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Mary Hunt Berg
In January 1997, five colleagues interested in language acquisition and AAC came together to form a reading group. We decided to meet in Berkeley because it was centrally located. Once a month seemed to be the maximum amount of time each of us could realistically commit. The first task of the Berkeley AAC Study Group was to decide what material to read. One group member had recently purchased the book Meaningful Differences in the Early Lives of American Children (Hart & Risley, 1996) but hadnt gotten around to reading it. Sound familiar? Some members never heard of it, one had heard that it was controversial in some circles of researchers, but didnt know why. It focused on language acquisition. Also, Time Magazine had just published an article called Fertile Minds (Feb.3, 1997) addressing the role of early experience on a childs brain development, as well as several aspects of early development. We used a process of sharing and discussion to select our initial and subsequent readings. Group members identified articles or book chapters that related to how children who use AAC might learn language. The Berkeley Study Group gave us all the incentive and commitment to make time to read, learn, and think about what we needed to learn more about. We ordered the materials, completed the readings and met as a group once a month.
At our meetings, we took care of important business first - ordering dinner, socializing and catching up with each other. This part of the reading group was valued as much as the subsequent discussion of the materials. When the discussions started, reactions to readings were varied, but our experiences and the readings generated common concerns among the group. For example, as a result of our initial readings, we learned that early experience actually influences brain structure, and that both the quantity and quality of linguistic input have important long term implications. Also central to development is social relationships with parents, family, and others. The discussions was sometimes spirited and at other times serious, e.g., one person strongly felt the book was culturally biased, another focused on research design issues....but all agreed that these two readings strongly underscored a need to shift our focus in AAC.
Until recently, early language development had been largely ignored in the field of AAC. Our readings suggested that language acquisition with AAC involves more than just symbols and devices. How might AAC techniques, devices, and intervention strategies support the early language acquisition process? What is the impact of our focus on AAC output rather than multi-modal input? What does this mean for parents and others who live with and care for young children with communication impairments? Should we be putting our resources into children at risk for developing language much earlier that we typically do?
Over the past year we have read about early language comprehension, transitions in typical language development, and the role of input and interaction in typical language development. We also read a recent issue of AAC which contained a series of articles on AAC and language development. These subsequent readings and discussions generated longer and longer lists of questions, but few immediate answers, and continually raised additional issues for us to learn about. As time went on we found that by having a common background through reading, the discussions became more focused. We asked different questions. As we went about our clinical work we began to think about things differently. More sharing of clinical questions became part of the discussions. Augmentative Communication News (ACN) published two issues on the topic of language input/intake, output/uptake. (Additionally, we became more efficient about ordering our dinner.)
How has this reading group influenced our thinking and how we go about our work? How might we share our experience with others in ways that are helpful? In putting this presentation together each of us listed those topics and concepts that had most impacted our thinking. What emerged was a series of frameworks that we have found useful in thinking about language acquisition with AAC.
As described in ACN (1997), Stephen von Tetzchner and Martinsen (1996) proposed three groups of children who are acquiring language while using AAC. Because the children who use AAC have such a diverse range of skills and needs, his framework has encouraged us to approach intervention more systematically by considering a childs abilities, the role of AAC, and the goals of AAC intervention. Another framework developed by Mary Ann Romski and Rose Sevcik (1996) described how AAC may best support language acquisition by children with varying levels of speech comprehension abilities.
We also read about several developmental frameworks that offered broader ways to think about AAC interventions. As Rhea Paul (1997) describes it, several important transitions take place during the first five years of language development, and AAC may play different roles at different points in time. She argues that by applying principles of typical development to the use of AAC techniques and devices, we may better facilitate the development of communication systems that are flexible and responsive to the childs communication needs. However, a model of normal development cannot serve as a complete framework for learning language with AAC (e.g., Gerber & Kraat, 1992). Specific challenges of using and learning language with AAC call for unique solutions. As described in ACN, AAC devices and symbols can be used as forms of input to facilitate comprehension (intake) as well as for output (expression) and to enhance a partners understanding of the childs message (uptake). For example, in the book Baby Signs (Acredolo & Goodwyn, 1996), we learned ways to attend to the important role of gestures in early communication and language development. At the same time, as a part of language intervention, it is important to facilitate a childs ability to vocalize and produce natural speech. Early on we cannot predict if and when intelligible speech will emerge. Vocalizations continue to be important communication signals throughout life.
Additional frameworks we read by Janice Light (1997) and Stephen Calculator (1997) discussed how a variety of contextual and environmental variables can either foster or impede early language learning with AAC. Bedrosian (1997) discussed a framework for language acquisition that points out the interaction of the AAC system itself, the childs linguistic knowledge and abilities, partner roles and support, and the nature of the communicative task. We also read about the importance of play as a context for language assessment and intervention (Lifter & Bloom, 1997) for children with speech and language delays. In another article, van Kleek (1994) discussed the important contextual framework of culture, cautioning us to be aware of our own cultural biases while remembering that language acquisition takes place in the course of daily social interactions. Current research on early language acquisition often reflects values and beliefs of white, English speaking, American families. Not all groups feel the same about the value of talking, how social interactions should proceed, and how to teach language to young children.
We brainstormed as to why and how children using AAC may be disadvantaged language learners. For example, a childs responsiveness influences the amount and type of input he/she receives. Children who do not talk well receive less input than other children in the same environment. Children with caregivers who use a more responsive interaction style progress more quickly, but interactions with AAC tend to be more adult directed. Nonverbal communication abilities underlie language acquisition, but adults may not recognize or respond to early communication signals from children with motor/speech impairment. We need to demonstrate the effectiveness of AAC interventions for young children to develop a how to map to guide the language learning process for these children.
A Few Tips for AAC providers (from ACN, 1997)
In our presentation we will share several case examples to demonstrate how these frameworks have influenced and organized the way we approach AAC interventions. And finally, we have included a list of references that we have found particularly useful in our discussions.
Acredolo, L. & Goodwyn, W. (1996). Baby Signs. Chicago: Contemporary Books, Inc.
Bedrosian, J. (1997). Language acquisition in young AAC system users: Issues and directions for future research. AAC. 13:3, 179-185.
Blackstone, S. (1997). The intakes connected to the input. Augmentative Communication News. 10:1, 1-8.
Blackstone, S. (1997). Supporting output and uptake. Augmentative Communication News. 10:2, 1-8.
Calculator, S. (1997). Fostering early language acquisition and AAC use: Exploring reciprocal influences between children and their environments. AAC. 13:3, 149-157.
Casby, M. (1997). Symbolic Play of Children with language impairment: A critical review. Journal of speech language and hearing research. 40:3. 468-497.
Gerber, S. & Kraat, A. (1992). Use of a developmental model of language acquisition: Applications to children using AAC systems. AAC. 8:1, 19-32.
Hart B. & Risley T. (1995). Meaningful Differences in the everyday experience of young American children. Baltimore: Paul H. Brookes.
Lifter, K. & Bloom, L. (1997). Intentionality and the role of play in the transition to language. In A. Wetherby, S. Warren, S. & Richele, J. (Eds.). Transitions in prelinguistic communication. Baltimore: Paul H. Brookes.
Light (1997).Lets go Star Fishing: Reflections on the contexts of Language Learning for children who use aided AAC. 13:3, 158-171.
Martinsen, H. & von Tetzchner, S. (1996). Situating augmentative and alternative language intervention. In von Tetzchner, S. & Jensen, M. (Eds) Augmentative and alternative communication: European perspectives. Whurr Publishers Ltd.
Paul, R. (1997). Facilitating transitions in language development for children who use AAC. AAC. 13:3, 139-140.
Romski, M & Sevcik, R. (1996). Breaking the speech barrier. Baltimore: Paul H. Brookes.
Romski, M.A., Sevcik, R. & Adamson, L. (1997). Framework for studying how children with developmental disabilities develop language through augmented means. 13:3, 172-178.
Time Magazine Fertile Minds (2/3/97).
van Kleek, A. (1994). Potential cultural bias in training parents as conversational partners with their children who have delays in language development. American Journal of Speech-Language Pathology. 67-78.
Whetherby, A., Reichle, J., & Pierce, P. (1997). The transition to symbolic communication. In A. Wetherby, S. Warren, S. & Richele, J. (Eds.). Transitions in prelinguistic communication. Baltimore: Paul H. Brookes.
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