Last month, we reviewed an article about parents’ perspectives on why their children’s AAC devices ended up rejected or abandoned. (Are you picturing a sad, dusty cabinet full of non-functional GoTalks and retro Dynavoxes? I am.) Now, we’ve got a natural companion piece from the same authors, flipping the script and talking to a group of Australian SLPs about similar situations.
Sometimes these interview-based studies tell us a lot of what we already know, and can lead to the pessimists among us getting bogged down in Barriers-ville. This one, though, has some thought-provoking and useful ideas for working with families to implement AAC systems more successfully.
First, commit yourself to family-centered practice. Specifically, the authors discuss:
Stepping up our counseling to help families move through any grief and increase their readiness for AAC.
Helping connect families of AAC users so they can support each other.
Moving away from a deficit mindset with families (they’re overwhelmed, they’ve got other priorities, they don’t have the resources…) and capitalizing on their strengths.
Focus on relationships, and bring families into the process as much as possible, through device trials, hands-on support, and follow-ups.
Next, orchestrate some early wins. Families may need to see their child being successful with AAC to overcome doubts, resistance, or previous negative experiences around devices. This might mean making an effort to share progress from speech sessions (via videos, maybe?) or even starting off with simpler systems like activity displays, to build momentum and motivation, before jumping into a complex device*.
Finally, this last point is the part where we clinicians need to humble ourselves a bit. Sometimes devices don’t work because the SLP didn’t recommend the right system for that child. We all have our favorites, the ones we know best, the ones we like most for many, totally valid reasons. But we can’t unilaterally impose that preference on our clients. That’s clinician-centered, arrogant, and just less likely to work. Clinician experience is also important here. The study authors suggest that having newer grads supported by seasoned AAC pros could improve device acceptance.
Selecting and implementing AAC is a complex balancing act between the user, the device/system, the family, the environment, and the clinician. Like the EBP triangle, but more of a pentagon? When we don’t consider all those factors, we’re risking another addition to that sad cabinet of lonely devices.
*This is NOT to suggest that kids need to start with low tech AAC, or implying any prerequisites to using a robust language system.
Moorcroft, A., Scarinci, N., & Meyer, C. (2019). Speech pathologist perspectives on the acceptance versus rejection or abandonment of AAC systems for children with complex communication needs. Augmentative and Alternative Communication. doi:10.1080/07434618.2019.1609577