Augmentative and alternative communication: treatment principles and strategies

This article has attempted to clarify the principles of AAC evaluation and intervention, in part by dispelling myths that have persisted for too long. To the list of general guidelines for deciding when to consider AAC and how to begin breaking down the barriers to full participation by children with severe impairments, we need to add some warning signs that we have learned to heed in our work with these children. These signs are listed in Table 6 and are indicators that aspects of an approach to AAC must be altered or the child may fail to benefit from an intervention. Each sign conflicts in one way or another with current principles of augmentative and alternative communication. We give you these signs along with some possible ways to eliminate or prevent these errors in the future. Providing the best possible set of strategies for communication for a child with severe communication impairments is an enormously complex task. Whether a child can or cannot be assessed with standard procedures or whether he or she has unitary or multiple disabilities, the barriers to communication are many and intricately constructed. Sorting out strategies and how to apply them ordinarily requires input from the consumers of AAC (i.e., the family, child, and primary communication partners), the core team of professionals, as well as a team of specialists in AAC. Conducting evaluations and intervention is challenging because of institutional, bureaucratic, and professional barriers that each member of the team faces. Few, if any, teams can provide services that meet all of the established principles of best practice for every child that it serves. Yet, attempts to identify weaknesses within AAC programs and work to strengthen them must be given high priority in order to provide the best possible AAC services for such children. Only then will it be possible for children with severe communication impairments to overcome their own barriers and begin to participate in their choice of life's activities. That is, after all, the ultimate goal.