Look Around That Corner!

By Ben Bond, Speech Pathologist (VIC), Liberator Pty Ltd

I was walking around a corner the other day and I ran into someone. The bad type of running into someone, the type where you bang heads and get coffee spilt on you.

With coffee on my shirt, I grumbled under my breath and offered a brisk apology and went on my not-so-merry way. For the rest of the day that memory continued to flash in my head each time I looked down at the coffee stained shirt I was wearing. I couldn’t help but WISH I considered what was coming for me around the corner.

I believe there is a lesson that can be applied here when considering this in light of AAC practice.

My names Ben and I am a consultant at Liberator Australia. I love what I do, I get to speak with hundreds of speech pathologists and parents every year about AAC. I get to help them trial different systems and I get a front row seat in seeing what works and what doesn’t work so well.

I wanted to use the above story of me walking into someone as a way of exploring one issue I see that can cause some people to stumble in their adoption of an AAC system.

When I was walking, I was only focused on what was immediately in front of me. When introducing AAC systems we can get too focused on what we see during an AAC trial or at the beginning of an implementation period and not consider what skills would help the user around the corner.

This can happen at times because the home page is full of useful core words and it may be all that the user accesses when starting out. As such, sometimes we forget to ask the question “what other skills are needed to access vocabulary deeper down in this system?”.

We know that there are no prerequisites for learning AAC, but there are certain cognitive skills that go a long way in helping us master some AAC vocabularies. Consider a Single Meaning Picture System where there is one picture for each word and words are largely organised by parts of speech categories (Verbs, Adjectives, Nouns). It is logical to assume that for mastery of a system like this the user would benefit from having a knowledge of these categories so they can narrow down where a word may be.

Another consideration is literacy skills. Some systems have verbs all grouped together. This is a problem when someone doesn’t have literacy skills because verbs are not “picture produces”, that is, a drawing of a verb like “learn” won’t reflect the word well. Without literacy skills it is very difficult to find a word you want in the verb folder as the pictures on the buttons don’t look like the word and the individual is unable to read it!

It is important to remember that even though many words are not “picture producers” and can be difficult to locate without learning their associated icon (in Single Meaning Picture Systems), many individuals access these words through the process of motor planning.

Now, if we are starting with only the first page of a system, we may find that a device trial or the early intervention period, was a real success! But this may be misleading. Sure, they may be able to request with “want”, protest with “stop” and comment with “like” (if they are on the home page) but is this “success” a true reflection of how they will be able to use their chosen system going forward or have they simply just learnt the position of that word?

We might find ourselves in the unfortunate situation where when they outgrow those first few pages and need to access more, they can’t because they do not have the cognitive skills (e.g. categorisation & literacy) that help with accessing that system! It is like they have turned the corner and Wham! They have run into a man with a coffee.

The takeaway message here is simple.

Don’t be blinded by “success” in an early intervention period or a device trial if the user has only accessed a few words. Consider what’s waiting for them around the corner.

Opinion piece by Benjamin Bond