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Why Is There Reluctance to Try AAC With Children Who Have Apraxia?

Gary Cumley, Ph.D., CCC-SLP

My research has focused on determining the effect AAC has on the communication quality and quantity of children diagnosed with CAS or suspected CAS. Trying to determine why professionals and parents are reluctant to introduce AAC to this population is of great interest to me. Professionals and parents have the same goal for these children and that is for these children to talk. Both groups fear that if AAC is introduced into the intervention, then the child will not talk or stop talking. In addition, if AAC is introduced, there is the feeling that the professionals have given up on speech production. However, research has clearly not shown that. What it has consistently shown is that if AAC is introduced into the intervention plan of children with severe expressive communication disorders, there is often a marked increase in speech output. In my own research, when AAC was available to these children there was an increase in their speech usage or there was no marked decrease in speech usage. When looking across all the childrens communication modalities, it was found was that when AAC was available, there was a decrease in the use of gestures. Gestures are frequently used by children with DAS and often are a useful communication mode. However, frequently these gestures are not communicatively specific enough to convey the childs communication intent and result in their communication attempts being unsuccessful. AAC should be viewed as a positive means of supporting a childs speech attempts and a more communicatively efficient means of conveying their communication intent.

The lack of AAC knowledge can be another reason professionals and parents are reluctant in introducing AAC into a childs intervention plan. Many professionals view AAC as only being associated with high tech voice output systems, which is not always the case. Yes, these children need to have a voice, but professionals and parents need to select which AAC system, high and/or low tech, best supports the communication intent of the communication situation. Children should always be provided with different multimodal communication options, such as speech, gestures, high and low tech AAC, and sign language as a means of communicating. The ultimate goal for children with DAS should be to provide them a successful means of communicating. AAC should not be viewed as giving up on speech, but rather viewing AAC as providing a means to support the childs speech attempts, increasing successful communication and providing a strategy for repairing frequent communication breakdowns. In summary, the introduction of AAC into the intervention plan of children with CAS should be viewed as using all communication modalities, including AAC that successfully support the speech attempts of this population and facilitates the access and successful participation in communication interactions.

(Dr. Cumley is an Associate Professor at the University of Wisconsin – Stevens Points in the School of Communicative Disorder. He received his doctoral degree from the University of Nebraska-Lincoln in the area of Augmentative and Alternative Communication (AAC). He has presented at the local, national, and international levels in the areas of augmentative and alternative communication. His areas of expertise are in AAC, childhood language acquisition and intervention and language issues for special populations. Before entering the doctoral program he worked for 16 years as a public school speech and language pathologist and program specialist in California. He served children with various communicative disorders resulting from cerebral palsy, mental retardation, language learning disabilities, CAS or suspected as having CAS, and autism.)

© Apraxia-KIDS℠ – A program of The Childhood Apraxia of Speech Association (CASANA)