An Interview with Sonja Higham from Speak2Me on Assistive and Augmentative Communication for CP kids with speech challenges

What is AAC and how does it work?
Sonja Higham from Speak2Me in Cape Town guided me through the different types of assistive communication

What is AAC and how is it used??
Augmentative and alternative communication (AAC) is an umbrella term for all types of assistive communication. Some people might only need support in communicating – so their skills are “augmented”, while others who have no communication abilities are given “alternative” forms of communication.

Can you give examples of assistive communication?
Assistive communication provides an individual with a means of communication other than the spoken word. This may be for a temporary period or as a long-term solution and could be in the form of gestures, key word signing, picture or symbol exchanges or computerised voice output systems.

Which children are good candidates for AAC?
AAC is prescribed for any person who has less than 15 functional words. A functional word would be a word that is useful in daily life. Good examples of these are: come, up, no, go, yes. Words that wouldn’t be described as functional, would be those like mint, leaf or car.

There’s no age limit for AAC devices. Children or adults, no matter what their diagnoses, who have less than 15 functional words would be great candidates for AAC.

What’s the best way to access AAC in South Africa?
I highly recommend contacting the Centre for AAC at Pretoria University. They have a lot of information and will probably be able to refer you to someone in your area.

What is possible with such a device for my child?
The possibilities with AAC are limitless. AAC can be used effectively in all areas of life from the young child learning basic communication, such as “I want to eat” or “I need the toilet”, to being able to share dreams and desires. It is also used effectively within the educational setting to answer questions, complete exam papers and to interact socially on the playground. The possibilities of AAC do not end there, if the communication strategies are being used effectively, this can then also be taken into a work place.

However, it’s important to remember that the possibilities of AAC do not solely rest on the communication strategy, but also on the capabilities of the individual and the time invested in learning and using these strategies.
What’s the best time to start with AAC?
Our recommendation would always be to start as early as possible. AAC has been shown to reduce frustration in typically developing toddlers, as it provides the child with a means of getting the message across before their speech skills have developed enough to take over the function. By starting earlier, you will reduce frustration, allow for a deeper level of bonding and often even reduce stress and thus physical tension in the body.

Shouldn’t I wait? What if my child starts speaking? I don’t want to give my child a different method of communication that might make them lazy and inhibit their own speech.

There has been extensive research on this topic and the outcome is a clear “no, don’t wait”. Speech is always the easiest method of communication. If your child can speak they will prefer this over any alternative method of communication. Speech is faster and is always with you, so a child that is going to be able to learn to speak will do so and then they will start dropping their alternative methods.

If we wait, we just increase frustration in the child and this can then easily move over to “learned helplessness” which is not a good place to be in. This is when the child stops trying and gives up because they feel “no one is listening to me anyway”.

Can AAC promote speech development?
Yes, research has shown it does. The theory is that is takes the pressure off speech and allows it to develop naturally, it provides the child with words that they hear over and over until they start copying these familiar words. When you use an assistive communication method it naturally slows the rate of the communication partners speech down, making it easier to understand and copy. AAC also provides the child with language development so that they gain an understanding of the use of language before they start speaking and have something to base their speech on.

Having said this, not all children will learn to speak, or will have enough words to convey all their needs and desires, so they may need to continue using AAC. In this situation it is important that the children have not been denied the ability to communicate due to their inability to speak.

What’s the biggest lesson for parents in this?
When your child learns to communicate, you need to learn to listen.