Communication is a key element of human life, and its lack can lead to serious difficulties in social and emotional functioning. Conversation is an exchange of thoughts and feelings in interpersonal relationships. It gives a sense of unity and belonging to a group. However, there are people who, for various reasons, cannot use speech as a communication tool. Various methods of alternative and supportive communication have been developed for such people, in accordance with the assumption that this type of communication is not at all inferior to verbal communication. It is simply different – unique, designed for special people. It gives them a chance to participate in normal functioning in a peer group, family and society. In the context of special education and sensory integration therapy, Augmentative and Alternative Communication (AAC) plays an important role in working with people with communication difficulties. AAC methods can range from simple gestures and images to advanced technological devices.
This article aims to discuss various methods of alternative communication, their advantages and disadvantages in the context of the work of a special educator and sensory integration therapist, with examples of people with different types of disorders who may need this type of help. I would like to emphasise that in my work I encounter various types of disability as a special educator and sensory integration therapist. I also work with people with normal intellectual abilities, e.g. during sensory integration classes, as part of early development support. I work with children, teenagers and adults.
Methods of Alternative Communication
Currently, many systems are known and used in Poland to help people with speech disorders or who do not speak at all. People using alternative communication belong to different age groups and differ due to their
needs determined by the type of disorders they have. A common feature of all people using alternative and assistive communication is the lack of speech, insufficient speech education or loss of speaking skills caused by illness or accident.
Among the AAC methods, we can distinguish the following:
1. Picture Exchange Communication System (PECS)
The PECS system is one of the most recognisable AAC tools, especially useful in working with children with autism spectrum disorders. PECS is based on the exchange of pictures that represent objects, actions, or concepts, allowing a person to communicate their needs and desires.
Advantages:
- Simplicity to use, especially in the early stages of learning.
- Fast results in basic communication.
- Allows the user to initiate communication.
Disadvantages:
- A limited number of expressions that can be passed through images.
- It requires constant access to a set of images, which may not be practical in some situations.
- It may be less effective for people with severe cognitive or visual deficits.
2. Communication using gestures and sign language
Sign language and gesture systems are often used when working with people who are deaf or have severe speech difficulties. The use of gestures can also support speech development in children with language delays. The development of the program and methods of working with people with hearing disorders is carried out by a surdopedagogue. The experience of a surdopedagogue is also used by an oligophrenopedagogue and a sensory integration therapist in their work. The combined activities of a team of specialists, based on the developed work program, allow for the achievement of the best possible therapeutic results.
Advantages:
- It allows you to express a wide range of emotions and needs.
- The opportunity to learn in a natural way through observation and imitation.
- It supports the development of fine and gross motor skills.
Disadvantages:
- It requires learning and practice, which can be time-consuming.
- Language barrier – not everyone knows sign language.
- It can be difficult to apply to people with motor limitations.
3. Speech Generating Devices (SGD)
SGDs are electronic devices that generate speech based on data entered by the user. These can be simple buttons that play recorded phrases or more advanced tablets with communication software. The Polish device developed for the needs of AAC is “Mówik“.
Advantages:
- Ability to express complex thoughts and sentences.
- It supports the development of language and cognitive skills.
- Customisable.
Disadvantages:
- Expensive to buy and maintain.
- It requires regular maintenance and charging.
- It may be susceptible to mechanical damage.
The role of the Special Educator and the Sensory Integration Therapist
The special educator and sensory integration therapist play a key role in the introduction and application of alternative communication methods. Their task is not only to select the right tools, but also to teach and monitor progress in communication.
1. Individual approach
Each student has their own unique needs and abilities, so an individual approach is crucial. A special educator should always be ready to accurately assess the child’s communication skills and adapt the AAC method to his or her needs.
Advantages:
- Possibility to adapt methods to the individual needs of the student.
- Improve results with a personalised approach.
- Increased student motivation to learn.
Disadvantages:
- Time-consuming evaluation and adjustment of methods.
- The need to constantly monitor and modify the work plan.
- It requires a lot of flexibility and creativity on the part of the educator
2. Cooperation with the family and the therapeutic team
Effective implementation of alternative communication methods requires cooperation with the child’s family and other specialists, such as speech therapists, psychologists and occupational therapists.
Advantages:
- A holistic approach to therapy.
- Consistency of therapeutic activities in different environments (home, school, therapy).
- Greater emotional and educational support for the child.
Disadvantages:
- It requires coordination and communication between different specialists.
- It can be difficult to organise in practice.
The need for commitment and cooperation on the part of the family.
Practical examples
1. The case of a child with autism
Autism Spectrum Disorder (ASD) encompasses a wide range of neurodevelopmental disorders that affect communication, social interaction, and behavior. People on the autism spectrum often experience difficulties in verbal and nonverbal communication, which can lead to frustration, social isolation and difficulties in everyday functioning. In response to these difficult challenges, the developed methods of Augmentative and Alternative Communication (AAC) are becoming an invaluable therapeutic tool. A child with autism may have difficulty communicating verbally, which makes it difficult for them to function in the school environment. This is often the case, and he also has difficulties with the proper reception of messages addressed directly to him. People on the autism spectrum usually do not feel the need to exchange information and very often show a lack of spontaneity in terms of trying to communicate. Some children with ASD use single words but have difficulty naming objects. There are also linguistic stereotypes and echolalia. The introduction of PECS allows a person with impaired communication to express basic needs, which reduces frustration and supports social development. Properly selected AAC methods enable people with autism to develop communication skills, which leads to better social interactions. With AAC, these people can express their needs, feelings, and thoughts, which reduces frustration and improves their quality of life. This is very important when working in class and during SI therapy. When we understand each other well, both in terms of messages and feedback, learning and therapy are much more effective and bring greater satisfaction to both parties.
2. Case of a child with cerebral palsy
A child with cerebral palsy may have problems with motor control, which makes it difficult to use traditional methods of communication. In this case, pictograms and communication aids that are adapted to the child’s motor skills can be helpful. When starting work on alternative communication, the therapist should, if possible, start by practicing the child’s pointing gesture, which facilitates the use of various therapeutic tools and initiates the exchange of messages.
Summary
Alternative communication methods are an invaluable tool in the work of a special educator and sensory integration therapist. The choice of the appropriate method depends on the individual needs and abilities of the student, as well as on the resources available in a given educational institution. Despite limited financial resources, an attempt should always be made to develop an effective method of working with children. Younger children have a chance for much better development if pedagogical intervention is undertaken early enough. Special programs such as early development support are used for this purpose. Developing a plan and schedule of therapy supporting the development of communication in a child with speech disorders is a multi-stage process, spread over time. It requires the involvement of many specialists and cooperation with the family environment. Therapeutic activities are always based on an appropriate diagnosis and opposition to harmful stereotypes, according to which alternative communication is in any way worse than traditional communication.
Article written by Honorata Kolasa
Bibliography
M. Nosko Goszczycka, AAC for everyone. A guide for parents and therapists. Harmonia Publishing House.
M. Grycman , M. Jerzyk, M. Bucyk- Active model, augmentative and alternative communication. Rehabilitation Publishing House Center for the Development of Communication.