Augmentative and Alternative Communication (AAC) systems are a common assistive technology (AT) intervention for learners with complex communication needs (CCN) – those learners who are unable to use speech and language as a primary mode of communication. AAC systems can be a powerful intervention; however, these systems must be integrated with strong, early and conventional literacy instructional opportunities. In this chapter, we provide parents, educators, researchers, academics, and other professionals with the most up to date and innovative information as well as practical resources regarding early literacy and AAC for learners with CCN. Emphasis will be on young children with CCN in preschool and early elementary school settings. Features of AAC systems and evidence-based literacy assessment and intervention, as well as the benefits and challenges, are presented to provide the reader with information on the current state of the field. The chapter concludes with directions for future research and provides a comprehensive list of resources and organizations.
TopIntroduction
Learners with complex communication needs (CCN) face barriers to using speech and/or language as their primary communication mode. Learners with CCN are a heterogeneous population often with developmental disabilities, which may include autism, cerebral palsy, intellectual disability or other disabilities. Approximately 3.5 million persons in the United States do not have the speech skills to meet their communication needs on a daily basis (Beukelman & Miranda, 2005). Prevalence rates of 3-6% have been reported for school-aged learners (Matas, Mathy-Laikko, Beukelman & Legresley, 1985), while Binger and Light (2006) report that for preschoolers receiving special education, the prevalence of CCN may be as high as 12%. Sign language skills may be introduced but may be potentially inadequate for independent and total communication. Without the ability to speak and, in a large percent of these learners, without the ability to use sign language as a meaningful mode of communication, these learners may have severely limited communication opportunities.
A common intervention for learners with CCN is the provision for augmentative and alternative communication (AAC) systems. Picture symbols representing words or phrases are selected by others and provided as a means to facilitate communication by pointing, directly or indirectly, to a desired symbol/message. These symbols are presented in a variety of mediums from paper-based arrays to high tech computer based systems. Novel and independent communication requires literacy skills to compose and supplement messages that may not be available on AAC systems (Millar, Light, & McNaughton, 2004). Without literacy skills, learners who use AAC systems may encounter immediate and future long-term consequences which include: (a) decreased participation across settings, (b) decreased educational options, and (c) decreased options for independence and employment (Fallon, Light, McNaughton, Drager & Hammer, 2004; Millar, Light, McNaughton, 2004).
Gus Estrella, an individual with CCN, captured the power of literacy for persons with complex communication needs.
The words I was given were words that would produce pictures, not words that would make language. And they wanted me to master a language? I was also given piles of sentences and criticized for not using them. I don't know about you, but I don't think in terms of preformed sentences. Sometimes I even change my thought half way through the sentence, and I have also been known to throw in a very descriptive word, when the mood strikes me! I can think of few things more dehumanizing and even demeaning than selecting canned sentences from a list. And seeing that the subject matter you want to talk about is nowhere to be found! What gives communication joy is when you tell your partner something he or she doesn't already know, and perhaps you didn't know yourself what you were going to say until you were halfway through composing your sentences! (Estrella, 1997)
Learners with CCN who use AAC systems are often deprived of reading and writing skill instruction, which Estrella (1997) believes is necessary for “communication joy.” Estrella was empowered with access to AAC systems and conventional literacy for full communication opportunities. Without these skills, learners have severe limitations throughout their lifespan (Koppenhaver, Hendrix, & Williams, 2007; Millar, Light & McNaughton, 2004).
It is well established in the literature that individuals with CCN can develop literacy skills (Koppenhaver, Hendrix, & Williams, 2007; Light, McNaughton, Weyer, & Karg, 2008; Lund & Light, 2006). Instruction can result in positive language, communication and literacy outcomes for children with CCN. A significant need exists to translate literacy research for learners with CCN into the literacy practices of homes, schools, and community programs (Light, McNaughton, Weyer, & Karg, 2008). Bringing the educational significance of literacy interventions to the forefront will afford ALL learners the opportunity to develop reading and literacy skills beyond the emergent level.