Setting Up Your AAC
Step 1: Design and customization
Once you have been approved for and received your AAC, it is time to design and customize it for you, a process often called personalization. This should be based on the belief that you can think, learn and understand and grow no matter what your disability is, also called your presumed competence, and support your ability to communicate as independently as possible.
Person-centered AAC
Personalization will be person-centered or focused on your needs, goals and preferences. That means you will not get a “one-size-fits-all” system or something you can just take out of a box and start using.
Instead, while your SLP will initially select an AAC system based on your evaluation, they will set it up so that it works for you in your everyday life. For instance, they will consider your reading ability in their recommended system. But they will also ask you about your preferences for text versus symbols.
To personalize it, they will focus on:
- Daily routines. Your SLP will want to know the details of your day (both during the week and on weekends) how you get to and from places and who you see every day.
- Transitions between activities in your day. Often this is where you may find unexpected situations and interactions with people. For instance, you may take a bus from school to a life skills program and notice the bus is not on time. You may want to ask others waiting with you if they know why. Or you may need to reach out to your program to let them know you might be late.
- Social interactions. Keeping and building friendships and connections with other people is important for your happiness and well-being. The SLP’s goal is to make sure you will be able to chat, share news, stories or humor, and participate in fun activities or your special interests with others.
As stated in the previous section, your SLP will have you try out your AAC system and ask you to let them know what you like and don’t like, what works and doesn’t work for you. Your input matters. Your SLP will listen and make adjustments based on what you tell them. So again, you may try out several systems. That is good. You should consider all your options. The goal is to find what works best for you.
Device customization
Appearance of symbols/pictures/icons
Your AAC system can be set up to reflect your personal identity and features. If you text on a mobile phone, you may already use this sort of personalization. If you use an emoji to respond or give a message a “thumbs up” you probably have seen that you can change the skin tone of them. It is the same within the AAC system. You can modify it to reflect your:
- Gender
- Physical characteristics such as hair color, eye color and stature
- Personal items such as a wheelchair, glasses or preferred clothing.
Voice
Most major AAC systems with a speech generating device (SGD) include many pre-recorded voice options. You can choose from teen and adult voices, by gender and different accents. You can adjust how slow or fast they speak and how high- or low-pitch they sound. Some even have technology that allows you to create and store a custom voice based on your vocal sound or record specific phrases to be stored in your AAC. This is called “banking.”
Vocabulary
Your SLP will make sure your AAC has many words in many categories so that you can communicate in all different situations and settings. They want you to have a big enough vocabulary so you can request things, ask and answer questions, share your knowledge and opinion, share your emotions and feelings, have social conversations, tell stories and jokes and get help when you need it.
How will they do this when there are about 470,000 words in the average dictionary? They will start by making sure your AAC has all the core words. This is a list of about 200 words that are known to make up about 80% of all daily communication by everyone. They are mostly verbs (“go”), adjectives (“more”) and pronouns (“I”).
They will also add what are called fringe words. These are words used less frequently, typically nouns, but specific to a person’s interests. To do this, they may fill out or have you fill out a Personal Interest Inventory. It is a questionnaire that asks about things such as your favorite activities, important people, likes and dislikes and sensory needs. An example of a Personal Interest Inventory is in Handouts.
You should know:
- Text-based systems typically have word prediction. You may already see this in use in texting apps, browsers and email. You type a few letters and see a suggested word appear on the screen. You can then select the word or phrase which saves you time and keystrokes.
- Your AAC system should have a keyboard and access to the alphabet, even if you will not spell much. You can use it to store more words in the device. It is also good to have it as an option, then to miss it if you need it and don’t have it.
- Your AAC’s vocabulary will be updated as needed, like when you start a new school or community program, get a job, find a new hobby or learn new skills.
Step 2: Planning
Your SLP should create an AAC Implementation Plan to support your use of your AAC system. This document should clearly outline all the ways you communicate, describe strategies to help you and your communication partners, outline AAC communication goals, and clarifies who will charge, program and maintain the AAC system. You will be involved in this planning process. Your parents/caregivers, any direct service providers, your school and/or employer can also participate. Planning should also include backup systems, in case your device fails or is misplaced. Maintenance, repair and ongoing tech support for high tech devices will also be needed.
You and your team may use a tool called SMART Goals to make your plan. Each letter stands for a step to turn a general idea into a specific goal. It makes it easier to track your progress and find success. It also helps your team find good ways to show you how to use AAC, practice together, and figure out what support will help you use it easily wherever you are. This chart explains each letter and provides an example of turning each into a goal:
Additional resources for developing goals:
Setting AAC Goals: Strategies for Emergent AAC Users - Avaz Inc.
Once goals are set, your AAC Implementation Plan is written up. It should be shared with all of those who will be interacting with the AAC user in their specific environment.
Step 3: Training and Implementation
For the AAC User Much of your training will happen during your trial phase of your system, personalization of it and implementation planning. But now it is time for you to use your system in daily life with others.
As important as it is for you to know how to use your system, it is important for your family, friends and daily communicati on partners to understand it, too. The rest of this section will focus on training them.
For Communication Partners It is important for communication partners to take the time to learn the AAC system and how to use it with the autistic AAC user. You do not need specific skills for this. But you do need to have patience, with them and yourself, as you work together.
Supporting a positive communication environment
A positive communication environment is one where you notice and respect every communication attempt. That means you respond in the same way all the time, even when attempts may not be perfect. This will encourage your autistic partner to keep communicating with their AAC.
Additionally, you should never take away an AAC device because of behavior, rule-following or convenience.
Encouraging Communication
Successful AAC use depends on you, not just the autistic person’s AAC device or their skill using it. You can encourage them by creating opportunities for them to communicate. For instance, you can offer them real choices (Do you want “this” or “that”?) rather than tell them what you are going to do for them so their only response is “ok.” Or, you can invite them into activities where communication is needed (games, meals, planning, problem solving) rather than tell them what is going on.
The key is to make sure you are encouraging give-and-take communication. You want to listen, wait and respond. This gives them natural practice, builds confidence in communicating with one another and is likely to lead to more spontaneous communication.
Teaching through modeling
Modeling AAC, also called partner‑augmented input or aided language stimulation, is one of the most effective strategies for communication partners to support communication. It involves showing the AAC user how to use the system by using it yourself.
Sometimes you may have your own device, but most often both you and the AAC user will use theirs. You should do so during favorite activities, daily routines, social time and work tasks and establish a relaxed, conversational give-and-take. What you don’t want to do is ask a ton of questions and demand responses, or “drill.”
How you should model:
- Model one step ahead of the AAC user. If they use one word, you should use two- or three-word combinations.
- Give them time to respond. If they do not after 15-20 seconds, model for them again. But do not force them to respond.
- Model more than just requests. Use the AAC for greetings, comments and simple small talk. You should even use the AAC for an observation that doesn’t require a response like, “The rain is really coming down hard.”
The benefits of modeling include:
- Building vocabulary and grammar: Modeling helps users to combine text and symbols into sentences which will help them increase usage, express their needs and initiate conversation.
- Reducing pressure to perform: Modeling without demanding a response or drilling, allows the user to learn by observation, decreases pressure and reduces anxiety.
- Showing and teaching acceptance: Modeling shows that AAC is valued and a normal form of communication. It also spreads awareness among others that AAC is acceptable.
- Helping communication partners be true partners: As family, teachers, service providers and other partners become familiar with using the device, they can give consistent support in all areas of the autistic AAC user’s life.
What does this look like in real life? Here are a few examples to better explain.
Post-secondary classroom During a small group activity at a community college, the instructor can use the AAC device to model phrases like “I think,” “good idea” and “I agree.” The instructor can also use the device while speaking to the group, showing the AAC user how to share opinions and take part in class discussions. The bonus is classmates will see how the AAC device is used so they know what to expect when interacting with the AAC user.
Hanging out with friends accompanied by a support professional While spending time with friends at the bowling alley, a support person can use the AAC device to model words and phrases like “fun,” “I like this” and “good job.” When a friend shares something with the AAC user, the support person can use the device to respond with a comment or ask a question. This shows the AAC user how to join conversations, share feedback and be social.
Day program During morning check-in, the staff member can use the AAC to say “good morning” and “I am happy.” The staff member then uses the device to say “schedule” and “art class” on the device while pointing to the visual schedule. This shows the AAC user how the device can be used to greet others and talk about plans for the day.
Additional training programs for communication partners:
AAC Essentials – AAC Community
For All: AAC User and Communication Partners
The AAC Device Should Always Be Available
An AAC system should always be out, easy to see and within reach. While it may be used more at certain times or in certain settings, it should always be available. It is just as important a communication tool and normal to use as a voice. It can also travel anywhere, too.
Effective AAC Use is Situational and Lifelong
As emphasized throughout this guide, effective use of an AAC requires teamwork. But different implementation strategies may be necessary for each team member, depending on setting and typical interactions.
Additionally, everyone’s communication needs change throughout life based on new life situations, new interests and/or new hobbies or activities. Support for AAC users can change too.
We have provided Handouts for different communication partners so they can support an autistic person and their AAC usage. Please feel free to give these out to those partners.