Check out this quick video for help! It also shows the difference between passcodes and guided access.
Play is a normal, expected, even necessary part of learning for children! I think as adults we sometimes forget that for children, play IS learning. Please never remove an AAC device just because the user is having fun with it! Kids have been known to "play" with their natural voices too, for example by saying silly words or making funny noises. Instead of removing the device, respond to what they said on the device as if they said it verbally. My personal style is to respond playfully ("Oh, you silly goose!") but there may be times when you have to respond more firmly ("Shhh" or "Time for work now"). Another option could be to show them how to use a "whisper" voice (low volume, or low tech) so they can keep talking, but without disrupting their class. For more helpful tips related to repeated button tapping, check out this article from an SLP and an AAC user.
It's okay if they aren't repeating immediately after you. Natural conversations don't really work like that, so please avoid the temptation to prompt them with what to say. Instead, think about providing "aided language input". You're just showing them things they COULD say, not things they MUST or SHOULD say.
Also, know that sometimes it may seem like they're not paying attention visually, but they may be hearing you anyway. Be patient. Learning to use an AAC device takes a long time! Just like learning a spoken language (which takes years, even if you don't have a disability making it difficult for you.)
I know it may seem like the aided language input and modeling isn't working at first. I'm always tempted to say, "trust me, it will!" because I've seen it happen so many times. But instead, what I know I should be saying is, trust the evidence for aided language input.
Tip: to understand what to do instead of prompting, check out the Top 3 AAC Strategies Handout (note - link requires LVJUSD login to access).
... Just kidding!
But this is what I feel like my face looks like when people ask me this question. And if so, I'm sorry!
Here's a short version: more buttons are better for almost all AAC users.
If that sounds crazy, here's a longer answer, and it's a little complicated, which is why I might look like grumpy cat while trying to think of everything I want to tell you about this topic...
Every time I assess a child to determine the best "fit" of an AAC device for them, I look at (1) what is the smallest size of icon they can see and touch, (2) how much information can they visually attend to on one page, and (3) how much vocabulary are they going to need to be able to function in daily life, among other things that are also important but less relevant to this particular question.
We want the smallest possible icons, and the largest number of icons per page. Why? Because this means (a) exponentially more vocabulary overall and (b) many less folders to scroll through. The less folders there are, the lower the demand on the user's memory (and patience!), and also the faster they will be able to use the device to form whole sentences.
Almost every time I test a child for a high-tech AAC device, I will first offer them a version of the device with "masking" applied. This means they will probably only see about 10-15 words on it at first. When they have success with that, I add more. So by the time you see it, there's probably a lot more than those first ten words.
If the device seems visually overwhelming to you, it's probably because you're not familiar with it! But every high-tech AAC device has color-coding, folders, and a "search for a word" feature that you can learn to use, and that will make you feel more comfortable with it. Let's meet, and talk, so the device doesn't look so scary to you. Send me an email!
Head's up: I will be making videos for this website that will give you a "tour" of each device, and that should help!
Finally, the reason I give students so many words on their AAC devices is because I believe in their ability to learn them. Not just because I have faith (we call it "presuming competence"), but because I have data on the specific child/adult, and evidence from research and practice to show me that more words are better, and that robust, well-organized vocabularies are better.
No. This is a very common fear, but I always tell parents, don't worry! There is lots of research to show that AAC improves overall communication skills, and does not delay a child's speech. Actually, I've personally witnessed many cases where, shortly after introducing an AAC device, the child started talking for the first time! Something about learning AAC seemed to "unlock" their communication skills, and they began verbalizing.
Why does this happen? We don't know exactly, but here are a few factors that might play into it:
We know that it's always faster and easier to speak than to go get and use an external object to communicate. Think about it: you always have your voice with you, but do you always have your laptop? No, you'd have to go get it if you wanted to use it to type something. So as soon as the child can verbalize a particular word or phrase, they will, because it's easier! If they can't, or are struggling with it, they will probably go to their AAC.
We know that learning to use AAC mirrors the way children learn to use verbal language. Starting from the very basics of teaching a child to communicate using core vocabulary, and making that interaction fun and motivating, might give the child the support they needed to use verbal language for the first time, too.
We know that the visual language of AAC can be very powerful, especially for autistic children who have a relative strength in visual vs. auditory processing. It may be that something about seeing language symbols helps them begin to associate sound with meaning. Or it could be that hearing single words repeated the same way each time (i.e. by the text-to-speech voice, which doesn't vary as much as a human voice) makes them more accessible to the child, and therefore easier to imitate.
This is the case for many AAC users! Aside from the Essentials (which are the same for all AAC users), the important thing to know is that we need to convey respect for all communication modalities. So if they use their device, there's no need to ask them to repeat verbally. If they say something verbally, no need to ask them to repeat it on their device.
There is just one exception: if you don't understand what the child said verbally (e.g. for those with articulation challenges), you may ask them to try using their device to tell you. For example, you could say, "I didn't understand that, can you tell me with your AAC device?". But please be aware that the AAC user may or may not know where to find that same message on their device! For that reason, it may be helpful to teach them strategies such as "show me the first letter" (on the alphabet page), or using a "Clues" page if available on the student's device. Please contact me with any questions about your particular student.
This is a complex topic with los of nuance. It's important to pick apart: is this behavior that we see really stimming?
Sometimes it's actually learning! Check out this awesome blog post from Rachel Madel. The story she tells about a child teaching herself to use her device? I've seen that happen too!
Sometimes it's a child repeating the same word many times because they are struggling with activating the screen. If that's the case we may need to program the device a little differently to accommodate them.
Sometimes the child is stimming on the device, and in that case, we need to think about why the child is stimming - because it may be serving an important purpose for them. Check out this awesome article for reasons a child might stim, and ways to support them.
Laura Hayes gave an amazing presentation at AAC in the Cloud 2021, and developed an entire website of resources on this topic.
Everyone stims sometimes (Have you ever found yourself fidgeting during a boring meeting? That's stimming!), and it's important that our AAC users have options to stim that are supportive to them, and less likely to interfere with their communication.
This is an individualized decision, but I like to follow two rules of thumb: (1) Be quick to give AAC and slow to take it away, and (2) If the child/person can tell you verbally and intelligibly that they don't think they need AAC and they prefer speaking, then they're ready. Please note that we don't stop using AAC the moment someone says their first words, or starts imitating speech. There's a lot more to communication than single words, and we need to make sure they have a way to create spontaneous, novel sentences, for a variety of purposes. Please note also that we definitely don't stop using it just because someone hasn't learned to use their AAC yet. They may need more time, or different strategies, but we don't give up on any student. All human beings have a right to communication (source: Communication Bill of Rights).
When someone asks me this question, I typically start by reassuring them that in the first year of using a new device, it's very normal for kids to not use the device spontaneously or productively. Typical kids need a whole year of modeling (i.e. listening to their first language) before they say their first word! So we have to offer our AAC users a whole year of modeling in their new "language" of AAC, too. On top of that, they also need ongoing modeling to maintain the motivation and skills to continue using it. This is similar to what happens when someone learns a language in high school, but then doesn't continue using it as an adult - typically it doesn't take long before they forget it.
So if someone says, "he's not using it," often I will ask, "Are you using it?" because if not, we have to start there! And if the adults around the student are using the AAC, then it's important we make sure those adults are using it correctly! Are they prompting, or modeling? It's important for everyone to be modeling without expectations, because over-prompting is the other most common reason why a student won't be using their device (i.e. they don't want to be told what to say!). For a handy handout explaining this in more detail, please see the Top 3 AAC Strategies (note: link requires LVJUSD login to access).