High Expectations, High Technology

I’m going to let you in on a fact that insurance companies and even some school districts don’t want you to know: there is no hierarchy of AAC devices. That means:

• Kids do not have to start with low-tech before they can learn high-tech.

• Success with low-tech does not predict success with high-tech, and vice versa. 

When I started out as an AAC Specialist, I already knew these things were true. But I still came in expecting that some kids would benefit from low-tech and mid-tech devices… And the problem was, I didn't know how many. As a result, my first round of purchasing for the AT Library that I had at the time went a little heavy on the mid-tech! 

Years later, having established a program in Castro Valley Unified School District (a place I’m still very fond of), I ran the numbers and was surprised to find that 95% of my students were using some form of high-tech AAC (plus low-tech back-ups, always). The vast majority of kids were able to benefit from it, and so I saw no reason not to start there. 

After all, if we have high expectations, and we presume potential of our students, then… why not?

High-tech AAC has so many benefits over low-tech or mid-tech, including: 

• Quicker and easier programming, so it’s more customizable 

• Having a voice that can be heard across the room

• Auditory and visual output (i.e. multimodal means for a child to learn to use it) 

• Lighter weight than a similarly robust low-tech device

• The “cool” factor - motivation to use a device matters! 

I’m not the only one who feels this way! Here are some links to other AAC Specialists who have written about this: 

• Amanda Soper

• Kate Ahern

• Rachel Madel (see also her fabulous freebie about PECS)

• Jane Farrell - "Why are you using PECS?" and "What is Beginning AAC?" (please note the date on these... they were published TEN years ago!!!)

• Autism Little Learners

Higher tech, higher barriers?

You might be thinking, “But that’s so expensive!”

Yes, it is… and there’s no sense in sugarcoating that point. However, you should also know that NOT providing high-tech AAC devices is MORE expensive than providing them. 

When we in the public schools don’t give a child an AAC device, we WILL end up spending more money in the long run: 

• They’ll likely require a more restrictive placement than they otherwise would have, because communication deficits result in challenges with academics, behavior, etc. Translation: more money on staffing for the 18-ish years that they’re in school (don’t forget to include adult transition). 

• They may have more severe behavioral problems, through NO fault of their own - because they cannot communicate. Translation: more money for behaviorists, and in extreme cases, more money to support staff after work-related injuries. 

• Their parents are going to be REALLY unhappy (can you blame them!?!). Translation: more money for lawyers, IEE’s, and non-public agencies. 

Listen, I would hope that the potential benefits of AAC for the child would be enough to convince you that it’s needed. I would hope your love of children would make you want to do the morally right and scientifically evidence-based and expert-recommended thing for them. 

But if you’re strictly looking at the bottom line, then it’s important to realize that if you don’t provide kids with AAC devices, your school district is NOT saving money. You’ll be spending way more in other places, and possibly without realizing how much you could have saved by giving kids a way to communicate. 

What we would do at “LUVUSD” –

In my dream district we would:

1. make individual decisions for each student,

2. if in doubt, presume potential, AND

3. plan to get high-tech for about 95% of the kids who need AAC, because it's a safe bet we'll need that many. 

From previous articles in this series, you know that the fictional LUVUSD has 10,000 students, and statistically, about 130 of those will need a robust, personalized AAC device. And now you know that roughly 124 of those (i.e. 95%, rounded up) will need a high-tech device. The other 6 might need something else, for instance a robust PODD book, perhaps combined with a partner-assisted scanning system. 

In looking at LUVUSD’s AAC program, we’d make sure to think about a Mobile Device Management system, an inventory organization system, and having a few extra iPads around for those “just in case” situations (a child forgot their iPad, something needs troubleshooting, a new student enrolls, etc.). 

It’s not just a dream - 

That 95% number comes from my personal experience in one school district. But since then I've seen that number be verified in other districts, and in my consulting work with other SLPs and AAC Specialists.

There are districts already out there that do provide enough high-tech devices to students, and keep a few extras around. 

If you’d like some help with getting your school to that point, here are some resources: 

• Building an AAC/AT Library from Scratch

• AAC/AT Library Inventory Organizer 

And if you’re a parent who is looking to get a device for your own kid, here are resources for you: 

• AAC Advocacy Class

• Getting AAC when you don't have an SLP

Next month, we’ll talk about the importance of connection over compliance, and an intervention that is more effective, yet far less well-known than ABA.