This is a question that consumes many speech pathologists assessing a child for a communication aid that will serve as the child’s “voice”. In the past speech pathologists resorted to making communication books from scratch, painstakingly choosing vocabulary that would meet the child’s needs. They’d spend hours programming whole pages of words into a high tech system so the child had vocabulary for their lesson the next day.

Today, growth in the Speech Pathology field, expanding research into Augmentative and Alternative Communication (AAC), and the meteoric rise of technology in society, there is now a wealth of choice when it comes to selecting a robust and comprehensive communication system.

Here are some key elements to look for when selecting a communication system for a child’s day-to-day communication.

Choose something that will work for your child.

There are tools available, such as the SETT framework, to guide us when selecting a communication aid for a person’s individual needs. It encourages us to consider all aspects of a person (their personal abilities, places they go, things they do, things that are expected of them, who is with them) to make sure the communication aid is the right fit for them. For example, can the child carry a heavy device? Or perhaps it sits on the school desk so it doesn’t matter. Does the child need larger buttons to access the board better, or a bigger speaker so it can be heard over shouting children at break time? Perhaps it needs to have access to Facebook, or maybe it’s better if it doesn’t? A framework can be helpful to ensure we think of all the practicalities in the child’s life.

 

Ensure the aid supports communicative interactions.

How often have you seen a child who has a communication aid, but the words they need aren’t in there? Make sure that whatever you choose, it is a robust communication system. A child may have a picture of a ball, but without more information we can’t understand the context. Is she is telling us she has ball? She wants to play catch? Her ball is lost! That the ball rolled into the road and she has wants to share the story? A robust communication system will have core words (words that can be used in many different situations and activities) that allow us to say more than labels for objects. It will have words that help to navigate the system, talk socially with others, fix communication breakdowns and learn language.

Conversations move quickly, and using a communication aid can be frustratingly slow. Look for communication aids that allow for fast messaging. There are many systems available now that use rate enhancement through word-prediction, memory, motor planning using consistent placement of words, and pre-programmed messages for quick access.

Make sure the communication aid works for the child now, and in the future.

The communication aid you choose needs to provide a way for your child to share their ideas now, but we also want to ensure that language continues to grow. Many communication systems have built-in grammar, with levels of complexity increasing as a child masters early words and starts putting words together.

 

Providing access to an alphabet, even at an early age, can be critical in developing literacy skills. Once a person can spell, all words become immediately available! Children are exposed to their ABCs from as early as kindergarten, or even earlier. For our little ones who aren’t talking, we can only trust that they have the potential to be as competent in the same skills as their peers. While the alphabet may not be the focus when learning to use the communication aid, children who are exposed to it will explore it and eventually move to using it when they are ready.

Ultimately, it is not the communication system that makes a successful communicator.

What matters is how we implement what we choose – it is the parents, siblings, teachers and helpers using the system

• how therapists teach others to use it
• the support children have to learn language

 

With all the good that comes with having choice, we can become overwhelmed. If you are unsure if the PODD book your child has is right for him, or whether he’d do better with Proloquo2Go like other kids in his class use, or Minspeak is something you’d like to try, or you’d like to move to a NOVA Chat system because high tech must be better…I can tell you that they are all examples of great communication systems. It may be that you have reached the hard part, and also the fun part, of really making what you have work.

I’d like to echo the question renowned speech pathologist Chris Bugaj asks: do we need to split hairs over getting the perfect system? With the limitations on the time speech pathologists can spend with children, our time may be better spent building a program that family, teachers and friends can implement using the communication system the child already has.

For support and advice in accessing communication aids, contact Scope’s Communication and Inclusion Resource Centre on 03 9843 2000 or circ@scopeaust.org.au