Augmentative and Alternative Communication in the Early Childhood Years

Author(s): Mary Frances Hanline, Dbora Nunes and M. Brandy Worthy

Source: YC Young Children, Vol. 62, No. 4 (July 2007), pp. 78-82
Published by: National Association for the Education of Young Children
Stable URL: http://www.jstor.org/stable/42730056 .
Accessed: 07/12/2014 15:20
Your use of the JSTOR archive indicates your acceptance of the Terms & Conditions of Use, available at .
http://www.jstor.org/page/info/about/policies/terms.jsp

.
JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, and build upon a wide range of
content in a trusted digital archive. We use information technology and tools to increase productivity and facilitate new forms
of scholarship. For more information about JSTOR, please contact support@jstor.org.

National Association for the Education of Young Children is collaborating with JSTOR to digitize, preserve
and extend access to YC Young Children.

http://www.jstor.org

This content downloaded from 165.123.34.86 on Sun, 7 Dec 2014 15:20:58 PM

All use subject to JSTOR Terms and Conditions

ANd

Auqmentatve
N

ThE

EarIy

AIternatve

Childhood

Communcaton
Years

MaryFrances Hanline,Dbora Nunes,and M. BrandyWorthy

FOR MOST pEOplE, communicationinvolvesspokenlanguage.
However,forsome,theabilityto
hearspeech or to speak is compromised.Thereare childrenwhocannot
use speech because theyhave difficultymovingtherequiredmuscles,
or heardisabilities,
developmental
Forthesechildren,
ingimpairments.
nonspeechcommunication
strategies,
calledaugmentative
and alternative
communication
(AAC)systems,may
be beneficial.
AACsystemscan augmentexistingcommunication
skillsor
an
alternative
to
provide
speech.

What is AAC?

ofbookcoversattachedto Plexiglas.
Whenoffering
choicesofwhatshirt
to wear,his mothermightexchange
thebookcoverswithsmallpieces
ofcoloredfelt.The childpointsto,
looksat,or otherwiseindicatesthe
symbolthatrepresentshis choice.

AACsystemsofcommunication
do
notrelyon speech.Forsome children,
an AACmaybe theprimary
means
ofcommunication;
othersmayuse
an AACto clarify
and expandtheir
speech (McNairn& Shioleno2000).
Hightechnology(hightech): HighAACsystemsare categorizedinsevtechsystemsincludetheuse ofeleceralways(Heller2004).Belowis comtroniccommunication
boardsand/or
monterminology.
computerized
speech synthesizers.
No technology(no tech): These AAC
Electronic
communication
boards
systemsinvolveonlytheindividual's
havea displayofcommunicative
body.Somesystemsinvolveformalline
messagesusingphotographs,
izedlanguages,
suchas American
Sign
drawings,
phrases,words,or letters.
Language(ASL).A simplersystem
The messageis activatedbytouchor
MaryFrancesHanline,PhD,is an assomayinvolvegesturesuniqueto a parlaserbeamto producea printout
or
ciateprofessor
at Florida
StateUniversity ticularchildthatthecaregiverundersynthesized/digitized
speech
(syninTallahassee.MaryFrances'sareaof
stands(forexample,whena child
thesizedspeech is computergenerinterest
is theinclusion
ofyoungchildren
toucheshercheekto ask fora hug).
ated;digitizedspeech is recorded
with
disabilities
inplay-based
community
childcareprograms.
She can be reached Lowtechnology(low tech): Lowusinga humanvoice).
at mhanline@fsu.edu.
techsystemsare nonelectronic
but
DboraNunes,PhD,is an associateproinvolvematerialsoutsidethechild's
fessorat Universidade
Federaldo Rio
body.Examplesare phoGrandedo NorteinNatal,Brazil.Dbora
and/
tographs,drawings,
has studiedinBrazilandtheUnited
or wordsthatare kept
theuse ofAACsysStates,examining
ina notebookor photo
temsforchildren
with
autism
spectrum
andcerebral
palsy.She can be reachedat
album,fastenedto a piece
deboranunes@ufrnet.br.
ofPlexiglas(or anyother
M.BrandyWorthy,
of
MEd,is director
materialthat
lightweight
Behavioral
Intervention
Services,a coris easilycleaned)with
inHuntsville,
that
Alabama,
poration
Velcroor bymetalrings.
works
with
families
andschoolsystems
A low-techsystemmay
withchildren
ontheautism
spectrum.
She can be reachedat bworthy@
also involvea collectionof
behavior-intervention.com
objects(such as a spoon to
Photoscourtesy
oftheCreative
Center
thedesireto eat)
represent
forChildhood
ResearchandTraining,
Talin
a
box
or fastened
kept
lahassee,Florida.
to Plexiglas.Forexample,
Thisarticle
is onlineinBeyondthe
whena childchooses a
Journal,
2007,atwww.journal.
July
bookto be readto him,he
naeyc.org/btj.
mightchoose fromphotos
nae^c

2,3,7
July
Children
2007
Young

78

This content downloaded from 165.123.34.86 on Sun, 7 Dec 2014 15:20:58 PM

All use subject to JSTOR Terms and Conditions

needto learnto comHowwillthe symbolsystembe

municateto getbasic
displayed?Considerhowbestto
needs met(such as
maketheAACavailableto thechild.
Does
he
A
childwhouses a wheelchair
hunger)?
need to learnto comboard
mayneed a communication
municatemorewith
attachedto his chair.A physically
activechildmayprefera smallset of
peersinplay?
picturecardsattachedto herbelt.
WhatAACsystemis
Withwhomwillthe childbe intermost likelyto build
on the child's abiliacting and in whatsettings?
thisquestionwillhelp
ties? Forexample,a
Answering
determine
howportablethesystem
childwhohas develmustbe and whattypesofcommunioped herowngestural
cativemessagesshouldbe included.
systemto communiA childwhofrequently
cate maydo wellwith
playsChutes
and Ladderswithhis sistermust
signlanguage.
about
havesymbolsto communicate
Howwillthe child
A
child
whose
that
family
activity.
communicateusing
enjoyshikingmayneed a verylight
an
AAC
Considerthe
system?
Developing an AAC system
and portablesystem.
child'smotorabilities.Can she
AAC
The selectionofa particular
point?Reachand touch?
Formsignswithherfinsystemfora specificchildis best
madethrough
a collaborativeteam
gers?Does she relyon eye
decision-making
process.The team
gaze?Willshe need a head
AAC systems can augment
membersand
activelyinvolvesfamily
pointer?
skills or
existing communication
includesteachers,childcare
typically
Whatare the child'scogniAACtechadministrators,
providers,
tiveand visual abilities?
provide an alternative to speech.
and speech and
nicians,physicians,
A childwhois notyet
language,occupational,and physical
able to understandletters
thequestions
therapists.
Answering
froma system
maybenefit
belowcan helptheteammakedeciusingpictures,drawings,
sions aboutthemostappropriatetype
The detailsofthesystemare usuand a childwhois
or photographs,
ofAACsystemforan individualchild
notyetable to understanddrawings allyworkedout inclose consultation
(Blackstone& HuntBerg2003).
a
or imagesmayneed objects.A child
bya speech and languagetherapist,
Whatare the child's communication
willneed sym- special educator,and/oran AACtechwitha visualdisability
needs? Considerwhyand howthe
bols largeenoughand withsufficient nician.Choosinga vocabularyis the
childcommunicates
now.Does he
firststep.
contrastto be visible.
wordsshouldbe motivatThe first
ingto thechild- forexample,namfoods,or
ingfavorite
toys,activities,
of AAC Systems
Research
on the Effectiveness
drinks.Parentsand othercaregivers
can providevaluableinsightintothe
and
Children
withcognitive
disabilities,
developmental
delay,physical
disability,
and needs.The
child'spreferences
autismcan use AACsystemstorequestitemsandrespondtosimplequestions
theculalso shouldreflect
vocabulary
& HuntBerg2003;Ganz& Simpson2004,Schlosser& Raghavendra
(Blackstone
tureofthechildand theculture(s)
the
2004; Romskiet al. 2005).Otherstudiesshowthattheuse ofAACimproves
inwhichthechildwilluse theAAC
et
al.
Tincani
verbal
communication
and
of
children's
2002;
(Kravits
quantity quality
system(Janzen2003).As children
toform
etal. 2000),andtheir
ability
(Schmit
2004);theirreceptive
languageabilities
in
becomeolderand moreproficient
& Williams
2000; Keen,Sigafoos,& Woodyatt
2001). In
speechsounds(Cummings
able
to
comof
the
the
use
AAC,
being
wereabletolearntouse theAACdeviceswith
otherstudies,teachersand parents
municateemotions,ask questions,
& Howlin
children
inhomeandschoolenvironments
2003;
(Stiebel1999;Magiati
and use thevocabularyoftheirpeers
&
Kashinath
Nunes,Hanline,
2005).
becomesmoreimportant.

July
Children
2007
Young

79

This content downloaded from 165.123.34.86 on Sun, 7 Dec 2014 15:20:58 PM

All use subject to JSTOR Terms and Conditions

Teachers

can help the other

children in the group to understand the AAC system and use it

to communicate

with the child.

Using AAC at home and in

early education settings

H
E

proLanguageintervention
H|
when
are
most
effective
grams
theytakeplace inthechild's
setnaturallanguage-learning
in
the.
home,
example,
tings(for
and when
school,or community)
is actively
thechild'sfamily
& Prizant
involved(Wetherby
1992;NationalResearchCouncil2001;
of
see "Researchon theEffectiveness
AACSystems"forfurther
research).
Mostparentsand childcare providers
who have had littleor no experience
withAACsystemsneed professional
guidance- usuallyfroma speech therapist- to beginusinga system.Soon
theybecomecompetentand creative
intheuse and continueddevelopment
ofthesystem.
WhenusingAACsystemsat home,it
is criticalthatfamiliesmaintaintheir
can
typicalroutines.The professional
the
families
incorporate systems
help
intotheirusual activities.Hereis an
exampleofa motherusingan AAC
duringa
systemwithherfour-year-old
routine:
play
Juliann
showsClaraa Plexiglaspictureboardwithseparatephotographs
andwhiteplayofblue,red,yellow,
is
Each
photo attachedtoa
dough.
different
cornerofthepictureboard.
Juliann
asks Clara,"Whatcolorof
wouldyoulike?"When
playdough
Claramakesherchoicebypointing
tothephotooftheblueplaydough,
and
Juliann
handshertheplaydough
you
says,"Here'stheblueplaydough
askedfor."
Juliann
nextsets upthecommunicationboardcontaining
photosof
toolsoftenusedwithplaydough
(such
as a rolling
pinandcookiecutters),
butshe putsthetoolsthemselves

outofClara'sreach.Clarahas
slightly
to pointtothephotoofthetoolofher
choiceeachtimeshe wantsa differenttool.
Clarauses thisAACsystem
to learn
becauseshe has theability
a morecomplexsystemandthisis
thefirst
process.
stepinthelearning
talks
theirplay,Juliann
Throughout
to Claraaboutwhatshe is doingand
aboutthechoicesshe makeswithher
AACsystem.
integrating a system into
the classroom

carecenterwiththeirfather
Manny.
Diegohas a severe
prehearingimpairment
himfromhearing
venting
andunderstanding
speech;
Emma'shearingis normal.
Shannon,theteacher,
greets
them,signingHi.Manny
andDiegosignHIback,and
EmmagivesShannona good
morning
hug."Howis everyonetoday?"Shannonasks,
andaftera brief
exchange,
she adds,"Okay,kids.Take
offyourjacketsandhang
themup."She signsJACKET
OFFandpointstothehooks
inthechildren's
cubbies.The
twinssay good-byetotheir
father.
Shannon,whilesigning
PLAY,
says,"Nowit'stimeto choose
Emmaquickly
a playactivity."
chooses blocksandtellsShannon
she wantsto builda zoo. Diegosigns
PAINT.
Shannonsays (andsigns),
"Great,Diego.Youcan go paintwith
brushesattheeasel."
thedayShannoninterThroughout
actswithDiegowithsignandspohimto
kenlanguage,encouraging
use bothsignandspeechto communicatehisneeds.Attheendofevery
day,afterthetwinsgo home,she
learnsseveralnewsignsto introduceto Diegothenextday.

Inan earlyeducationsettingan
into
AACsystemshouldbe integrated
such
ongoingactivities.Professionals,
as speechtherapists,
specialeducators,and earlyinterventionists,
experiencedinusingAAC,can collaborate
withchildcare providersto determine
waysthechildcan use thesystem
withinroutinesand playactivities.
Teacherscan helptheotherchildren
theAAC
inthegroupto understand
systemand use itto communicate
withthechild.Adultsshouldcontinue
to talkwithand encouragethechild
to makesoundsor speak.Hereis an
exampleofusingan AACsystemduringa program'sdailyroutine:
Diegoand histwin
Four-year-old
sisterEmmaarriveatthechild
2007
Children
July
Young

80

This content downloaded from 165.123.34.86 on Sun, 7 Dec 2014 15:20:58 PM

All use subject to JSTOR Terms and Conditions

Obtaining resources
Teacherscan helpfamiliesobtain
resourcesbycollaborating
withcomchild
evaluto
have
a
munity
agencies
ated foran AACsystem,securefunds
forpurchaseofthesystem,
andarrange
will
for
the
who
be helppeople
training
the
child
learn
to
use
the
ing
system.
Some familieshave privatehealth
insurancethatpaysforspeech and
languagetherapyand AACsystems.
Children
threeand olderwhoreceive
specialeducationservicesfrompublic schoolscan haveassistivetechnologyservicesprovidedthoughthe
schoolsystemundertheIndividuals
withDisabilitiesEducationAct(IDEA;
PartB,Section619;34CFR& 300.308),

No

eligible

child can be

denied

an assistive

nology

device

because

tech-

or service

of a family's

inability to pay.

Additional
information
about
forAACscan be foundat
funding
thelinkprovidedon theNECTAC
Websitelistedin "WebResources
and Alternative
forAugmentative
Communication."

References

2003.
Social
Blackstone,
S.,& M.Hunt
Berg.
networks
: Acommunication
for
indiinventory
viduals
with
communication
needs
complex
andtheir
communication
partners.
Monterey,
CA:Augmentative
Communication.
& W.L.
Williams.
2000.
Visual
A.R.,
Cummings,
andvocalimitation
trainidentity
matching
children
with
autism:
Asurprising
ingwith
Journal
onDevelopmental
Disabilifinding.
Conclusion
ties7 (2):123-41.
& R.L.Simpson.
2004.Effects
on
Ganz,
J.B.,
andspeech
communicative
and alternative
comrequesting
Augmentative
ofthePicture
Comdevelopment
Exchange
munication
systemsprovideindividuinchildren
munication
with
charSystem
als unableto communicate
effectively acteristics
ofautism.
Journal
ofAutism
and
Disorders
34(4):395-409.
withspeech a methodofcommunicat- Developmental
K.W.H.
2004.Technology
forassessHeller,
ing.The choiceand use ofan AACsysment
InYoung
andintervention.
children
temis a complexand challenging
4thed.,eds.S.R.Hooper
with
proneeds,
special
& W.Umansky,
188-222.
SaddleRiver,
Upper
cess. Itis bestaccomplishedwithin
NJ:
Merrill
Prentice
Hall.
Pearson,
a collaborativeteammodelinvolving
J.2003.Understanding
thenature
of
Janzen,
autism.
2nded.SanAntonio:
Skill
members,childcare providers
family
Therapy
Builders.
and teachers,therapists,
and other
& G.Woodyatt.
2001.
Keen,
D.,J.Sigafoos,
who
interact
with
the
child
on
people
behaviors
with
funcReplacing
prelinguistic
a regularbasis.
tional
communication.
ofAutism
and
Journal
Disorders
31(4):385-98.
Developmental
A youngchild'sabilityto communiK.Kemmerer,
& J.
Kravits,
T.,D.Kamps,
cate withfamily
and friendsineveryPotucek.
2002.Brief
comreport:
Increasing
and activitiesfosstumunication
skills
foranelementary-aged
dayenvironments
dent
with
autism
the
Picture
using
Exchange
and
overall
terslearning,
socialization,
Communication
Journal
ofAutism
System.
AACsysdevelopment.
Appropriate
andDevelopmental
Disorders
32(3):225-30.
Apilotevalua2003.
temscan increasechildren'sindepen- Magiati,
I.,& P.Howlin.
tionstudy
ofthePicture
CommuExchange
denceas wellas supporttheirinclunication
with
System
(PECS)forchildren
sion inactivitieswithotherchildren
autistic
disorders.
Autism
7 (3):
spectrum
297-320.
and withfamily
members.

iftheservicesarespecifiedina child's
IndividualEducationPlan(IEP).
Servicesmayincludeevaluating
the
needs ofthechild,providing
forthe
acquisitionofassistivetechnology
devices(such as an AACsystem),and
and assistanceforfamilies
and
training
intheuse ofthedevices.
professionals
Inaddition,on a case-by-casebasis,
IDEAallowsschool-purchased
assistivetechnology
devicesto be used ina
child'shomeor othersetting.
Forchildrenunderthree,ifassistive
is identified
as partofa
technology
child'sIndividualFamilyServicePlan
has exhausted
(IFSP) and ifthefamily
all otherpossiblesourcesoffunding,
such as Medicaidor healthinsurance,
itmustbe provided"atno cost"under
PartC ofIDEA(34CFR& 303.527).No
eligiblechildcan be deniedan assistivetechnology
deviceor service
because ofa family's
to pay.
inability
July
Children
2007
Young

81

This content downloaded from 165.123.34.86 on Sun, 7 Dec 2014 15:20:58 PM

All use subject to JSTOR Terms and Conditions

2000.AugmentaMcNairn,
P.,& C.Shioleno.
- Part1: Canwetalk?
tivecommunication
Parents'
onaugmentative
and
perspectives
alternative
communication.
TheExceptional
Parent
30(2):72-73.
National
Research
Council.
2001.
Educatwith
eds.C.Lord& J.
autism,
ingchildren
McGee.
DC:Committee
onEduWashington,
cational
Interventions
forChildren
with
National
Press.
Autism;
Academy
& S.Kashinath.
2005
Nunes,
D.,M.Hanline,
theAACuseofa child
with
Enhancing
autism
a parent-implemented
natuthrough
ralistic
intervention.
Manuscript.
L.Adamson,
& R.BakeRomski,
M.,R.Sevcik,
man.2005.Communication
ofindipatterns
viduals
with
moderate
orsevere
cognitive
disabilities:
Interactions
with
unfamiliar
American
Journal
onMental
Retarpartners.
dation
110(3):226-38.
2004.EviSchlosser,
R.,& P.Raghavendra.
dence-based
inAAC.
practice
Augmentative
andAlternative
Communication
20(1):1-21.
D.Raschke,
& D.L.Ryndak.
Schmit,
J.,S.Alper,
2000.Theeffects
ofusing
a photographic
routine
schooltransicueing
package
during
tions
with
a child
with
autism.
Mental
Retardation
38(2):131-37.
D. 1999.
comStiebel,
Promoting
augmentative
munication
Aparent
routines:
during
daily
intervention.
Journal
ofPosproblem-solving
itive
Behavior
1(3):159-69.
Interventions
M.2004.Comparing
thePicture
Tincani,
Communication
andsign
Exchange
System
forchildren
with
autism.
language
training
FocusonAutism
andOther
Developmental
Studies
19(3):152-63.
1992.
A.,& B.Prizant.
Wetherby,
Profiling
children's
communicative
young
compeInCauses
tence.
andeffects
incommunicationandlanguage
eds.S.Warintervention,
ren& J.Reichle,
217-53.
Baltimore:
Brookes.

and Alternative
ComAugmentative
munication
Centersprovides
inforAugmentative and
mation
aboutvendorsofAACsysAlternative Communication
andAAC,
tems,earlyintervention
andtheuse ofAACworldwide.
AbleDatacompilesa databaseof
http://aac.unl.edu
assistivetechnology
and
products
and Alternative
ComAugmentative
rehabilitation
available
equipment
munication
(AAC)Connecting
from
domestic
andinternational
YoungKids (YAACK)givespractical
sources.Products
are notsoldon
andeasy-to-understand
information
thesite,www.abledata.com
aboutAACandAAC-related
issues
TheAllianceforTechnologyAccess
forchildren
atvariousstagesofcomnetwork,
(ATA),a national
munication
helps
http://aac.unl.
ability,
locateresourcecenters,
technology
edu/yaack
vendorsanddevelopers,
andprovid- Augmentative
Communication
Inc.
ersinlocalcommunities.
Linksprofocuseson keeping
thoseworking
videinformation
aboutAACsystems
with
AACsystemsup-to-date
onthe
within
No ChildLeftBehindregulawww.
latestdevelopments,
tions.www.ataccess.org
augcominc.com/links.html
AmericanSpeech-Language-Hear- ClosingtheGap Inc.highlights
assisingAssociation(ASHA)provides
tivetechnology
its
through newspaofAACsystemsand
descriptions
andWebserper,resourcedirectory,
information
abouthowtouse them
vices.www.closingthegap.com
andtellshowtoestablisha teamto
International
SocietyforAugmentatheuse ofan AACsystem
support
tiveand Alternative
Communicaand howtoassess outcomesand
tion(ISAAC)givesinformation
about
progress,
theorganization
www.asha.org/public/
and provides
joining
speech/disorders/Augmentative- linkstoothersiteswithinformation
and-Alternative.htm
aboutAAC.www.isaac-online.org/
TheAssociationforPersonswith
en/home.html
Severe Handicaps(TASH)provides NationalEarlyChildhoodTechniforeducators,
and
support
parents,
cal AssistanceCenter(NECTAC)
serviceproviders,
anda publication
has information
aboutfunding,
laws,
listofbooks,monographs,
andvidandotherissuesrelatedtoAACand
eos. www.tash.org.
Linktoitscatawhichcan be found
youngchildren,
andtraining
informa- byselecting
logofproducts
Assistive
in
Technology
tion.Some manualsare availableto
thedrop-down
listunderTopicPages
download
freeofcharge,www.
onthehomepage,www.nectas.
2007
National
Association
for
the
EducaCopyright
bythe
tashinc.com
tion
ofYoung
Children.
SeePermissions
and
online
unc.edu
Reprints
atwww.journal.naeyc.org/about/permissions.asp.
Web Resources

for

This
resource
links
with
bestpractice
and
engaging
theory
information
onallaspects
ofthekindergarprovides
key
tenyear.
Inthis
overview,
comprehensive
experts
leading
what
ishappening
inthekindergarten
andwhy.
explore
year

Today:
Teaching
. .
*
s 4k
olili L6ar nine} In
1116
Year
Kindergarten

1discusses
Part
thevariety
ofkindergartens,
kindergarten-Do#l?##I#C
F. GullO, Qditor
andtheir
families.
agechildren,
2examines
thebasic
andsocial-emotional
cognitive
0 Part
children's
development
underlying
learning.
insixcurriculum
domains
outline
what
children Order Onlineat
experts
Next,
should
know
andbeabletodo.
www.naeyc.org/shoppingcart
thebook
discusses
issues
andthetransition OfCall 800-424-2460
policy
% Finally,
from
tofirst
kindergarten
grade.
MA
I BiOMEp
Item:
Non-Members:
Members:
$15.00
#155;
$18.00,
0

82

Children*
2007
Young
July

This content downloaded from 165.123.34.86 on Sun, 7 Dec 2014 15:20:58 PM

All use subject to JSTOR Terms and Conditions