It’s time to admit I have a bit of a reputation. I’m that SLP who slates an AAC evaluation for a child’s second birthday.

One of my roles is to serve as the liaison to our hospital’s multidisciplinary Angelman Syndrome clinic. If you are unfamiliar with this syndrome, it is a genetic disorder affecting chromosome 15, which always results in communication deficits. I have yet to meet an individual with this syndrome who is a functional verbal communicator. Our neurologist does not bat an eye at referring a child under two for an AAC evaluation. Knowing this prognosis, there is rarely a second thought in considering a communication device.

But what about the other kids we see with a less clear prognosis?

Despite research indicating that AAC can actually promote verbal speech and that there are no true prerequisites to introducing alternative means of communication, many professionals in our field continue to think of AAC as a last resort. The result? Many of our kids have to fail every other option and lose precious time in development because they are judged to be “too young” for AAC.

How many words should a child have at age two? How should they be able to interact in their environment? How intelligible should their speech be? Haven’t seen a two-year-old with typical language lately? Check out this little girl.

Claire's birthday message for mommy

I recently ordered a communication device for a two-year-old with suspected apraxia. No one is giving up on his verbal speech, but his treating therapist realized he needed a way to communicate right now. She got backlash because of his age from some, but guess what? Within one week, Mom came in gushing about her child who could tell her what he wanted, who was happier, and who was more engaged. Why? Because he could communicate.

So why should we make him—or any child—fail for one, two, three, or more years? We know children’s brains are wired for the most language development in the first six years of life, so why do we let kids get to eight-, twelve-, fifteen-years-old before we look for a communication solution?

No, every child who comes through our doors does not need a communication device, but could more benefit? I would advocate that many do. Yet sadly many of these children get passed around without a voice for years.

No  two children are the same and no one solution works for all. However, no child deserves to be stuck without the ability to express his/her wants, needs, opinions, and ideas.

Failure should not have to be a prerequisite for success and growth.