Guest Authors – Gabby May and Marisa Bierenfeld (Seton Hall Speech-Language Pathology graduate students)
Understanding how an individual gains communicative competence with an AAC device is essential to developing an appropriate and effective intervention plan for that person. While there are many facets to that plan, the over-riding one is to enable the user of the AAC system to express him or herself to the best of their ability. In doing so, they are better equipped to achieve to the fullest of their potential. Speech-Language pathologists play a key role in this process. They not only need to articulate the appropriate speech-language goals, but they must help others on the team to understand these goals and how they too can work to help the augmented communicator achieve them.
Remember to Explore the Evidence
Janice Light and David McNaughton state that for a person to achieve communicative competence with an AAC device he or she must be able to communicate functionally and adequately within the linguistic, social, operational and strategic domains. AAC intervention team must understand these four domains along with the three fundamental constructs of communicative competence. In doing so, each patient/client can receive a tailored intervention that aligns with The World Health Organization and International Classification of Functioning, Disability and Health.
Janice Light’s three fundamental constructs of communicative Competence in AAC include: (1) functionality of communication, (2) adequacy of communication, and (3) sufficiency of knowledge, judgment, and skills.
- Functionality of Communication:
Attainment of the skills is dependent on the communication demands in the environment, in the classroom, therapy room and/or a professional setting. It is underscored that functionality of communication should be attained not in a structured setting but rather in a natural environment which supports buildings skills applicable in real world environments for daily life.
- Adequacy of Communication
Adequacy of communication will depend on the individual AAC user’s speech-language goals and what is needed to meet those goals. Not only the goals, but the communicative environment or setting impacts the demands imposed upon the AAC user. In a structured learning environment, a single word response may be adequate. Social settings often require the use of phrases and/or messages. Depending upon skill level, the goal may be to use pre-stored messages or quick phrases or to have the user create unique well-formed messages.
- Sufficiency of knowledge, judgment and skills
Adequacy of functioning is achieved and dependent on having sufficient knowledge, judgment and skills across for connected domains; linguistic, operational, social and strategic. Linguistic and Operational competence include knowledge and skills in the tools of communication, that is, an ability to use targeted features of the device. Social and Strategic competencies involves use of the tools in day to day communication
Key Points for Intervention
Linguistic Competence requires the development of sufficient knowledge, judgment and skills in the spoken and written language of the AAC’s users personal community and extended network. For many of our users this takes many years to achieve. Use of an AAC device with a core-word vocabulary is critical to the development of Linguistic Competence. It means that intervention goals may need to begin with use of single word messages, then moving to telegraphic messages and gradually on to creating well-formed messages. It involves both receptive and expressive aspects of communication. For preliterate uses of an AAC device, it also includes representational knowledge of AAC symbols contained within the user’s vocabulary.
Operational Competence is often an easier skill set for the users with direct selection capabilities to achieve. Due to impairments in motor planning and coordination, it is often more challenging for users who must master alternative modes of access including scanning and eye-gaze.
Operational competence also includes having knowledge of the contents and location of device vocabulary. That is he or she must know if a word is contained in his dive, and if so, on what page where on the item is located. If a user is to access a system such as Unity, that requires using symbol sequencing, the sequence for each word must also be mastered.
Operational competence also includes teaching the user functions such as deleting words, speaking a message and for advanced users, it may also include teaching them to store new words into their own device.
Social Competence is a challenging goal for many of our AAC users to achieve. Without social competence, one will never be able to appropriately participate in a conversation. Social competence includes goals such as topic maintenance, initiating conversation, turn-taking, as well as expressing the full range of pragmatic functions. Many AAC users can request and respond. Intervention must also include activities to teach commenting and requests for information.
Strategic Competence is key goal to master. While we encourage use of multi-modal communication, it is critical for a user to understand which mode is best for which communication partners. Idiosyncratic signs may be acceptable for use at home and with other familiar listeners but their use with an unfamiliar listener will likely result in a communication breakdown. Some individuals have speech that can be understood by familiar listeners or when the context of a conversation is known. These individuals need to learn to use a more formal means of communication so that they can succeed in communicating in a wide range of communicative context and with both familiar and unfamiliar communication partners.
Janice Light and David McNaughton also remind us that motivation, confidence, and attitude are key factors influencing the attainment of skills needed for communicative competence with AAC use. The attitude of the AAC user and their familial support can affect how that user utilizes their device. Further, motivation or the individuals desire to communicate in their day to day life will affect how often one uses their device.