"AAC" (augmentative and alternative communication) and/or “SGD” (speech-generating devices) Recommendations and Justifying Medical Need for Speech Friends
The routine practice of exposing speech friends you deem “total communicators” to the 4 different methods of communication would include the following:
-verbal word production
-American Sign Language (ASL) or Makaton
-low tech core board
-high-tech augmentative and alternative communication (high-tech AAC) also known as speech-generating device (SGD) for short
For the sake of short-hand communication I refer to these as "The Big Four". As we fully embrace culturally competent approaches as a society, exposing speech friends to all 4 methods of communication provide communication experts with the evidence needed to prove, without a doubt, that AAC is truly a medical need for the beautiful friends we serve.
Valuable Insights
During the initial evaluations, I expose friends to The Big Four (always using simultaneous ASL with core words I verbally express. If the child does not respond/imitate my model of ASL/verbal utterance then I model with core board use then apply the same approach to SGD).
You may say to yourself, "but my friends are already positively responding to SGD!" And I completely understand this perspective but, as scientific experts, we need to add evidence to SGD being the child’s preferred choice and their power/right to choose, not ours.
This is why, when seeking to obtain SGD funding, ethical SGD/AAC funding support providers require SLPs to indicate if a child has been exposed to “The Big Four” as a means of determining true insurance coverage (if we haven't trialed all methods of communication then we technically have no subjective evidence to prove SGD is a medical need; no evidence = subjective or assumed need).
We don't want to assume a child's preferred method of communication without first exposing them to “The Big Four”. This is the evidenced based reasoning behind commonly used "total communication" goals- when we model The Big Four (which includes acceptance of sounds and word approximations), it allows the child a safe/encouraging space to show us which one is his/her/their preferred means of communication through observed evidence.
I realize some friends may not have "total communication" listed within their goals (at the time of assessment, maybe these friends appeared to prefer verbal communication) but, if your observed evidence is proving that a friend behaviorally and/or emotionally benefits from a total communication approach, careful consideration to update this accommodation to his/her/their treatment plan (so as to fully capture this technique as a documentable and evidenced reminder) is best professional practice.
Expert Expressions that Improve Parent's Understanding of SGD:
-Replace “tablet/iPad” with the specific use of “high-tech AAC” (augmentative and alternative communication), "AAC" for short, and/or “SGD” (speech-generating devices) for most precise naming
-Remind parents that AAC can be low tech or high tech
-Repeated use/exposure of these labels to help channel the message that it is actually the access to the words on the SGD/high-tech AAC device that supports the child’s ability to communicate not the tablet use alone.
For a professional consults related to this topic please reach out to schedule a client consultation session with me on Liricare as I am happy to discuss more❣️
