AAC: A parent’s guide to using high technology to help nonverbal children

Editor’s note: Here at Verizon, we strive to move the world forward based on the fundamentals of diversity, equity and inclusion. To optimize the digital experience for all our customers, we strive to meet the web accessibility standards recommended by the World Wide Web Consortium (W3C) in their Web Content Accessibility Guidelines (WCAG) 2.1 AA. We take a number of steps to strive to meet or exceed these standards, while providing critical support to global initiatives such as Valuable 500 and Ability Beyond that adapt low-cost devices so that their clients with disabilities can communicate and thrive.

Jay, as he will be referred to here, and his family never thought a tablet could change their lives. Jay was born without the corpus callosum, a broad band of nerves that connects the left and right hemispheres of the brain. Even before Jay was born, the parents knew their son could have problems with a range of abilities, from walking to talking.

Today, at age 4, Jay is typically developing in many ways. But when I started working with Jay as a speech pathologist who specializes in using augmentative and alternative communication (AAC) to help children communicate, he didn’t speak. Now, Jay interacts with his siblings, peers and parents using a tablet and a specialized communication app that helps him express all his thoughts.

Jay is one of over 2 million Americans who use AAC to communicate, according to the American Speech Language and Hearing Association (ASHA). For parents and kids like Jay, AAC technology can be as accessible as downloading an app. But ease of use and access aren’t all that’s important. While AAC devices are more effective, three out of five AAC apps and devices may be abandoned or forgotten after a year because caregivers struggle to get them to work. So when it comes to helping children in need use tools to express themselves, a little understanding of this technology can go a long way.

This parenting guide is ideal for those just learning what AAC technologies are and how they can help children express themselves better.

What is AAC?

AAC is any means of communication other than spoken words. It can be a gesture, for example a thumbs up from across the room, or a wave hello. No-tech and low-tech AAC includes written words, sign language and even drawings. High-tech AAC—which we’ll focus on in this article—includes anything technology-based, such as a computer or tablet with an app that can provide speech.

These units are also known as speech generating units, or SGDs. It’s just a fancy way of saying “it speaks for you.” For example, Elizabeth Bonkers, a non-verbal college graduate, recently gave a commencement speech using such a device. You can watch her speech here.

AAC can be used by a range of children with a range of abilities. With the advent of AAC applications for smartphones and tablets, they are more accessible than ever. Most of these new apps are highly customizable so that each child’s needs are met on an individual basis.

How high-tech AAC helps children communicate

Long before tablets and apps, AAC devices were paper pages bound in three-ring binders, or they were the size of small computers. Usability was limited to pointing at pictures or pressing buttons with pictures, and if there was speech output, it was mechanical and robotic by modern standards.

Today, technology has become high-tech. There are AAC apps for tablets and smartphones, and there are stand-alone devices designed specifically for AAC and preloaded with communication software.

Voices for speech output are natural and personalized, and these devices can be accessed by direct touch, gestures, keyboards, and even electromyography-based controls, meaning the device can be accessed by measuring electrical activity associated with activation of a muscle group using a small , wearable piece of technology that communicates with the device.

With these high-tech changes, AAC is now available to people in ways that it wasn’t 20 years ago. And the cost is often partly covered by the insurance, but it depends on the policy.

Benefits of high-tech AAC technology for children

Here are six benefits of going high-tech.

1. Robust vocabulary: High-tech AAC options give children faster access to more vocabulary words. Low-tech options are limited to what can be printed on a page. For example, if you go out to a restaurant, you are limited to ordering what you see printed on the menu as opposed to asking for what you really want. Something that can be limiting in a situation where communication must be more spontaneous, or improvisational.

2. Adapts to the child’s developmental progress: Apps like Proloquo2go, a communication tool for iOS devices, are designed to adapt as your child develops. For example, you can start with 15 to 20 vocabulary words per screen on the tablet or device, and as the child grows, you can easily add more words.

3. Better auditory feedback: Some children have problems decoding different parts of verbal communication. For example, one speaker can hear and understand the phrase “I want the ball.” For those high on the autism spectrum, for example, small changes or fluctuations in the speaker’s tone or facial expression can make the phrase mean something different. The consistent message output from a high-tech app or device means that the user can experience the message in the same way every time it is produced, making it easier to decode, and then easier to repeat. Research also shows that some children are eventually able to repeat phrases from these units verbally.

4. More language options: Many apps and devices offer multiple languages. This is ideal for children living in bilingual homes. High-tech AAC options make switching back and forth between different languages ​​relatively easy.

5. Communication with larger groups: With low-tech options, children are often only able to communicate with people who can see their AAC card or screen. If the child communicates, but no one sees them doing it, the message may go unrecognized. The voice of high-tech apps and devices allows everyone nearby to hear the user.

6. Internet access: Many apps and devices offer options to turn messages into social media posts, emails, and more. This is an important part of being young in today’s world, and not available when you use low technology.

Things to know when choosing high-tech AAC apps and devices

Before choosing an AAC app or device, whether it’s high-tech or low-tech, be sure to talk to a speech therapist. Making the decision is a long, complicated process that should be completed with a speech therapist and an enhanced communication team. This short list can help you get started with your search.

Not all apps or devices are created equal. Some tablets may have limited access to functions such as social media or e-mail. Some have monthly subscriptions. Some may not be covered by insurance, so it is important to work with the insurance company and the speech therapist.

Not all AAC apps and devices are created equal. Some use different symbols than others. Some are very complicated to program. Also in my experience the cheaper apps don’t work as well. They may be buggy, or have a lot of pop-up ads. Seek the opinion of a speech pathologist, and remember that those trying to sell these devices are trying to sell them. I have had experiences where families have spoken to a salesperson before a speech therapist. It is important to ensure that the therapist’s recommendation comes first.

Not all apps are available on all tablets. Some apps are only available on iOS devices, and others are available on multiple platforms. This is important information if you have several products you plan to use at home. For example, you might buy an app on your phone, only to later discover that it can’t be used on your tablet.

How to choose the right AAC app or device for your child

It is important to note that not all speech therapists have experience with high-tech AAC technology. Ask if they use them and how long they have worked with children who use AAC.

Here are some tips for choosing the right AAC technology for your child:

Define the child’s communication needs. What are their communication goals? What do they want to be able to communicate? Who are they talking to? Where do they need to access their app or device?

Assess the child’s physical abilities. Although there are no prerequisites for using AAC, there are some medical conditions, such as cerebral palsy, that will need a team approach. There are AAC apps and devices designed for different age groups and abilities, and your speech therapist will know what’s best for your family.

Try different devices and apps. Many companies offer free trials of their devices, and many speech therapists also have access to these apps and devices. Acquiring a device may feel like an urgent matter, but choosing the wrong device can lead to device abandonment.

Check the parental lock options on the tablet. Not all tablets have this feature. Parental controls are essential, especially for devices used by younger children. For example, if your nonverbal child already uses a tablet to watch videos or play games, he or she may be more inclined to continue using it for entertainment, not therapy. So you want to lock down anything on that device that might distract them from using it as a therapy tool.

Check the display light options. Some iOS devices allow you to turn off the blue light from screens, which studies show can have a negative neurological impact.

Get a protection case and buy a protection plan if you can. Devices will be lost, spilled on and more. Be prepared.

If the AAC team can find the right app or device for your child, it’s possible to unlock their world in ways you can’t imagine. Like Jay, your child can become more confident and engaged in his world. Not only does Jay express his wants and desires, but he uses his device to learn new concepts and interact in social situations.

Recently, using his device, Jay was able to tell his parents, “I love you,” a powerful phrase that’s been inside him for a while and just needed some high-tech help to express.

With smart family, you can protect your kids and keep an eye on their online activity with one simple app.