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Best Practices for Implementing AAC Devices

OK Parents – the information on this website may be A LOT – but it is super important! Please take this all very seriously, grab a pen and paper & take lots of notes! The better you start to understand these concepts now, the better you will do when you have your AAC device… and the better your child will do!

1 - Parents can’t teach their child a language they don’t know themselves

Its great if you have a therapist or teacher to help and support you, but YOU as the parent have more time with your child than anyone else!  You know your child best; you can motivate them better than anyone else.  When you use the device (AKA their language) … so will they! 

2 - Customize the device for your child

  • Start with a large grid size (unless your child has a physical or visual disability)

    • A grid size basically means the number of buttons on the page

    • So a grid size of 60, or 6 x 10, means the default setup has up to 60 buttons on each page

      • Just because a grid has 60 buttons on it does NOT mean the child has to use all those buttons right away (or ever), but they should have ACCESS to all language for when & if they are ready to learn and use it ​

    • Studies have proven that most children using AAC do not have trouble with the large grid size - its the adults that get overwhelmed, rarely the children

      • ​​Children have only ever lived in a world surrounded by technology, the majority handle tech and screens without issue​
      • AAC users learn to use their device just like children learn to use a keyboard... they learn one button at a time. BUT we don't remove all the keys off a keyboard while a child learns, right?  Same with AAC - we don't have to remove all the buttons while they learn.  
         

  • It is harder to find words and/or build a sentence when there are less buttons on each screen – don’t make things harder without reason (i.e. visual or physical impairment)
     

  • The goal of the AAC device IS NOT to limit your child to the few words they might know now, it’s to set them up with ALL language options so they can learn as they go!

    • People learn language through exposure, and they can’t get exposure without a large grid size
       

  • You don’t need to model all the buttons right away, but studies show they should all still be available so your child has access to language as they grow

    • NOTE: If your child appears to be overwhelmed visually, or they have physical challenges with the buttons, you can make changes, just don't limit their language without trying a larger grid size first (and giving them some time)

    • Always presume competence and give robust language a try… then adjust as needed

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  • Here are the recommended grid sizes (minimum) for different apps:

    • 7×11 or 6×10 minimum in Proloquo2go

    • 80 or 60 minimum in TouchChat

    • 8×10 or 7×7 minimum in TD Snap

    • 84 Grid in LAMP Words For Life

2a - Customize the device for your child: Parts of the AAC Device

  • The device will come preconfigured with a ton of language you need to be successful

    • There will be folders built in for just about everything, outside of special interests (such as people, food, activities, toys, games, places, actions, etc…).

    • Utilize the language that is built into the device as a good base - THEN add your own

    • All people do not want to talk about the same things - custom language is key to clicking with the device
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  • Terms you should know: Core words, Fringe Words, and Templates

    • Core Words are more generic and can be used across a wide range of environments with a variety of communication partners

      • A persons pronouns, words like want/need/see/give, little words like “the” “and” “it” etc... – hundreds of words used commonly in all communication are considered CORE words
         

    • Fringe Words refers to vocabulary that is more specific to a topic, environment, or individual

      • Fringe words are like nouns (food, people, places, toys, activities)

      • Custom buttons and child specific buttons are the FRINGE words
         

    • Templates are the sets of buttons that appear inside folders and throughout the device

      • Templates are designed to offer words for communicating on any topic, without making the person navigate in and out of all the folders to get to the words they want

      • When a button appears across multiple folders/pages, you want it to appear in the SAME spot so the person always knows where to find it (example, the word “I” will always be in the top left corner no matter the template or folder)

2b - Customize the device for your child: Customization Notes

  • Use the customization tools available to make things easier on them!

    • Customize skin tone, voice, background color, and anything else that will help your child connect to their device

    • In Proloquo2Go: Use the color code settings (change from FRINGE ONLY to ALL) to make visual tracking way easier
       

  • Add lots of motivating buttons that will matter to your child!

    • Add favorite things, foods, toys, characters, people, places, folder for their special interest, etc… ​
       

  • Edit the buttons to use real photos for things like people, favorite places, favorite toys, wherever it makes sense and will motivate them - you don't need to replace all the icons with images, ONLY use photos where it makes sense and helps!
     

  • Add buttons in a respectful location – don’t just throw favorite people or things on the Home Screen, put people in the people folder and toys in the toy folder, etc...

    • These devices are organized a certain way for a reason, it helps the child map out in their mind where to look for things no matter what, random placement of buttons can make it HARDER
       

  • IMPORTANT – Do not customize the device so much that major functionality (or language) is lost

    • Adding phrases/gestalts is a great idea for those that need them, but don’t remove a bunch of core language in the process

    • AAC users still need access to ALL language

    • Even after you add phrases for them, and they should be able to CHOOSE how & what they wish to communicate – don’t box them in!​

3 - Make communication fun and rewarding!

  • Have good energy, be creative, and make sure there are lots of opportunities to learn & communicate! 

    • If you feel upset or overwhelmed by the device, you will pass that attitude on to your child... which is unfair

    • Get comfortable with the device, have some fun while modeling and using it around your child​
       

  • Don’t ever make the AAC device a negative thing or a chore

    • Don’t create tasks to force a child to use the device before they are ready!

    • Children are not motivated by work or punishment - make sure the AAC doesn't feel like either of those things
       

  • Teaching someone to use a device should NOT involve grabbing their finger and forcing them to say things… the internet is full of ways to model and teach, be respectful (use hand UNDER wrist instead of hand over hand)

4 - Children are ABSOLUTELY allowed to explore and play on their device!

  • Any use of the device is GOOD - if they are interested and exploring, that's GREAT!

  • Do not take it away, correct them, discipline them, hide/delete buttons, or lower the volume just because a child is hitting buttons repeatedly

    • Don't let anyone else do those things either (if school or a therapy clinic says they will... you know they are not well informed on AAC)
       

  • People have a right to explore their own voice, and they will learn how to use it even faster if they are intrigued by it!

5 - Model model model… then model some more

  • The more exposure a child has to their AAC (aka language), the more they will learn how powerful communication can be! 

    • Children that speak and process mouth words, are exposed to their language all day every day... our AAC users need exposure too!

    • Think of AAC like learning another language... can someone teach you Spanish if they never speak to you in Spanish?  NOPE!
       

  • Model without expectation – Use their AAC device to talk about about everyday things/activities, WITHOUT requiring their direct attention or response, they are learning in their own way, I promise!
     

  • Model with opportunity – When engaging in a highly motivating activity (swinging, eating a snack, tickling, playing with a favorite toy), model something repeatedly and then create an opportunity for the child to engage (organically).  
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  • Start slow, one button at a time, and then build on it. Always work at one level above where the child is!

    • Example – if you are just starting with the device, you should model something like “grape” and hand the child a grape. Once they know that the buttons mean something, and perhaps push the grape button to get a grape… then you model things like “yummy grape” Or “I want grape” or “green grapes” or “grape please”. After they know a couple buttons, then build on it from there (and so on).
       

  • Don’t focus on “filler words” in the beginning.  Words like “more” or “please” are too vague and they are not a priority when learning to communicate. Model words like “pretzel” “pizza” “toy” “park” “mommy” “school” “yes” “cry” etc…  – model things with immediate meaning.
     

6 - Keep the device in "Guided Access" at all times       (at least for now)

  • By using an iPad as an AAC device, and having it be their play device as well as their "talker", you are teaching them that they can EITHER have fun OR communicate... but every person has a right to do BOTH at the same time!
     

  • The AAC device cannot be seen as anything other than their "talker" or "words" or "communication device" or whatever you want to call it right now, because the distraction of other apps (that they consider to be fun) will prevent their interest in AAC and learning communication - They are CHILDREN, they shouldn't have to have the discipline to go from one to the other
     

  • Kids should never see the AAC app as a negative thing - and if they know you can unlock the app and get to photos or games or YouTube, they will see the AAC app as torture and constantly try to get out of it (instead of learning to use it)​
     

  • When someone becomes a more confident communicator, they can use the device for more than one app… but right now, its way too much of a risk to take 

7 - Keep the device nearby at all times

  • People shouldn’t have to pause their thought process to “run to a designated area” and get their device
     

  • If communication on AAC becomes labor intensive or a chore, why would they want to do it?
     

  • Until a child becomes motivated enough to carry the device around themselves... then the adults need to help make sure it is always around, so they can express a thought anywhere at any time (and parents/teachers can model anywhere at any time)

8 - Everyone learns at their own pace – This is a marathon… not a sprint

  • Children that use vocal speech are exposed to it all day every day for a minimum of 18 months before people make assumptions about their abilities... why do we have unrealistic expectations of AAC users with a new device?
     

  • Give them grace to learn on their own timeline, there is no need to rush!
     

  • Don’t panic if they don’t start using their device right away and please don’t compare them to others… stay positive, have good energy, and just keep modeling the device!
     

  • Some children take a few days before they are interested in the device or buttons, but some also take weeks, and some take MONTHS! I know of one child that took over 6 months before he was willing to touch a button… but he was soaking it all in while his parents modeling.

    • Now he navigates the device like a pro and even uses the keyboard to type out tons of words!

9 - Make & Review your AAC checklist to ensure you are doing your best

​If there was a quick checklist for success with an AAC device, it would likely have the following items – Write them down and MAKE SURE you do these things when you have your device:

 

  • Access! Did you set it up with a robust/Large grid size to start? You can go back and enable features that hide buttons or change grid size later if needed… but presume competence to start!
     

  • Connection! Did you select a child’s voice? Did you change the skin tone on the icons? Have you enabled different look/feel settings to help them connect? If not… make that happen ASAP!
     

  • Customizations! Are all their favorite things in the device? Make sure you add what THEY will care about! Favorite foods, places, people (with pictures), shows, toys, phrases buttons, gestalts, etc… You can make custom folders, use special features in your AAC device, and have some fun!
     

  • Good Energy! Have you played around with the device and are comfortable with it? Are you having fun when you model? Do you make sure your child has access to play around and hit buttons (without ever being corrected)? Are you giving them time to catch on? Your child needs to learn this device organically, which means lots of exposure & access WITHOUT pressure. Model Model Model!

10 - The most important phrase you should learn on this AAC journey:

Compliance is NOT communication!

 

  • Forcing a child to hit buttons (like using hand over hand, or setting the number of hits as a goal) – is just a form of compliance.

    • Learning how to comply (AKA do what you are told) is not the same as learning to communicate.
       

  • You want your child to learn how to use the device, and see all the benefits, so they can effectively COMMUNICATE however THEY want and need!!!
     

  • Everyone has a right to communicate!

11 - Getting an AAC device for your child is an opportunity you don't want to waste!

  • Parents always say “I would give anything to help my child communicate”… then they get an AAC device for their child, and don’t work half as hard as they should to help them
     

  • Through Lilly's Voice we can give you EVERYTHING you need to be successful on this journey - We will give you Best Practices, YouTube Videos that walk you through step by step how to do things, accounts on IG that can support you and teach you – but we cannot force you to pay attention... only you can control that
     

  • If you read everything and watch everything, do your own research, then try your best... you will do great!!!!

    • If you skip over the reading, stop watching the videos, and don’t listen to the things we have shared with you… you likely will not do that well
       

  • You are not hurting our feelings if you don’t listen to us or take this opportunity seriously… but you will be hurting your child and their opportunity to communicate.

    PLEASE PLEASE PLEASE – Even when its hard or confusing, please still try to do your absolute best for your child, and reach out for help!

Have you read through the Best Practices, taken lots of notes, and you are ready to start working on your AAC app? 

  • Check out the videos on our Family Training page! We have Youtube links for Proloquo2Go, TouchChat, and more!!!   

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