One of the most common questions that we get from therapists  is, “Should I target AAC and natural speech within the same session? And if so, how?” The answer is an emphatic “yes!” and you can do this in a couple of different ways. You can target them separately with part of the session focusing on speech and the other focusing on AAC or you can target natural speech and AAC simultaneously.

The first step in determining how to target natural speech and AAC in a session is to evaluate the child’s communication. Some questions to consider include: What is the child’s primary mode of communication? Is the child making progress in their speech? Are you working on speech goals using drills or during conversational speech? These questions can help guide your treatment plan. If you have specific articulation goals, it can be beneficial to target speech and AAC goals separately in order to engage the child in articulation drills so they get that practice. However, articulation goals can also be targeted within the context of language therapy. In that case, it could be beneficial to target speech and AAC goals simultaneously.  Ultimately the decision of how you want to structure the therapy session is up to you and what your student/client is willing to engage with. If you want some ideas on how to target speech and AAC goals simultaneously, here are some suggestions:

If the child primarily uses speech to communicate and can be understood by his communication partners most of the time, you may want to focus mostly on speech and use AAC for communicative repair. Consider a child who has lots of language, but is considerably unintelligible. It is not beneficial to restrict the child from talking, but it is beneficial to provide them with AAC to use when they experience communication breakdowns. The youtube video linked below is a good example of how to use AAC as communicative repair.

https://www.youtube.com/watch?v=JaAKMgtIRpk

In the video you will see the caregiver encouraging the child to use both natural speech and AAC when he continues to be unintelligible. When using AAC for conversational repair, the caregiver models where the correct symbol for the bus is located on the AAC device. Although this interaction did not take place in a therapy room, the same principles can be employed when working with a child with natural speech goals and AAC goals. 

In addition to using AAC as communicative repair, you can also target natural speech and AAC goals simultaneously by using AAC to expand the child’s utterances. If the child is producing speech at the 1-2 word level but has much more language, AAC can be utilized to add more information to the sentence. For example, If the child verbally says, “ice cream.” The therapist or caregiver could prompt the child to use AAC to add information and produce the sentence, “I want chocolate ice cream.” It may also be helpful to guide the child to think about communication partners. Within familiar partners, “ice cream” may be all that’s necessary to get the child’s preferred chocolate ice cream dessert. With a new babysitter, the child may need the whole sentence. When using AAC to expand utterances, It is best to structure your therapy session to work on natural speech and AAC simultaneously.

Written by Emily Pierce