessions at local, regional, state, national and international events, including TEDx.
Chris presenting the Specific Language System First Approach at the Assistive Technology Industry Association Conference 2019