Writing AAC Goals - Got Precepts?

I originally wrote this article for the Northwest Augmentative Communication Society blog.  This is a reposting (and slightly condensed version) of that article.

As an AAC-SLP, I believe that appropriate goals naturally flow from a good evaluation. However, I am not the only one working with the AAC learner, and therefore, not the only one crafting goals targeting skills related to communication. Parents have communication goals for their child. Teachers have communication-related goals for their student. Behavior specialists have communication-related goals for their client. Effective and efficient communication is a focus in supported living and work environments. As part of my role, I want to help every team member develop a basic understanding of what will help our shared AAC learner become a competent communicator.

precept (noun): a general rule intended to regulate behavior or thought

AAC Precept #1:  Presume Competence

We need to enter into any discussion about goals with the shared belief that the AAC learner CAN learn. We can never know the extent of someone’s potential – so we need to do everything within our power to make sure we are not inadvertently limiting the AAC learner’s potential. It is absolutely vital that we provide the teaching, supports, access, and opportunities and then watch and see how far the AAC learner goes!

“The greatest danger for most of us is not that our aim is too high and we miss it, but that our aim is too low and we reach it.”  ~Michelangelo

AAC Precept #2:  Keep it Real

Authentic, independent communication. SNUG (spontaneous novel utterance generation). We need to keep our end-goal in mind. Our job is to discover, teach, and support the access to communication (the how). Our job is to teach all the words and provide access to all the words at all times (the building blocks). Our job is to create reasons and opportunities to communicate (the motivation). The messages (the what) is all them, though. The content of communication is not about what we want the AAC user to communicate, or about what we think the AAC user should communicate. Real communication means that the message is what the AAC user wants to communicate – and that they can communicate it in the moment of their choosing.

"Independent communication is… the ability to communicate anything on any topic to anyone." ~Patricia Dowden, PhD, CCC-SLP, University of Washington

AAC Precept #3:  Quality, not Quantity

Often, goals are written in a format something similar to: name will do something X number of times in a certain time frame with X% accuracy. This does not work for communication. Authentic communication means that you can communicate whatever you want, whenever you want, to whomever you want. AAC goals should focus on increasing the appropriateness of communication – not the quantity of communication. We need to keep goals flexible enough so that the AAC learner can say what (s)he wants to say. Goals should also focus on increasing the variety of communicative functions the AAC learner is able to use to express spontaneous and authentic ideas, stories, thoughts, feelings, wants and needs.

AAC Precept #4:  Communication is More Than Requesting!

We communicate for a variety of purposes – and our goals should reflect that. We communicate to:

initiate interactions                    gain attention                    greet/take leave

accept                                      reject                                protest

request (objects, people, actions, help, information, reoccurrence…)

acknowledge                             answer/respond                  ask

express manners                       comment                            express feelings and opinions

relate information/events           tease/joke                          negotiate/bargain

assert independence                  self-advocate                      self-regulate

and SO MUCH MORE

Resource for Communicative Functions:

• The Pragmatics Profile for People Who Use AAC

AAC Precept #5:  AAC Takes Time and Work

Putting an AAC system in front of an AAC learner does not make them a competent communicator. AAC is a tool, just as oral speech is a tool. Verbal communicators spend years learning how to use their “speech tool” and years learning their home and community language in order to become competent communicators. AAC learners will also need years of the same intense exposure and learning to become competent communicators in their AAC language. Sometimes, especially with emerging communicators, we need to write goals for the communication partners! We need to “put AAC in” before we can expect “AAC out”.

"The average 18-month-old has been exposed to 4,380 hours of oral language at a rate of 8 hours/day from birth. A child who has a communication system (AAC) and receives speech/language therapy 2 times/week for 20-30 min. will reach the same amount of language exposure (in their AAC language) in 84 years." ~Jane Korsten, MS, SLP, ATR

AAC Precept #6:  The 4+1+1 Competencies

In 1989, Dr. Janice Light proposed that there are four key areas in which an AAC user must develop knowledge and skills in order to become a competent communicator:

• Linguistic Competence: receptive and expressive language skills of the home and community language, as well as learning and using the language code of the AAC system; this includes semantics, morphology and syntax, and the rules for combining words to form meaningful utterances
• Operational Competence: the technical skills needed to operate and maintain the AAC system, including accessing the system to transmit information
• Social Competence: using communication effectively in social situations (such as discourse strategies), as well as developing a self-image as a communicator, the desire to communicate and actively participate in conversations, and responsiveness to communication partners
• Strategic Competence: knowing how to overcome/minimize limitations of the AAC system (e.g. available vocabulary, speed), as well as compensatory strategies for effective communication (e.g. repairing communication breakdowns, knowing how best to communicate a message in a given situation)

Blackstone and Wilkins suggested a fifth competency area in 2009:

• Emotional Competence: awareness of emotional states and understanding and use of emotional vocabulary to express feelings, beliefs, and thoughts

I also consider a sixth area:

• Self-Advocacy (labeled by Kate Ahern in a blog post in 2014): the awareness of and ability to communicate about personal (physical/emotional) needs and issues (e.g. need a break, pain, sensory issue, abuse/neglect, health/safety complaint)

These six areas of competence offer a solid framework from which to base our interventions and create goals. We do not need to be addressing all six competency areas at once. However, if we are always considering and prioritizing goals within these competencies, we will be on the right track to guiding our AAC learners on the road to becoming competent communicators.

Resources for Communicative Competencies:

• Augmentative & Alternative Communication Profile – A Continuum of Learning
• The Dynamic AAC Goals Grid – 2 (DAGG-2)

AAC Precept Honorable Mention:  Literacy is for Everyone

We cannot forget (neglect) literacy! For each and every AAC learner.