Child characteristics

A detailed assessment of a person’s language and communication skills is an important part of making recommendations. Using standardised assessment tools in combination with informal observation ensures a comprehensive understanding of what they can do.

For some children who need AAC, it helps to consider their chronological age. For example, following assessment an 8 year old child may have the language and communication skills closer to that of a 3 year old child. Ensuring the child’s language opportunities are developmentally appropriate can help support their communication and language growth

Consider the child’s age when choosing the vocabulary system. It may be helpful to take a developmental perspective. Here you choose a system that offers a level of language that suits current abilities but also promotes the young person’s development towards increased language complexity.  

From the beginning, children require their AAC systems to be available across the day. Incidental opportunities for language learning happen at anytime and all the time.

No matter the age, the young AAC user needs a plan to support them develop their AAC skills. Finding highly motivating communication opportunities will help them become more resilient in using any AAC system – all of them are more demanding than just ‘talking’.

All AAC users will grow up. It is helpful to think about what will work for them as they become adolescents – especially when choosing new vocabulary.

Gather all relevant information, including formal and informal assessment, before making decisions about a child’s abilities. Understanding their comprehension of language is a key part.  

If information is missing, it is important to think about how this could affect the decisions being made.

Be mindful of assumed roles and responsibilities, make sure expectations for each person are clearly explained.

Provide opportunities to discuss expectations and assumptions to ensure all information is collected and considered before making a recommendation.

Incorporate child and young person preferences and perspectives in the AAC assessment and ensure they are reflected in decision making.  

Identify what motivates the child to use technology, or to communicate in anyway they choose.

Check with the child or young person that you have understood their preferences correctly, and work together to support any differences in opinions

Ensure aid trials are evaluated objectively so that child preferences are fully understood and inform decisions effectively.

Introduce AAC as early as possible to support understanding and expressive language development.

Use an appropriate standardised assessment to understand a child’s cognitive abilities. This is particularly important when these skills affect what services or support they can access.

While children are learning how to use AAC systems with higher cognitive demands, offer AAC scaffolding supports with lower operational demands. This will promote language and communication development.

Think about both the limits and the learning opportunities offered by the graphic representation system you choose.

Try to use one type of graphic system to support learning and consistency.

Only change the system if it better meets the individual child’s needs.

Avoid making changes for reasons that are not linked to the child

Find out how the child communicates in different places, such as at home, at school and in other settings.

Make sure any communication support or tools you recommend work well with how the family already communicates.

Find opportunities for the child or young person to learn how to use their AAC system, and support them to work towards agreed goals.

Identify how different ways of communicating (for example, speech, gestures, or AAC) are used and prioritised in different places, such as at home or at school.

Encourage the child or young person to communicate by using activities that interest and motivate them

Plan vocabulary changes carefully so children can continue to develop a range of communication skills.

Help families understand the progress that can be made when the right AAC support is in place.

Use a range of communication methods (such as speech, signs or AAC) to support quick and natural social interactions.

To avoid limiting children’s opportunities to develop their AAC communication skills, they should not be required to show their communication ability before trying an AAC system as part of the recommendation process

Think about the child or young person’s speech, language and communication skills. Use any available information about their diagnosis to inform your decisions. For example, consider social communication in children with autism.

Consider how other features linked to a diagnosis may affect communication. This may include physical skills, movement, sensory needs, and reflex responses.

Use referral and diagnostic information to help plan which professionals should be involved in the AAC symbol communication assessment.

Choose an AAC system that meets the child or young person’s current needs and can also grow with them over time.

Keep high expectations for all children and young people.

If progress has been slow, think about the communication opportunities they have had so far. Focus on how to improve future opportunities, rather than limiting expectations based on past progress.

Support AAC recommendations with goal setting that aims to build communication skills across communication and learning contexts.

Include sufficient discussion and consensus building during the AAC assessment so that everyone agrees on shared goals and understands the plan.

Interventions plans should support the child or young person to have frequent opportunities, in a range of situations, to communicate with different people.

Provide opportunities for children to see and learn from AAC role models, helping them to build confidence and positive expectations for themselves.

All AAC assessments should include clear summaries of the child’s language skills. These should be based on what has been observed and describe how much information they can understand in a sentence, or what concepts they can express using a sequence of related ideas. For example, graphic symbol sequence /hot/ + /Cereal/ = porridge.

Where possible, include results from formal (standardised) language assessments. These can be used as intended or adapted to describe the child’s understanding and expression.

Professionals should work together to gather this information, rather than assuming it is the responsibility of one service.

Where children’s physical challenges impact on access to AAC vocabularies, ensure specific communication opportunities with lower physical access demands. For example, providing opportunities to use repeated line Social Scripts for social conversation or use partner assisted scanning. 

Support the child to develop skills in choosing the best way to communicate for different situations and people. This is known as strategic competence.

AAC goals should highlight language development and communication development as separate but complementary areas.  

Provide drill and practice activities and real life opportunities to use and develop language and communication skills.

Provide AAC supports and strategies to facilitate literacy development.

Keep high expectations for the child’s language development and do not require them to show ability before they can access AAC learning opportunities.

Provide more time within learning opportunities for children with physical limitations so that they can actively participate.

Be aware that slower ways of accessing communication can affect motivation for both the child and their communication partner.

Provide other communication opportunities that are fast and place less physical demand on children.

Balance long-term aims for independent communication with how difficult a system may be to use. Supported or shared communication may be a helpful step.

When access needs are complex, involve the right professionals and keep a strong focus on language and communication outcomes.

Be mindful of team member preferences and aim to achieve consensus when choosing an access method.

Provide specific opportunities to develop access skills and provide separate language and communication learning opportunities.

Aim to gather as much information related to physical and visual skills as possible to avoid making decisions with information gaps.

Where setting up the AAC system takes time (e.g. such as with eye gaze systems), provide other AAC supports for spontaneous communication.

Offer opportunities to practise navigating the system outside of real conversations, so the child can focus on learning how it works.