Augmentative and alternative communication (AAC) includes all forms of communication (other than oral speech) that are used to express thoughts, needs, wants, and ideas. We all use AAC when we make facial expressions or gestures, use symbols or pictures, or write.
People with severe speech or language problems rely on AAC to supplement existing speech or replace speech that is not functional. Special augmentative aids, such as picture and symbol communication boards and electronic devices, are available to help people express themselves. This may increase social interaction, school performance, and feelings of self-worth.
AAC users should not stop using speech if they are able to do so. The AAC aids and devices are used to enhance their communication. (Based on American Speech-Language-Hearing Association)
When children or adults cannot use speech to communicate effectively in all situations, there are options.
This includes different forms of communication that is used to express thoughts, needs, wants, and ideas. There are different types of AAC systems (aided and unaided) along with different levels of technology: low-tech (paper-based) and high-tech (electronic).
Unaided Systems rely on the person’s body to convey messages. Examples include gestures, body language, and/or sign language.
Aided Systems require the use of tools or equipment in addition to the person’s body. Aided communication has different ranges: from paper and pencil → communication books and boards → devices that produce voice output (speech generating devices). Electronic communication aids allow the user to use picture symbols, letters, and/or words and phrases to create messages. Some devices can be programmed to produce different spoken languages.
Images below from Autism Helper
Everyone uses Core vocabulary to communicate. There are 2 types of Vocabulary – core and fringe.
Core vocabulary is a small set of commonly used words (high-frequency words) that support communication and language learning. It refers to words that speakers use frequently across multiple settings, such as the park, school, and home. These high-frequency words bridge topics and environments, and children can easily combine them to form meaningful phrases and sentences. They are often small, commonly used words (e.g. I, have, the, want, on..etc) and are typically pronouns, verbs, and demonstratives, such as it, go, want, eat, I, this, and no.
Core words are going to be more flexible to use across environments and communication partners.
– High frequency words that can be used in a variety of situations and with various communication partners.
– Make up about 80% of the words we use everyday
– You cannot form a sentence without using core words
– You can create a sentence using only core words
– Often more difficult to visualize
– Usually includes pronouns, helping verbs, prepositions, articles, and common verbs
– Examples include – I, he/she, like, play, have, on, open, help, more, can, do, it
– Sentences using only core vocabulary – “I like to play”, “I need help”
Fringe vocabulary is more situation specific (words that occur infrequently). Fringe words refer to a specific set of low frequency words that are specific to a particular person or activity. Their importance changes from context to context and from person to person (e.g., evaporation, museum, funny, etc.).They are often easier to teach because they are typically nouns -you can picture the item in your mind.
Since we don’t just speak using fringe vocabulary, it is imperative that we focus on teaching the core words even though it can be more challenging.
– Words more specific to a situation – mostly nouns
– Cannot be used across a variety of situations
– Cannot form a sentence with only fridge words
– Can visualize the fringe vocabulary words
– Examples include: “pig”, “school”, “teacher”, “pizza”, “TV”, “dinosaurs”
(Pictures are from Google Images)
Core Vocabulary are those words used with high frequency and make up about 75-80% of the words we use everyday. Core vocabulary should be a main part of all AAC systems because it allows for most flexibility across most situations.
It is import to teach these core words because it allows the student to communicate his/her wants/needs. This will decrease frustration. It is easier for the student to touch the icon or say “more” to request the desired item then learning each noun or trying to navigate a device through various categories to find that specific desired item. For example, if a student points/says “more” or “want” I allows for us to understand what the student is trying to communicate within the given text/situation. This helps reduce those behaviors of frustration due to communication struggles.
Researchers who’ve developed the Dynamic Learning Maps (DLM) have identified a basic core 40 words that are a beginning word set to meet needs of emerging communicators.
(Pictures are from Google Images)
– Gain true understanding of words and their meanings
– Develop basic communication language
– Increase diversity of application of words
– Communicate in more contexts
– Achieve active and independent communication
– Teaching communication for life
– Vocabulary, concepts, symbols or locations become familiar and known
– Focus is on learning new information / content
– Can learn to say what they want to say on a variety of topics in a variety of settings
– Express wants and needs
When using aided AAC Systems – core vocabulary should be the main focus because it allows for more flexibility. It is important to have the most frequently used vocabulary or core words easily accessible so it can be utilized efficiently. Fringe vocabulary are not used as often so they can be placed to the side or top of core boards (or programmed on further back pages in their AAC device).
Having the core words easily accessible and in the same place on the communication system is it allows the students to learn the motor planning patterns on the system which allows the student to also communicate quicker.
No student will be able to use core vocabulary without teaching and modeling.
Make a plan:
– Choose the new words
– Combine new words and symbols with known words and symbols to generate – – – Phrases Sentence illustrations
– Teach the words in the set you select
– Teach the symbols in the set you select
– Ask students to demonstrate meaning of word and symbol in sentence
– Assist students in creating their own sentences with target word(s)
All AAC learners need to see what it looks like to communicate using their AAC systems in real conversations.
– You don’t need to model every single word you say, especially to start with. This would likely be overwhelming to all concerned. Instead, model one step above the AAC learner’s current skill level. So if the AAC learner is not yet using the system to communicate in single words, model at the single word level. For example, if you’re leaving the classroom to go to the cafeteria, you can verbally say “It’s time to go to the cafeteria” and press the “go” button on the AAC system when you say the word “go”. Once the AAC learner is at the one word level, you can step up your game – add a word when you model. So if you’re leaving the house to go to see grandmother, you can verbally say “Let’s go see Granny” and press “go” and “Granny” while you’re speaking these words.
– To support receptive language (Receptive input using the system is critical)
– To teach new words and combine known words
– To demonstrate a variety of communicative functions
– Model the use of the vocabulary during instructional activities and all other communication activities
– To support the understanding of words and their varied uses in a variety of environments
– Create multiple systems encouraging peer and adult supports
When designing a communication board for a student with complex communication needs, a consideration of a range of issues related to the person’s ability is involved. Key factors to consider when designing a board focus around: mobility, vision, access, cognition, and language. Using person-centered questions help determine the best design for the student.
Because a single page on a device or board contains a limited amount of space, Special Educators and parents must carefully choose vocabulary. A student can use core vocabulary words to talk about a variety of topics for different purposes. For example, a student may have no, you, I, want, go, and more programmed on his device. How many messages can this student make? The student can combine words to make requests, such as “I want more,” or “I want it.” The student may also combine words to make rejections, such as “No more.” Finally, a student can attempt to make directives, like “You go.”
The context of a core vocabulary word determines the meaning of the message. If a student says “I want to go” in the context of a board game, he is indicating that he would like a turn to play. The same message in the context of a conversation regarding the grocery store indicates that the student physically wants to go to the store. In the context of a non-preferred activity, a student might use the same phrase to indicate that he is ready to leave. A communication device/board that contains mostly fringe vocabulary may include words such as paper, pencil, crayon, and glue. How many messages can this student produce? This vocabulary set severely limits the child to making one-word requests and labeling objects. When programming an AAC device or creating a communication board, it is important to find a balance between flexible core vocabulary words and appropriate fringe vocabulary words. By meaningfully and carefully selecting both core and fringe words for a device or board, parents and Special Educators open the door to strong communication skills.
In the world of AAC there are many icon families to choose from. Boardmaker icon, Pixons and Symbolstix, etc. to name a few. Choose a set that works well for you and your students. You may want to keep the future in mind – – – are you choosing a symbol set that will transfer well from a low-tech device to mid or high-tech?
There is a such thing as too many words. Don’t start with too many words! To demonstrate beginning the teaching process with core words, here are a sample of a possible first 12. (Image from Google Images)
– Page (single or multi-page repeated core)
– Symbol location (consistent location on page)
– Access (physical, visual or portability & availability)
– Motor Automaticity – makes communication faster & easier
– “Location Learning” vs “Symbol Discrimination” (requires consistent layout – symbols always remain in that location.
– Develop motor patterns with specific symbols such as “I want” or “please go home”
– Core words – select based on frequency of use (lists) and include range of parts of speech: pronouns, verbs, adjectives, adverbs, prepositions, social/interjections
– Extended Vocabulary:
Personal core – key people, key places, key things/objects
Generic school core – letters, numbers, colors, shape, calendar, etc
Grammatical markers – prepositions, add -ing to a verb, add ‘s’ to plurals, possessives, articles, etc.
Binders – “of” “with” “by” “for”
Word altering strategies – “same as” “opposite of” “add to the front” “part of “ “Sounds like” “Starts with” “same group/family” “join words”
(Pictures are from Google Images)
Combining a manual communication board (core board) and a communication device (speech generating device or mobile technology app) is not unusual. Sometimes a manual board is a back-up system. Sometimes a manual board is a supplemental system when the device is a limited device or when the device can’t be used in all environments (e.g., on the playground, at the pool, at the beach, etc.) When people are using core boards with a device, I would want them to define for me the role of the core board and the role of the device. If the person needs a manual board (core board) as a back-up system , I would want there to be a relationship between the board and the device/app (e.g., same arrangement, same pictures, same vocabulary) so that there isn’t a great need to learn 2 totally different systems. If the board is a SUPPLEMENT to a device/app, then the core board would be providing additional words not available in the device/app.
- If a student has a communication dedicated device that was purchased by their district, this device should be taught as the primary mode. Talk with SLP and AT Team about adding Core Vocabulary to the device, how to access Core Vocabulary, etc to work through CV challenges. It is important for the team to define the role of the board and the role of the device and include the district representative in the conversation to determine if the student has outgrown the device or app or what other needs exist.
- Take screenshots of the device screens, email to the teacher or yourself, print, laminate and put together for the student in the event the device is broken or the student exits the program and the device remains with the district.
Once the student starts to perseverate or touch all the icons, I suggest several things:
(1) use visual masking so that ONLY the key/target words are available.
(2) try a board with more white space (if visual perception/clutter is an issue).
(3) use some hand-over-hand to restrict the random movements– Focus on core vocabulary
– Frequent opportunities to practice
– Activities appropriate for students of different ability levels
– Different AAC tools and strategies
– Group and individual activities
– Use in Natural contexts
– Direct instruction in symbol/concept meaning
– Involve families
One way of structuring the process of teaching and modeling core words is to schedule a set of words to focus on each week or month. This makes the modeling more manageable, and as long as you keep modeling words from previous weeks, you will end up teaching a robust vocabulary with many core words.
Focus on 3-6 new words each week & continue to consistently use the previously learned words.
– Repeated reading of books
* Daily reading of the book of the week
* Say words of the week using AAC when they happen in the story
* Character poster
– Predictable chart writing activities
* Students use their AAC system to complete a sentence that starts with core words
Such as: “I like to” and “I can”
* The sentences can be combined with photos to create a book the students can re-read
– Typical classroom routines
* Using words of the week during school activities
Such as: circle time, snack, cooking, art, music, dramatic play centers and outside play
– Centers & Work Time
* Modeling words of the week whenever possible using large core word displays located throughout the classroom as well as on students’ AAC systems
– Home Connection
* Practice at home by sending home information to families about the words currently being learned and how to model them using the students’ systems
These strategies teach core words in natural contexts. Through repeated modeling of the words to communicate during real, fun activities, students learn the meaning of non-picturable words and how to use them to communicate.
Tell-Me through Multimodal Expression Model
A wonderful program for teaching core words using this method has been developed by Carole Zangari, Gloria Soto, and Lori Wise. The program is called TELL-ME (Teaching Early Language and Literacy through Multimodal Expression). (Link Above)
Yes, there can be a lot of new icons to learn and it is okay to teach one icon at a time! Maybe even spend an entire day using the icon “go” in as many situations and circumstances as you can. You might be surprised how many there are!
(Pictureare from Google Images)
– “Go” to the bathroom / “Go” sit down
– Take time to “go” eat lunch
– Indicate it’s another person’s turn by saying “go”
– Ask for a walk by saying “go”
– “Go” away
– Indicate you want a video to play by saying “go”
Think about the world in terms of core vocabulary and how you can express yourself using it.
Commands: “sit down,” “listen,” “wait,” “look,” “stop,” “all done.”
Games: “Your turn,” “my turn,” “go,” “stop.”
Projects: “Same,” “different,” “look,” “like it.”
– Book Activities – Touch different core words on the core vocabulary board or AAC device as you read a book.
– Hang a large portable core board in the room. You can use the core board during small group instruction or throughout the day to help teach those core words and concepts. Student can practice using their boards during this time through teacher modeling. Teachers should focus on modeling and encouraging the use core vocabulary during all activities throughout the day.
– Practicing word order: loose symbols from the wall chart you can move around into different word combinations
– Asking for help when you are supposed to be working independently: help picture card on the stick placed on the student’s desk to remind him/her to ask for help, when needed
– Asking questions in a social language group: 2-word phrases, core phrases, and sentence strips of possible things to say which can be ordered into a social script
– Cooking in a small group: phrase cards (put in, get more, turn on, turn off, take out) to hold up to prompt vocabulary use
– Writing 3 sentences about the book: wall chart of the 200+ core words as a word bank
Add your ideas for using functional core words for describing common school, classroom, and community objects.
Post visual symbols on the objects:
(Pictures are from Google Images)
Stairs – go, up, down, help, move, left, right
Trampoline – on, off, help, jump, my turn, go
Bathroom– in, out, turn on, turn off, open, close, push
Door – open, close, shut, in, out, push, pull
Door Handle/Knob – turn, pull
Fridge – in, out, open
Lockers – open, close, in, out, hang up,
Mailboxes -put in, take out
We need to take the time to model speech and language for children BEFORE we expect them to demonstrate that output of their words. Focus on modeling, modeling, and modeling for your students! Don’t stress about beginning AAC learners who isn’t touching their communication device often. Be the model that they need and deserve. Before you know it those little learners will be following that model.
So your AAC learners are starting to use core words on their own, but you still need to teach academic lessons! Teach nouns for academic lessons – nouns you know your AAC learners will not use once the lesson is over. The student uses core words to describe the concepts in the lesson instead of asking the student to memorize specific nouns to answer academic questions.
There are several bonuses to the descriptive teaching method:
– It gives the student more practice retrieving core words and combining them into meaningful sentences
– It requires the student to think more deeply and creatively about a concept in order to describe it his own words
It saves time spent programming and learning how to retrieve infrequently used words
(Pictures are from Google Images)