You’ll find a variety of blog posts aimed at parents, speech therapists, and students, with topics ranging from nonspeaking children and getting started with AAC, modeling AAC and how to support children wtih complex communication needs learning how to communicate with AAC.
How many times have you heard: "They are just stimming on their device.” In this blog post, I’ve teamed up with Laura Hayes (@AACinnovations on Instagram) to take a magnifying glass and zoom in on how AAC learners may “stim” on their devices and how we can utilize this information to better support them.
Have you ever worked with a student who appears to be randomly activating icons on their AAC?
You may hear people say that the child is “just stimming” or that they're “just playing with it” or they “aren’t using it functionally”. When in actuality, they're engaging in a very crucial part of language development!
I want to share a story about a student of mine whom everyone said was “stimming” all day on their device. I set this student up with high-tech robust AAC and she started activating every single word on that device on repeat. Everywhere she went she brought the device and would not stop activating all of the buttons. The team was calling, emailing, and texting me, saying, “She's not using it functionally!” and “She's distracting the other students in class!” or “She won't stop stimming!”
One day after four months of intense exploration and non-stop babbling, the student stopped. She started acutely listening to what the adults around her were saying. We realized that any word we said, she could find on her device. Even obscure words like “grasshopper,” “island” and “receipt.” These are words we had never taught her. It was UNBELIEVABLE. The whole team was in shock.
I share this story for two reasons:
1. We can never assume that what a child decides to do on their AAC system isn't purposeful or meaningful. In this case, the child was learning where every single word was located on her device. It was truly incredible that she had taught herself this skill!
2. This child knew where every single word was on their AAC --- BUT she still very limited understanding in how to use all of those words in meaningful ways. Memorizing the words on the device did not translate to her magically being able to communicate with us. This illustrates how CRUCIAL it is for the adults around an AAC user to model language in meaningful ways.
AAC learners sometimes explore their devices by pressing buttons and saying words out of context. This exploration is similar to the “babbling” stage that infants go through when acquiring language. Just like when babies explore producing sounds to say words, AAC learners explore their devices to learn the meaning and power of their words.
When a baby says “da” for the first time how do adults typically respond? “DADDY! You said DADDY, DADDY is coming home soon!”
That “da” could have been completely random —- but over time when we respond to that “da” as intentional then the baby learns that’s how they say “daddy”. It’s no different when it comes to AAC.
So what do we do when a child is “babbling” on their device? We attribute meaning to what they are communicating in the exact same way.
If a child says “shark” even though you are holding up the “dolphin” you can attribute meaning by taking what the child says and responding naturally.
EXAMPLE: “Should we try to find a shark?” or “This DOES look like a shark —- but it’s actually a dolphin.”
By attributing meaning, it validates what a child is saying. It also demonstrates that there is a cause-and-effect relationship between what a child says on their device and the actions of their communication partner.
Instead of expecting our students to have immediate intention and accuracy with their AAC, how do we cultivate space for more explorative learning of language? We can shape their language learning and see more progress if we actually pull back on our expectations and let the process flow more freely.
Read more about Stimming and AAC on my Instagram with my 5 part collaboration with Laura Hayes. (1, 2, 3, 4, 5)
Watch my YouTube video on What to do When a Child Makes a "Mistake" on their AAC device
If you want even more helpful AAC strategies and resources that I don’t share anywhere else then join my email list!
That’s where I share my clinical insight and my favorite resources. You also will gain access to my Freebie Vault where you’ll find downloadable AAC resources I use everyday in my practice.
When I’m working with children who have complex communication needs, my goal is to always strive for spontaneous language. This means a child has a novel thought or idea in their head, and they can communicate it autonomously.
In fact, it’s one of the first questions I ask parents: “What is your child communicating completely on their own?” If they’re not sure, I have them track their child’s spontaneous language throughout the week by writing down what a child said and in what context. During my consults I like to use this helpful PDF below that breaks this down even further:
When I give the homework of tracking spontaneous language, families often come back and report there’s not a lot of spontaneous language happening! This exercise made them realize their child is waiting for them to ask a question or model language or give them some level of prompting in order for them to communicate.
So the big question is: How do we get kids communicating more spontaneously? I use a least-to-most prompting hierarchy, featured on my AAC Vocabulary Bundle, that prioritizes giving kids the space and time they need to start initiating more communication.
I love this quote from Caroline Musselwhite. I often witness communication partners using demanding language like“What do you want?” or “Tell me with your device.” in order to elicit communication. While this might seem helpful, this type of language often results in children feeling pressured rather than encouraged to communicate. Instead, we can make a subtle shift in our language to be more enticing. For instance, if a child wants crackers, you might naturally comment, “Mmm, crackers!” or “Yes, I love these crackers.” When you use commenting like this you’re modeling language in a way that invites communication without demanding it.
I always start simply commenting about what’s happening FIRST to see if that’s enough to inspire communication.
Start building awareness of the types of language you’re using to encourage communication with AAC. Aim for your interactions to sound more like natural conversations.
Here are my favorite strategies to encourage communication:
First we need to give a child a lot of exposure to a specific word/phrase. For example, if I’m teaching the word “OPEN,” I immerse children in that word by modeling it frequently on their AAC system during motivating activities.
This could be opening up the refrigerator for a snack, opening up a game box or opening the door to go outside. Once I've given lots of repeated exposure to teach this word, it's time to start following the least-to-most prompting hierarchy.
Pick a familiar routine like opening up the refrigerator. The first step is to simply tempt and pause. This might mean that you put your hand on the refrigerator door to tempt and then pause and wait a communication attempt. Make sure the device is easily accessible to your child and be sure to recognize ANY attempt at communication… even if it’s not “accurate”.
A child doesn’t even have to select the “correct” word. The key here is that we're giving the child the space to have an idea and then independently initiate communication with us. If they use a word that doesn’t make sense we can simply attribute meaning to that word.
Let’s say the child doesn’t respond to tempting and pausing. You can use body language like a facial expression like raising your eyebrows or shrugging your shoulders as if to say “I don’t know. ”
If the child still doesn’t respond, then you can ask an open-ended question, such as “Now what?” or a comment like, “Hmm, I wonder what we should do next…”
Still no response? You might try asking a more specific question like “What do you want?” or “Tell me with your talker.”
If a child continues to need help you might give more support by pointing to their device or even pointing to the word “OPEN” on their device.
I never venture into physical prompting because it violates bodily autonomy AND I haven’t found it to be useful in supporting independence down the line.
If I’m not getting a response it tells me either the child isn’t motivated by the activity I’ve chosen OR they haven’t had enough modeling or teaching with the specific word/phrase I’m targeting to use it on their own.
The reality is that the more support and prompting we give, the more reliant our students will become on that high level of support. The secret art of amazing therapy is pushing kids out of the comfort zone just enough so that they are able to start learning and growing. When we give children space and time to formulate their ideas into communication we are supporting a broader vision of heling our students become as independent as possible when it comes to sharing their thoughts and connecting with those around them.
Watch this video about How Over-Prompting Kills Spontaneous Language
The takeaway message here is that we need to be really cognizant of how often we’re asking questions to a child and demanding communication. Ultimately, if we do this too much we’re training kids to learn to only talk when someone tells them to.
Instead, we can build a strong foundation for independent, autonomous communication. That starts with giving kids the space and time to formulate and communicate their thoughts on their own.
Do have a child who relies heavily on prompting in order to communicate? What strategies have you've found successful? Share your story in the comments below OR reach out to me on my Instagram - I’d love to hear from you!
If you want even more helpful AAC strategies and resources that I don’t share anywhere else then join my email list!
That’s where I share my clinical insight and my favorite resources. You also will gain access to my Freebie Vault where you’ll find downloadable AAC resources I use everyday in my practice.
This podcast episode with Lily Konyn and Alyssa Hillary Zisk aired on May 10th, 2023, and I cannot stop thinking about it!
One moment I keep coming back to was when Lily explained her perspective and lived experience when it comes to the “brain-to-mouth filter”.
Lily explains:
“Sometimes there are words in my brain that just have to come out. They don't mean anything, but the brain-to-mouth filter is not there. And we hear that a lot from people who experience significant apraxia or dyspraxia, that they just can't stop the words from coming out, regardless of whether they mean anything at all.”
Lily relates this to how we can get songs stuck in our heads. Just like I can’t help myself from singing out loud when I hear songs like Spice Girls “Wannabe” (am I right?!) and then those words start looping repeatedly.
Lily described how she and many other autistic adults can get phrases stuck in their heads, and just like how I sing the song in my head, the phrases in their heads come out of their mouths too. For many autistic kids and adults, this repetitive loop of words is a daily struggle, and it can be tough to control.
AND— (even more important) it may not be helpful to control.
Lily reports that scripting the same word/phrase repeatedly can be a comfort, especially when it's about something she's really into.
Lily expands on this in her article over at Assistiveware:
I use echolalia all the time, and it feels so many different ways. When all I can get out is the phrase stuck in my head, but I can’t explain why, it’s frustrating. When I’m telling you what I mean by echoing my favorite television shows, it’s joyful. When it’s tumbling out of my mouth just because it feels nice to say, it’s cozy. The only time it feels deeply negative, however, is when someone disconnects from me because of it.
One of the big takeaways for me from this moment was that it's really not just about using AAC tools “effectively”; it's about understanding and accepting the different ways people express themselves… whatever that looks like.
Instead of seeing repetitive communication as a problem, let’s get curious and dive into the possibilities of what is being communicated and why, and not write it off as a “behavior,” “nonfunctional,” or “stimming”.
It's all about empathy, acceptance, and making sure everyone's voice is heard
As Lily says in her article:
Listen to me. Affirm that I’ve said something, even if you don’t understand it. Repeat it back to me. Nod. Tell me that you’re trying to understand. Help me regulate. Find joy in my echoes!
If you haven’t listened to the episode yet, you can find it here. There is SO much wisdom and insight from both Lily and Alyssa that you won’t want to miss out on!
If you want even more helpful AAC strategies and resources that I don’t share anywhere else then join my email list!
That’s where I share my clinical insight and my favorite resources. You also will gain access to my Freebie Vault where you’ll find downloadable AAC resources I use every day in my practice
All children, regardless of their disability, CAN be taught how to read and write. Here are some ideas if you’re not quite sure how to get an AAC user started with literacy.
When we’re teaching vocabulary to children with complex communication needs, we need to be highly strategic about the words we’re choosing. I’m going to break down exactly how I figure out what words to start targeting for children using AAC.
Utilizing this least-to-most prompting hierarchy (see photo below) helps give children the scaffolded support they need to become more independent and autonomous communicators. Remember: if we are constantly prompting our communicators, then we are teaching them to only communicate when someone tells them to.
One of the most common problems I see in my practice is that kids are stuck using carrier phrases like "I want…" or “I see…” We call these “carrier phrases” because you simply rotate different words into the rote phrase. What’s the solution? Core words.
If you’ve spent any time here on my website or follow me on social media, then you’ve probably noticed that I love visual resources. Visual supports are imperative for child learning, and there are few visual supports that I love more than a communication board (you can download my FREE Core Communication Board).
As I finally see light peeking out from the end of the tunnel, I've been overwhelmed with emotions and reflection. The lessons of this long, arduous journey have given me even more compassion for the families and students I serve.
Without question, the following line is one of the biggest challenges I hear from parents: “My child isn’t speaking in sentences.” After all, building sentences is central to a child’s communication success. This skill develops as babies listen to adults around them having conversations. Then over time, babies slowly start to emulate adults by first producing single words and eventually short phrases. As language skills grow, their sentences become more and more sophisticated.
Unfortunately, this process isn’t quite as simple for children. A lot of my clients might be able to repeat words or phrases, but they are mostly using scripts and aren’t formulating their unique thoughts and ideas into sentences.
This is where I find visual supports to be incredibly helpful.
Podcasts= Life. Especially in LA traffic. There’s nothing better than the efficiency high I get when I’m driving around AND learning some new strategies, therapy ideas and get updates on the latest research. Below you’ll find 15 SLP podcasts that you have to check out on your next drive.
In my last post, I described the difference between core words and fringe words, and talked about the benefits of teaching core vocabulary. This is the fastest way to help a child start communicating more effectively.
We’re living in a digital age and children amaze me at how tech-savvy they are. Sometimes it can be overwhelming finding the right apps that both motivate children and also facilitate learning and communication.
So honored to get some gems of wisdom from early intervention expert, Stacey Landberg. Stacey is an LA-based speech-language pathologist who has developed a particular interest in the effects of screen-time and early childhood development.
As a speech therapist and technology specialist, I get asked all the time about my favorite apps I use in my practice. It can be overwhelming finding the right apps for children that are practical, but that also facilitate learning and communication, and aren’t just for playing games. So in my latest blog post I’m sharing a few of my favorite apps.
“You were a late talker too,” your mom says as she sips her latte. “I wouldn’t worry about it. Look at you. You turned out fine. Just give him time. He’ll talk when he’s good and ready.” Your well intentioned, reassuring mother might be absolutely right. Your child might begin talking (or talking more) any day now. But what if she’s not right? What if speech doesn’t develop like you hoped it would? While you wait to find out, might valuable time be slipping by when your child could be learning tools that could help him to communicate?
We don’t have the capacity to force verbal children to talk… so why, then, would it be acceptable to take a child’s hand and activate their words on their device or tell them what to say in any given situation?
And more importantly... how does requiring a child to say specific words actually translate into autonomous communication? Spolier alert: it doesn’t.
That’s where the “Inspire” piece of this catch phrase comes into play.
Hi my name is Rachel and I’m a podcast junkie. Every day I hop in my car, hit play and start flooding my brain with life hacks, compelling stories, news headlines and daily inspo all while I sit in L.A. traffic (YES, L.A. traffic is as bad as everyone says it is!).
My podcast addiction peaked last October when I was asked to co-host a new speech therapy podcast called “Talking with Tech”. Talking with Tech combines two things that I love most: speech therapy and technology. Not sure what kind of technology I’m talking about? Well there’s an earlier blog post in which I talk all about AAC and how it can transform your child's communication.
Our podcast was originally created to help guide speech therapists working with children who are minimally verbal, but we quickly realized the information was applicable well beyond the scope of speech-language pathologists. Now with 60,000 monthly downloads across 54 countries, we’ve gained a following of dedicated parents interested in helping their child start communicating more effectively.
It stands for Augmentative and Alternative Communication, and it basically refers to any kind of communication system that helps kids (or anyone, for that matter) express their needs to you if they can’t use verbal speech.
One of the biggest misconceptions I see in my practice is that people think that AAC only refers to sleek gadgets activated by fancy buttons.
In fact, some of the most effective AAC supports I use every day are quite simple, and considered “no tech” or “paper based”.
