Speech-language therapy and AAC for nonspeaking children.
After years of speech-language therapy with minimal change, can my child learn to communicate?
There are a variety of reasons why past speech-language therapy may have been minimally successful, because there are a variety of reasons why speaking might be hard for your child. Some of the most common reasons are:
Severe childhood apraxia of speech (CAS) which makes movement for speaking challenging.
Use of a behavioral approach to speech-language therapy or communication that focuses on compliance, diminishing the connection that is the vital foundation for communication and decreasing your child’s autonomy and self-determination.
Inappropriate application of analytic language strategies, where words are taught one by one, when your child is a gestalt language processor who learns language in chunks of phrases or sentences through natural language acquisition.
Lack of access to an appropriate augmentative-alternative communication (AAC) or speech-generating device (SGD), giving your child access to thousands of words that they want to say.
How can a nonspeaking child learn to communicate?
At North Star, our expert speech-language therapists utilize a variety of approaches to help individuals with minimal speaking skills improve their ability to communicate.
Application of Marge Blanc’s natural language acquisition framework to assist gestalt language processors to learn and use functional scripts and echolalia, setting them on the path to self-generated language. We work with your child to figure out what they want to talk about and start there!
Neurodiversity-affirming practices, including a focus on child-led activities, consent, connection, and autonomy. We never teach eye contact, use hand-over-hand prompts, or try to stop your child from playing the way they want to play.
Research-based apraxia strategies based on Dynamic Temporal and Tactile Cuing (DTTC), which is the most evidence-based technique for helping children improve movements for speaking.
A multimodality approach incorporating verbal speech and AAC, which allows your child to communicate in the way they choose at any given time.
Help your child communicate!
North Star’s Position on Augmentative and Alternative Communication (AAC)
Parent coaching is essential to AAC success. Many times, families receive access to an AAC device through self-funding, insurance, school, or other funding sources with no instruction for selection, programming, or implementation of the device. Without consistent instruction in device use, children are unable to learn to use the device, leading to device abandonment and frustration for the family. North Star’s speech-language therapists specialize in selection, programming, and implementation of AAC devices.
AAC use does not decrease verbal language. In fact, some studies demonstrate that AAC use increases verbalizations and vocalizations in minimally-verbal AAC users (Schlosser & Wendt, 2008; Millar Diane C. et al., 2006). North Star’s speech-language therapists will guide you in how to continue to support your child’s verbal skills as they acquire use of their AAC device.
There are no prerequisites for AAC. Children do not need to demonstrate any skills in order to be successful with an AAC device. There is no need for a child to prove that they have joint attention, cause-effect, or communicative intent prior to trial and implementation of AAC devices. Children can learn to use AAC from a very young age.
Functional language instruction and AAC implementation must include more than only requesting. A robust communication system should include a variety of common and specific words and phrases (e.g., gestalts, core and fringe vocabulary) that the communicator can use for various social reasons, including commenting, protesting, and rejecting. North Star’s speech-language therapists work with families to select and program relevant, functional, and high-interest vocabulary systems.
AAC is not a last resort treatment. Implementing AAC can help to decrease frustration and increase functional communication. Use of AAC does not mean that a child will never speak. For some users, AAC leads to an increase in verbal skills.
PECS is not a functional, robust AAC option. Picture Exchange Communication System (PECS) is an AAC system commonly implemented by ABA therapists. However, PECS focuses primarily on requesting specific objects and items and is laborious to use since the picture location changes with each use. AAC should be specialized and individualized based on your child’s individual needs.
Children who communicate verbally can still benefit from AAC use. Adults who speak verbally and use AAC report that AAC helps them communicate at times when talking is difficult.
North Star’s Position on Autism
Autism is a neurotype.
Behavior is communication.
Listen to and learn from autistic adults.