There have been online and “in person” conversations recently about the expectation of children using Augmentative and Alternative Communication (AAC) to form sentences in a relatively short amount of time. We give “typical” verbal children at least two years before we expect them to combine two words, but AAC devices are frequently abandoned before a child who is nonverbal has a chance to learn it well enough to combine words.
When I wrote this three years ago, I was trying to think of a way to explain why it’s preferable to build words into language when using AAC instead of using “canned sentences” that are already pre-programmed and grammatically correct. I think this analogy also works for thinking of the amount of time it takes to master complex systems – whether we’re talking about language or music.
My seven-year old daughter, Emma, has a little keyboard. She figured out that when she pushes one of the top buttons and then touches one of the keys, the keyboard plays, “Mary Had a Little Lamb.” If she pushes a different button, it plays, “Twinkle, Twinkle Little Star.” The keyboard has ten pre-programmed songs that are standard on every single keyboard they make. Emma didn’t get to choose the songs, so she experimented for about an hour pushing the buttons and listening to the keyboard play the song. The songs that were in the keyboard were exactly the same every time she hit the button and exactly the right notes. My daughter got very excited and told my son, who’s 3 ½ years older than she is, that she knows how to play the piano. Jarrod, with all of his ten year old tact said, “No you don’t!” She got upset, and said, “Yes I do! Watch!” Emma pushed the button and the keyboard played, “Twinkle, Twinkle Little Star.” My son said, “You don’t know the notes! You just pushed a button!” Of course, the argument continued so Jarrod went to get his guitar to show Emma the difference between knowing how to play an instrument and just pushing a button.
If we look at language in the same way, the words are the notes and in order to be able to play a piece of music, we have to learn which notes to play and be able to play them quickly with a certain level of automaticity. Once Jarrod learns the notes on his guitar, he can play any piece of music he wants. While it may be years before he can play “Stairway to Heaven” or put notes together to write his own music, when he does do it, it will be because he understands the system and has learned how to combine notes so that they sound like music. It may take him longer, but if he keeps practicing and keeps taking lessons, eventually he will learn to play the guitar. If my daughter never takes a piano lesson and never learns the notes, she will only ever be able to play those ten pre-programmed songs on her keyboard. Based on that, no one would say that she learned to play the piano.
Emma lost interest in her keyboard by the next day because after a while, she didn’t want to hear those same songs anymore, and no one in my house knows how to teach her to play the piano.
Typical children who are developing language verbally don’t begin to put 2-3 words together to talk about and ask for things until they expressively have “a word for almost everything.” When we consider the time it takes for development of verbal speech and language, it is impressive that our students using AAC are able to combine words as quickly as many of them do! I’d venture to say that they have in their minds an expressive “word for almost everything,” but without AAC, they have not had a way to express it.
AAC devices are frequently abandoned (1/3 of all assistive devices abandoned). When we look at the reasons (Lack of interest/training, Attitude, Poor fit, Not maintaining/adjusting the system, Lack of communication opportunity, Insufficient intervention environment), all of them are within our control. We have to be willing to teach the individual keys and then give them the time and support to unlock their own masterpiece.