Originally published on Feb. 8, 2020.
This blog post comes thanks to a Parent who asked me a question on Twitter. Thank you for all your questions, it helps me to understand what you need from me.
In this case, the child was using a low-tech AAC system, but being considered for transition to a high-tech system. The Parent wanted to know what sort of things a Therapist is going to be thinking about if they think a child is ready for high-tech AAC.
First, an overview: If you live in England, your child may be able to access funding for a high-tech device through one of the specialised AAC assessment centres across the country. If your Speech Therapist is considering requesting funding for a device through this system, then there will be specific criteria that need to be met, which will form part of the assessment that your local Speech Therapist is carrying out. One of the jobs of an assessment is to make a decision about which funding 'pot' would be appropriate if we do decide to pursue getting a device. In our area, key criteria are that children can combine more than one symbol in a message, and that they show some navigation skills using low-tech systems (e.g. they can navigate to the right page to build the message they want). This does not mean that there are not options for children who do not meet these criteria, but that we will be thinking about different funding options.
Each child is a little bit different, but some general principles we will be thinking about if we are considering moving to a higher-tech device:
- Does the child understand the purpose of communication yet? Are they making intentional attempts to communicate with other people?
A child who is not yet an intentional communicator is very likely to need more practise at this cognitive skill before we consider a device. A device is a means to communicate, but cannot compensate for other areas which a child needs to be an active communicator, such as motivation to communicate.
- Does the child consistently access a low-tech means of communication (whatever that might look like)? Is there some reason that this does not meet the child's needs, or do we have reason to suspect that their needs will be better met with a high-tech device?
It can take time to get an AAC system right. We need to explore and assess various factors in low-tech form so that we can make better decisions about which high-tech device and software will best suit a child's needs. In addition, we will always need a low-tech alternative to a device, for times when tech goes wrong or is not available for various reasons.
But there is definitely a point where a high-tech device will be a better 'fit' for your child. Some potential reasons that this might be the case are:
- Your child needs much more vocabulary available to them than we can reasonably keep on top of in a book
- Your child would benefit from the wider communication options that can be available to them in a high-tech device, for example, they could use their device to communicate, but it would also open up the potential for accessing email or social media for example, which some software enables.
- The physical access to a book is a challenge for various reasons. A device would therefore make communication quicker and/or more independent.
- Where a high-tech device would considerably reduce the barriers to communication for the child, for example, it would allow them to communicate with a wider range of people in their community and be understood (but we can't forget that an electronic device can also be a barrier to inclusion if it creates fear of the technology and reduces interactions with other people)
- Is there commitment from the team around a child to use a device?
This is a really big one for me - devices are typically highly reliant on everyone in an environment to be successful. We look for signs of commitment to and understanding of a child's communication using low-tech before we pursue high-tech. There is often a perception that a high-tech device is 'better' than low-tech (not necessarily the case at all). If a class team or family are not commited to using, updating and modelling a child's low-tech system, then they are not likely to be able to maintain motivation to support a high-tech system. There is often a lot of excitement when a high-tech device is being discussed, and a lot of motivation is created in the short-term. But the truth is that using a high-tech system requires a lot of learning, thought and maintenance from everyone around a child. It is not inherently easier to implement or use.
- Are expectations of a high-tech device realistic?
We need to make sure that our expectations of a high-tech system are realistic. A child who has very few motivators to communicate may find a high-tech device more motivating than a low-tech one, and this may be a reason to consider a move to high-tech. But they will not become a child who suddenly wants to chat and communicate as any other person of their age. If we do not make sure that this is understood, then we may be setting a child up to 'fail' at a system because we have not had shared understanding of what our own expectations are.
- What is the child's response to technology generally, and a high-tech device in particular?
I would usually be interested in a child's interest in technology, and want to trial a high-tech device with them (even of it is not necessarily what will be their system in the end), as this will give us lots of information about their readiness for high-tech.
This is a general picture of the kinds of information we will be gathering as Therapists, I hope that is helpful!
If you would like to ask any other questions about AAC or any other communication issue, please come and find me on Facebook (www.facebook.com/findthekeyslt), in my Facebook group (www.facebook.com/groups/findthekeyfamilies), on Twitter (@FindthekeySLT) or drop me a message via email [email protected]