Last week, my newly 12-year-old “typical” daughter asked to go to the movies with her friends…alone. I pictured the group of giggling 6th graders, dangling between confidence and unspoken anxiety in their independence. I offered to go with them and sit in a different row, but she refused. So, I said the first thing that came to my mind…No.
The next day, Emma excitedly approached the subject again. Her friend’s mom was going to be there (What a great idea! *eye roll*), and she wanted to know if it was okay now. I didn’t know the mom and the friend was a school friend and NOT one of the girls who spends time at our house. I said, “Maybe.” Emma bounced in her seat beaming and said, “Thank you, Mom! Thank you!” and she happily turned to her phone to share the news that the answer is “maybe”? I reminded her, “I only said ‘maybe.’” She looked at me, very seriously, and said, “But you didn’t say ‘no’ this time.”
I think a lot about words and language as a speech-language pathologist, so I thought about her reaction and the difference between “no” and “maybe.” I modeled “maybe” for a couple of students this week when they were asked a Yes/No question about an activity.
One interaction went like this:
Teacher: Do you want to take a walk?
Student: (looked at the door then back at the teacher)
(Modeled response): Maybe.
Teacher: Oh. Well, do you want to read a book?
Student: Walk
That day, that student learned that maybe gives her alternatives. Maybe opens the door for possibility. It allows consideration of the options and the ability to make a choice based on the information presented. Maybe means that a plan is not shut down completely and that it warrants more investigation. Maybe requires the mind to open, even if ever so slightly, and allow room for an idea to bounce around and have a chance to land in the “possibly” or “probably” zone.
I read posts or speak with parents who are heartbroken that their child is unable to verbally and intelligibly express himself. I see children scream or bang their heads on the floor because they are frustrated by their inability to clearly express their thoughts. Parents desperately want to know what their child is thinking and children desperately want to tell them. There is so much talk about children understanding everything that is said, but being unable to express their thoughts. I think… This is the perfect opportunity to use augmentative and alternative communication! They must not have heard of it, but this is exactly the purpose of AAC. It’s so exciting that there is a way to provide communication for someone who is struggling with speech. But I scroll down and see that someone mentioned AAC and there was no response… no excitement. No plea to “tell me more.”
Even in person, when parents or professionals know that I am a speech-language pathologist and ask how to improve a child’s speech, they seem disappointed with a suggestion to try AAC. This is especially true when the discussion is about a child with apraxia of speech. They may say, “We’re not there yet,” “I really want him to talk,” “She’s able to make so many more sounds now and I don’t want to give up on that,” or “My husband/uncle/grandfather on my mother’s side/Einstein was a late talker. He’ll catch up.” All of those statements may be true, but they all translate to No. No my child is not going to use a machine to communicate. No, we want him to talk. No, a Theoretical Physicist who was born 136 years ago started talking late, so my child will too. When people use the Einstein analogy, I always think that he must have been so frustrated. Einstein would have rocked as an AAC user.
I’ve been thinking about what it takes for parents and professionals to begin augmentative and alternative communication. When you decide to use AAC, it requires learning a comprehensive language system and figuring out how to implement it with your child. It requires giving your child access to a device dedicated to communication. It requires the admission that as hard as you are trying to help your child speak verbally, he’s not able to tell you that someone was mean to him in school or that a peer did something funny or that his favorite race car drivers crashed when he was playing cars in his room.
But what does AAC give?
If verbal speech is not intelligible to strangers or sufficient to convey the many complex thoughts in the child’s mind, AAC provides access to language and communication. That early access to expressive language and communication is so valuable…and more efficient than working only on receptive language. Having access to language and communication before speech allows a child to experiment with words and build phrases and sentences. It provides a way to clarify his speech when he is not understood. It gives him the ability to say “Me do it” or “Him go” and have someone respond, model and shape language so that he can learn from the feedback. It gives him the ability to express his interests and build relationships. It gives him his own voice.
Using AAC requires the belief that a device will not inhibit – and so often will help – verbal speech development.
If you are someone who likes to look at research articles to make decisions, there are citations about AAC and speech that you may want to check out in this article. Research has demonstrated that use of AAC poses no risk to speech development.
If you are someone who prefers video evidence and first hand accounts, here are videos of two children with apraxia.
Here is Elanor using the Speak for Yourself AAC app in July 2014:
And here she is 8 months later:
Using AAC does not hinder verbal speech development.
Take a look at Felix’s year and a half communication journey. He started using Speak for Yourself at 3 years, 4 months.
Providing AAC is the best thing you can do for your child who is struggling to speak….and you don’t have to stop anything else that you’re already doing. If you believe that fish oil, vitamins, PROMPT therapy, sign language, or special diets make a difference, then by all means, continue to use them.** Providing your child with AAC will not interfere negatively with any other treatment. There is nothing to lose.
This Apraxia Awareness Day, say maybe to AAC. Open the door of possibility that maybe this can be the bridge to communication while your child works on making sounds. Maybe AAC will give your child confidence in social situations as well as a consistent auditory model that she can explore independently. Maybe having the ability to express likes, dislikes, basic needs, and discomfort will reduce your child’s anxiety and allow him to be more at ease in social situations. Maybe having her own voice will alleviate her frustration the worry that keeps you awake at night. Maybe your child will tell you things that you never guessed he was thinking. With so much possibility, maybe AAC is worth considering? Definitely.
**I am not an “expert” in any of the treatments I mentioned in this list so I’m not endorsing or discouraging them.
If your “maybe” gets bumped up to, “Yes, let’s try this,” Speak for Yourself will be half price worldwide on Apraxia Awareness Day (May 14th, 2015).
Thank you to Felix’s and Elanor’s parents for sharing their stories and adorable children!
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