FAQs About Your Augmentative and Alternative Communication (AAC) Device

Want to know more about Augmentative and Alternative Communication? Read on! 

Q: AAC…what does that mean?

A: AAC is an acronym for Alternative Augmentative Communication.  The 2 A’s in AAC are important to understand. The first A stands for Alternative. Meaning simply, an alternative method to communicate. If a child is unable to verbalize, then in order to have communicative exchanges, there needs to be some alternative. The second A is more overlooked and less understood: Augmentative. What do we mean by “augmentative”? Basically, it is used in a supplementary role. This means the child may have limited verbalizations but AAC is there to support the child in expanding their ability to communicate with a variety of people across many different settings.

Q: My therapist has started suggesting that we use AAC? What exactly does that entail?

A: AAC basically covers any type of communication that does not use verbalizations to communicate. This can take many forms, including (but not limited to): Sign language, objects, pictures, and speech generating devices.

 

Q: Has my therapist given up trying to have my child communicate verbally?

A: The very simple answer is: No. In fact, a recent study has shown that introducing speech generating devices may increase verbalizations in children with Autism (Schlosser and Wendt (2008)). But the fact is that a tremendous amount of growth in children’s communication skills happen from birth to 3. And for older children, being unable to fully communicate can lead to high levels of frustration, which in turn can lead to behavioral issues. If a child is struggling to communicate verbally, only working on verbal communication while not supporting the child with another pathway to communicate locks them out of a multitude of communication experiences.

Q: Will using AAC stop my child from communicating verbally?

A: No. When people communicate, we use the fastest, most efficient communication that we possess. If a child is able to get their message across verbally, that is what they will do. Using AAC requires more planning and more steps. For example, if a child needs to go to the bathroom, the easiest thing to do will be to say “potty”. The more complex task is to sign bathroom, find a picture, or use an icon on a device that says “potty”. But, if for whatever reason a child cannot verbalize the need to go to the bathroom, then ideally he or she will have another way of letting you know. From my own personal experience as a therapist, I have had children master high tech AAC, but use their limited verbalizations as well. And if the child can get their listener to understand their verbal message; that is ALWAYS what they use first.

Q: What is the best AAC to use?

A: There is no one size fits all, best AAC to use. Every child is unique in their abilities and their areas of need. What works fantastically for one child might be completely wrong for another child. All methods of AAC have pros and cons. You and your therapist should work together to select what is right for your  child.

Q: What different types of AAC are there?

A: AAC is often organized into 3 broad categories: No tech, Low tech, and High tech.

  • No Tech: Sign language, gestures
    • Pros: No cost. Available to the user at all times. No additional equipment needed.
    • Cons: Limited to the people who understand the signs and gestures. For example, the general population does not understand the sign for “more”.
  • Low Tech: Object/Picture Exchange
    • Pros: Low cost. Can use actual object representation or print out actual pictures of specific objects or use abstract symbols. Understood by a wide variety of people.
    • Cons: Difficult to transport. Difficult to have every symbol printed out and available at all times for every situation. Can be time consuming to use. No voice output.
  • High Tech: Speech Generating device
    • Pros: Voice output. Messages are easily understood. Can call out to people to gain attention/communicate with people who are not directly looking at the individual. Individuals get auditory feedback of their message. Can generally communicate a wide variety of messages (dependent on the device)
    • Cons: Wide range of cost. Devices can start at a couple of hundred dollars (generally these devices are limited in the amount of messages that they are able to communicate, such as devices found at: https://www.ablenetinc.com/technology/speech-generating-devices) to thousands of dollars. More expensive devices can be explored through companies such as TobiiDynavox (tobiidynavox.com) and Prentke Romich (https://www.prentrom.com/). Some insurances will cover high tech devices. They can also be broken, not charged, or otherwise not available, then the individual will not be able to communicate.

Q: Does my child have master no tech/low tech AAC before getting a high tech device?

A: No. These classifications should not be seen as a hierarchy to move through. In my experience as a therapist, I have had many children-especially those with Autism- struggle with sign and picture exchange, but become highly skilled at using high tech AAC. Again, the system that you use is dependent on the child’s needs and should be chosen in collaboration with a Speech Language Pathologist. 

-Amanda Cox, M.S. CCC-SLP

If you have more questions regarding speech/language impairment and AAC devices, please contact contact Curlee Communication Consultants at (865) 693-5622. We have a team of experienced speech-language pathologists that would love to meet with you and discuss options for your family.

Language Scavenger Hunt

Who doesn’t love a good scavenger hunt?  The best part about this particular scavenger hunt is that that you can do it from the comfort of your own home.  Did you know that you can target multiple language skills during a scavenger hunt?  I can think of five language skills off the top of my head—and yes, I am here to share them with you!

  • Object Function: a typically developing child should understand the use of objects between ages 3;0-3;5 and expressively tell how an object is used between ages 4;6- 4;11. Some ways to target object function while scavenger hunting could be:
    • Show me the object that (insert function).
    • What does (insert object) do?
    • What do you do with (insert object)?
  • Following Directions: a typically developing child should follow commands/directions without cues between ages 2;6-2;11. Some directions to follow while scavenger hunting could be:
    • Go to the kitchen.
    • Go to the bathroom and look under the sink.
    • Go to your room and sit on the bed.
  • Prepositions: a typically developing child should understand spatial concepts (in, on, out of, off) between ages 3;0-3;5 and expressively use prepositions (in, on under) between ages 4;6-4;11. Some examples of how to target prepositions while scavenger hunting could be:
    • Where is the spoon? (on the table, under the bed, etc.)
    • Place the ball under the couch.
  • Describing: for this skill, I like to start off describing an object by stating its category. A typical developing child should be able to expressively name categories between the ages 5;0-5;5.  Some examples of how to target categories while scavenger hunting could be:
    • A bed is a type of (insert category).
    • A hat is a type of (insert category).
    • Can you name two more types of clothing?
  • Vocabulary: your child’s vocabulary is continuously expanding. By introducing more and more objects each week, your child’s receptive and expressive vocabulary skills will begin to grow.   It’s as easy as that!

All developmental milestones were taken from the Preschool Language Scales, Fifth Edition basic developmental milestones chart.  See additional resources section below for more information. 

Here is a list of objects to get you started on your scavenger hunt: a napkin, scissors, crayons, a spoon, a key, a telephone, milk, a cup, soap, a bed, a hat, a chair, a ring, an apple, and a lamp.    When it isn’t raining, head outdoors and find some things around your neighborhood!Try mixing it up and add some new objects each week. Be creative, and HAVE FUN! 

Breann Voytko M.A., CCC-SLP

**If you have any concerns with your child’s speech, language, hearing and/or feeding development, please contact Curlee Communication Consultants at (865) 693-5622. We have a team of experienced speech-language pathologists that would love to meet with you and discuss options for your child. **

Additional References:

https://speechramblings.weebly.com/uploads/2/1/1/3/21134946/plsmilestones.pdf

Milestones taken from PsychCorp. (2011). Preschool Language Scales, Fifth Edition. Person, Inc.

Six Communication Tips for Speaking to a Loved One with Dementia

Dementia is a neurological disease that impairs the brain in areas of cognition, such as memory loss and judgment. As the disease progresses, your loved one’s social skills, such as carrying a conversation, will be impacted. Here are some helpful tips to successfully communicate with your loved one affected by this disease.

Communication Tips:

  1. Use normal tone instead of talking to them as if they were a child, slow down your rate of speech, and as appropriate, increase volume.

 

  1. Minimize environmental distractions when conversing, such as the TV or radio volume, or choose to engage in conversation in a quieter environment without other ongoing distractions.

 

  1. Increase your pauses and allow your loved one extra time to think and respond. They need extra processing time to understand and create a response. Try not to complete their thoughts or finish their sentences, but rather let them collect their thoughts and speak on their own. 

 

  1. Use specific vocabulary, rather than non-specific words such as “it” or “he/she/they”. Rather, identify the object using its specific name or person’s name. Additionally, avoid using sarcasm as this type of figurative language is difficult for your loved one to understand.

 

  1. During a conversation with more than one speaker, take turns speaking while providing extra processing time.

 

  1. Use external aids as appropriate. Use of calendars, photos, and memory books may help orient your loved one to the topic on hand, helping them communicate.

Natalie Keller, M.A., CF- SLP

**If you have any questions concerning your loved one and their communication, please contact Curlee Communication Consultants at (865) 693-5622. We have a team of experienced speech-language pathologists that would love discuss options for your family. **

Defining Receptive Language

Children’s receptive language (ability to understand language) typically develops before expressive language (ability to use language to express wants/needs). For example, by 18 months, typically developing children understand approximately 200 words (receptive language), and produce approximately 50 words (expressive language). Receptive language is important because it helps children understand what is happening around them and in learning to identify desired objects/actions in their environment. Playing, talking, and reading books to your child will certainly help increase your child’s receptive language. There are more specific strategies that a speech-language pathologist might use during language therapy to focus on improving your child’s receptive language. Some of these are listed below!

  1. Hold objects/pictures in your child’s field of view and verbally label each one so that he/she can learn to associate a verbal word with a real object/picture.
  2. Model how to point to objects so your child can observe how to identify objects using hand and finger movements. If necessary, you can help your child by guiding his/her hand to an object (hand-over-hand movements).
  3. Present 2 or more objects/pictures (apple, train) to your child and ask him/her to show you one (“Show me apple”). Encourage your child to grab or point to the named object. You can also use this as an opportunity to allow your child to indicate his/her wants or needs by asking, “What do you want?” and encouraging him/her to point to it. Immediately give your child the object that he/she chose to teach him/her that his/her actions can bring about a change and get him/her want he/she wants (cause and effect).   
  4. Use errorless teaching to limit frustration and increase your child’s success when you ask him/her to identify objects. Errorless teaching means you give your child as many cues as he/she needs to be successful and not make any errors. For example, while completing a puzzle with your child, hold up two objects (truck, car), and say, “Show me truck.” If your child starts to reach for the car, move the car out of his/her reach, so that he/she reaches for the truck and therefore successfully identifies the correct object. Praise your child for choosing the correct puzzle piece and immediately give that piece to him/her as an award. From here you can increase the complexity as their ability increases in order to attain their specific goals.
  5. Ask your child to find things in your home. For example, you can ask them to find a specific food on his/her plate or in the refrigerator. You can also ask your child to find their body parts, clothing items, toys, or other household objects. 

Try implementing some of these strategies into your daily routines to help your child learn new words. Learning really can be fun! Good luck!

-Andria Burris, M.S. CF-SLP

**If you have any concerns with your child’s speech, language, hearing and/or feeding development, please contact Curlee Communication Consultants at (865) 693-5622. We have a team of experienced speech-language pathologists that would love to meet with you and discuss options for your child. **

How Do I Practice Speech With My Child At Home?

Your child’s speech language pathologist (SLP) asked you to practice the /k/ sound at the beginning of words at home. But how do you go about doing that? It doesn’t have to be time-consuming or expensive. Here are a few ideas!

  • Scavenger Hunt – You and your child can go around your home to search for items that include your child’s target sounds in their name. Ex: toy car, cup, cartoons, coat, candle
  • Books – While reading a story together, look for words or pictures in the book that include more target sounds. Depending on what your child can produce correctly, have them repeat the word back to you or put it in a phrase such as “I found the car.”
  • Coloring/Painting – Grab some crayons, paintbrushes, paint, and some paper and draw pictures of animals, toys, or other objects that include certain sounds. Ex: car, cat, candy, kite
  • Play-doh – create objects out of the Play-doh that start with your child’s target sound. You can pretend to bake a “cake” or “cookies” together.
  • Catch – While playing catch with your child, say a word using the target sound before each throw. For repeated practice in short phrases, you can say “I caught it” after a catch.

If you are having difficulty coming up with words with your child’s target sounds, be sure to ask your child’s SLP to provide you with a list of possible words. I am sure he or she will be thrilled to help you!

This can be done targeting all sounds in all word positions, so take these ideas and run with them to practice the sounds that are applicable for your child’s therapy. Working on sounds in your home outside of direct therapy sessions is extremely important for developing carry-over skills of your child’s target sounds. Hopefully these ideas can provide more opportunities for fun practice together!

-Shannon Greenlee M.A., CCC-SLP

**If you have any concerns with your child’s speech, language, hearing and/or feeding development, please contact Curlee Communication Consultants at (865) 693-5622. We have a team of experienced speech-language pathologists that would love to meet with you and discuss options for your child. **

The Importance of Vocal Hygiene

What are the things that truly define you?  Your personality?  Your appearance?  Your career?  All of these things make up different parts of who we are, but one part of us that people often leave unaccounted for is our voice.  Your voice is a defining aspect of your identity.  Protecting your voice is important.  The act and art of keeping your voice healthy is called vocal hygiene.  Vocal hygiene involves taking steps to keep your vocal folds healthy and your voice strong and clear. 

Our vocal folds are covered by a thin layer of mucous.  This mucosal layer is vital to the correct vibration of the vocal folds.  To function properly, the mucosal layer needs to stay moist.  Adequate consumption of water is vital to keeping the mucosal layer moist.  Water is your best ally in practicing good vocal hygiene!  One of the worst enemies of vocal hygiene is caffeine.  Caffeinated beverages (coffee, soda, etc.) dry out the mucosal layer, resulting in a rough voice and possible damage to the vocal folds.  Drinking water and avoiding caffeinated beverages is one of the best (and easiest) ways to maintain healthy a healthy voice.  Of course, water has many other health benefits as well.

Another important aspect of vocal hygiene is protecting your voice from abuse.  Vocal abuse occurs when the vocal folds are used improperly.  Do you love to cheer on the Vols every Saturday in the Fall?  Are you a teacher or a pastor?  If so, all your enthusiastic and heart-felt cheering or teaching might just be harming your vocal folds.  This “vocal abuse” occurs when the vocal folds are used improperly, such as with loud or prolonged shouting, cheering, screaming, or even talking.  While you are cheering or shouting, your vocal folds are slamming together hard.  After a period of time, this slamming could result in pathologies, such as vocal fold cysts or nodules.   These can be painful and result in permanent damage.  Protect your vocal cords from abuse!  If you find yourself led to cheer, do it!  Just be sure to have plenty of water on hand and rest your voice for a few hours afterward.

Following these simple steps will put you on the road to good vocal hygiene.  Drinking plenty of water and treating your voice gently (i.e. not using a loud voice or yelling frequently) both go a long way in preserving one of the most important parts of who you are:  your voice.    

Katherine “Kacey” Clark M.S. CF-SLP

**If you have any concerns with your child’s speech, language, hearing and/or feeding development, please contact Deborah L. Curlee Communication Consultants at (865) 693-5622. We have a team of experienced speech-language pathologists that would love to meet with you and discuss options for your child. **

Teachable Moments

 

Everyday can be filled with teachable moments. It’s easy to forget that your child is always taking in information. During the first few years of your child’s life you should be looking for new ways for them to experience language and practice their developing sounds. Below are just a few ways you can expose your child and help them grow.

It’s Playtime

Playtime is a great way to teach your child. Children learn by seeing you in action. Jump in there and have some fun. You don’t have to take control, just follow your child’s lead. Remember they are watching everything you do and provide a good clear example. As you play you can in a way “talk your way through it” by saying what you do out loud. This is called “Self- Talk.” For example, if you are walking a toy through a door you may use a dialogue such as, “Boy goes through the door” or “door open” and “door close”. If this feels difficult, keep practicing and you will get the hang of it. Practice makes perfect! Some things you can target during play include:

  • Producing “p”, “b”, and “m” sounds
  • Spatial concepts (in, out, over, top, under, next to)
  • Colors
  • Nouns
  • Adjectives
  • Follow directions
  • Turn taking

Let’s go to the Park

Going to the park with your child can be a fun way to expose them to new vocabulary items. Though you may think they’ve been to the park many times and are familiar already, repetition is important. Exposure will provide them with a hands on experience that they can associate with new words. Be sure to use the words in your surroundings as much as possible when in different environments (e.g. bench, swing, slide, mulch, etc.).

Story Time

You can visit a local library or other child development centers and have your child participate in story time. This is a wonderful way for your child to work on social skills while increasing their knowledge in expressive/receptive language. Providing this experience will help them learn from peers and understand how to create appropriate interactions. This is can also be a fun time for you to be around other parents and discuss other opportunities to help your child learn.

This list is not inclusive don’t forget to be creative and have fun!

Gina McCurry M.S. CF-SLP

“Hunting” For Language!

With spring and Easter coming up, it is the perfect time to plan an activity that will be both fun and a great way to stimulate language. For this egg hunt, it is likely that many of the items I am going to suggest are already in your house or easily accessible at a local store. Using plastic eggs, fill them with spring themed items. Such items could include candies, flowers, a plastic butterfly or other insects, seeds, etc. Depending on whether the egg hunt is inside or outside, lay out other items that may be too large to fit inside an egg, including a fluffy bunny or a shovel. Once the set up is complete it is time to start the game!

Specific Language Targets:

Following Directions/Learning Concepts:

Rather than letting the child wander freely to each visible egg, direct the child to a specific egg. For example, you could work on the concept of colors by instructing, “Go get a yellow egg.” Another possibility is the promotion of spatial concepts, “Get the egg in the basket.” “Find the egg beside the bunny.” “Find the egg under the table.” The complexity of the directions can be adapted to fit ability level and age. You could direct a child to two different eggs at different locations, or you could make the child discriminate between choices at the same location by indicating, “Get the blue egg in the basket.”

Answering Questions:

Either with each egg or once all the eggs have been collected, open them up and begin to ask questions. Start with “What did you find?” or “What is inside?” If the child does not know explain what he/she has found. In this way you will be working on expanding vocabulary along with answering the question. After the child has identified an object begin to ask questions about the object itself. If the child has found a flower some sample questions could be, “Where does a flower grow?” or “What makes a flower grow?” To stimulate language a child does not need to always be answering questions.  It is likely that a child will grow bored of the activity if all you do is ask questions constantly. Allow time for the adult to talk about the item without expecting any response to maintain interest. “You found a flower. That flower is a daisy. It is white and has lots of petals. Mommy grows flowers in her garden.”

This activity is limitless in its possibilities. Do not feel constrained by my suggestions. Instead, be as creative as you can.

Happy Hunting!

Erin Norwig, M.A. CF-SLP

**If you have any concerns with your child’s speech, language, hearing and/or feeding development, please contact Deborah L. Curlee Communication Consultants at (865) 693-5622. We have a team of experienced speech-language pathologists that would love to meet with you and discuss options for your child. **

Hearing Impairments: Building Your Child’s Language Made Easy

Often times, learning that your child has a hearing impairment/loss can leave you with a wide range of emotions and questions. One of these questions often comes when we start to think about how this will impact a child’s language. Since a child’s exposure to sound and talking is crucial to developing their language, it is important for amplification (hearing aids, cochlear implant, etc) to be worn as much as possible.

Bombard your child with as many environmental sounds as possible, label every item you see, talk about what you’re doing, talk to them all day every day- you cannot interact and talk with your child too much. When possible, make sure that they can see your face and that there is minimal background noise.

Easy strategies used to enhance a child’s listening experience:  

  • Create an auditory sandwich – Pick a familiar routine for your child, for example, ‘Time to brush your teeth’. First you say the phrase to your child ‘Time to brush your teeth’. Next you say the phrase and use visual cues to reinforce what you are saying, ‘Time to brush your teeth’ + model brushing your teeth’. Last say the phrase again without any visual cues, ‘Time to brush your teeth.’
  • Acoustic highlighting – Use this to emphasize a particular sound or phrase when talking to your child. You can follow your child’s lead when using this strategy. If your child says they see a ‘tar’ you can replay by saying ‘No, that isn’t a tar that’s a caaaar’. By emphasizing the word car it differentiates between the wrong word and the correct word. You can implement this when teaching new vocabulary or sounds. This not only reinforces the use of new words/sounds but also promotes better listening skills.
  • Self talk – Talk about what you are doing. If you are cooking than say out loud what you are doing. ‘I am cooking. I am cooking on the stove, I am cooking supper on the stove’.
  • Parallel talk – Talk about what your child is doing. If your child is playing with cars than say what they are doing. ‘You are driving a car, you are driving a red card’.
    • For Parallel and Self talk use both of these as opportunities to say a phrase and expand on what you are saying. This allows your child to first hear a simple phrase and then to build on it as provided in the examples given above.
  • Recasting – When your child says a phrase such as ‘daddy go’, use this opportunity to put your child’s utterance into a question ‘Oh, did daddy go to work?’.

Good luck!

Danielle Beaudette, M.S. CCC-SLP

**If you have any concerns with your child’s speech, language, hearing,  and/or feeding development, please contact Deborah L. Curlee Communication Consultants at (865) 693-5622. We have a team of experienced speech-language pathologists that would love to meet with you and discuss options for your child. **

The 5 Best “Baby Signs” to Teach and How They Lead to Verbal Communication

Although there is considerable debate about the benefits of baby signs, numerous research studies have proven that baby signing is positive for communication as well as other areas such as emotional development and self-regulation (i.e. sleep/wake cycles, feeding, etc.). Results from the Original Baby Signs Study by Drs. Acredolo and Goodwyn showed that those children who received signs averaged a three month advantage in their language capabilities versus children who did not receive signs. Similarly, children who received signs had longer sentences thus putting them a full year ahead of their peers. 

To be effective, caretakers should begin signing when their baby is, at the latest, 8-9 months old; however, signing can begin as early as the caretaker prefers. Signs are very easy to learn (the five most common are explained below), but they must be produced correctly in order for the child to learn from them. They should be always be accompanied by the caretaker’s speech (e.g. signing while speaking the word) and repeated often. This will provide the maximum input for the child, thus the most opportunity for the child to imitate the caretaker’s speech and signs.

The baby may begin to sign back between 10-14 months, with vocalizations beginning soon after. Signs will begin before speech and then will gradually fade when speech becomes the prime mode of communication. Baby signs are a simple boost that a caretaker can give their baby to kickstart their speech and language development. See below to get started!

Milk

  • This sign is done with the baby repeatedly opening and closing his fist.
  • To teach your child this sign it is best to use it before, during, and after feeding your child. Make sure the child maintains eye contact while signing and make it clear that you are referring to “milk.” At first, make sure the milk is present while signing. After a while your child will be able to do the sign without the milk present.
  • This is generally taught to help your child recognize symptoms of hunger. It can be used for breast milk or formula, and it helps your child let you know when they are hungry. This often prevents fussing and tantrums because instead of crying, your child uses signs as communication to let you know that they are hungry. Using this sign along with verbal language will help develop your child’s communication skills.

All Done/ Finished

  • This sign is made by turning both hands to alternate palms up and down.
  • To teach this sign, look for indicators that they are finished with their meal (fussing, throwing food, etc.) Ask them if they are “All done?” while doing the sign repeatedly. Soon, your child will recognize this context and copy you.
  • This is a great sign to use at the table, or while nursing your child. Babies dislike being overfed so this may let you know when they are finished. This prevents fussing and throwing food, but also facilitates communication between you and your child. This sign can transfer into other activities throughout the day as well.

More

  • This sign is made by putting your fingertips towards your thumb and repeatedly moving your hands together and apart, letting your fingertips touch each time hands are brought together.
  • This is a great sign to do at the table when feeding your child and also to facilitate play, such as asking for “More blocks?”. To teach this sign, look for cues that they want more (such as reaching for the food, toy, etc.) and demonstrate the sign while asking them if they want more, encouraging them to shadow your movements. If they are still having trouble, it may be helpful to gently help put your child’s hands together to sign.
  • Using this sign along with verbal language will help your child to communicate more efficiently during play and at the dinner table.

Please

  • This sign is made by putting your hand to your chest and making a clockwise motion.
  • This is a great first step in teaching your child manners! This sign can be done in any context, whether it be at school or during bed time.
  • Do this sign while you say ‘please’ and encourage them to imitate you. Soon they will associate the sign with the verbal cue.

Eat

  • This sign is made by having one hand’s fingertips touch your thumb and repeatedly putting your hand to your mouth.
  • Do this sign whenever you are asking your child if they want to eat or encourage them to respond with this sign (after it has been learned).
  • By pairing this sign with the verbal cue and positively reinforcing the behavior with giving them food, your child will start associating the sign with the desire to eat.

Check out the website www.babysignstoo.com for more information!

Sara Lowczyk M.S. CF-SLP

**If you have any concerns with your child’s speech, language, and/or feeding development, please contact Deborah L. Curlee Communication Consultants at (865) 693-5622. We have a team of experienced speech-language pathologists that would love to meet with you and discuss options for your child. **