Robin Hurd

You’re’ never too old to communicate!

How old is too old to increase your communication potential by receiving your first voice output AAC system?

You’re never too old!

In this article we’ll look at some of the reasons why people do not receive an AAC system at a young age, and provide reassurance that AAC is worth considering at any age.

Some of the reasons why a child may not receive an AAC system at an early age are: the labels of their disability, fear that they will not learn to talk if AAC is given to them, fear and lack of familiarity with AAC technology on the part of school, and budgetary concerns.

Certain disability labels often trigger an automatic reaction against using AAC, even though speech is impaired. If the child has a diagnosis of mental retardation or autism, often it is assumed that the child cannot learn to communicate: “he’s too low functioning”. A classic example of a diagnosis that ought to trigger a recommendation for AAC immediately, but does not, is Angelman’s Syndrome. As soon as a child is diagnosed with Angelman’s, you know that fluent speech is not likely. However, very few children with Angelman’s are given the chance to use AAC, because another documented part of Angelman’s is an MR label.

The problem with using an MR label alone as an indicator of whether a child can benefit from AAC is twofold. First of all, the testing for MR at an early age is reliant on motor abilities, communication abilities, or both. When a child has impaired motor skills and lack of speech, the results will look like the child is mentally retarded, when in fact the test may be asking the child to do things that are physically impossible to do, even if they are cognitively able. Secondly, children as young as 18 months communicate; therefore, a person with a cognitive delay is not necessarily “too impaired” to begin communicating.

So, some children are not given an AAC system until 8, 10 , 13 years old or even older. Is there an age at which the child is too old to benefit from AAC? When we look at the generation of adults who grew up without speech and now use AAC, most of them did not receive a communication device until their teens, some even until adulthood. However, they are able to communicate effectively with their AAC systems. This should re-assure us that children can receive AAC at a later age, and still benefit from it.

You’re never too young to communicate!

How young is too young to receive your first AAC system?

As we think about this question, we must think about how very young children communicate. Even before children can speak, they are actively engaged in communication with the people around them. Tiny infants smile, coo and “do the wiggle dance” when adults speak to them, in order to continue the dialog. They cry to let adults know they have a need, and can even wait to have that need met when a trusted adult is holding them. Long before they can speak, young children follow such directions as, “Look at the camera! Smile! Over here, Sam! Come to mommy!”

The question of how young a person can benefit from an AAC system is often asked because the person asking is concerned that there are prerequisites that must be met first, in order for the person to “earn” an AAC system. Young children who are developing normally do not need to meet any prerequisites at all to begin communicating, and neither should people who cannot speak.

AAC can begin simply, with low tech symbol boards or simple voice output systems. However, as the child learns to use these communication means, developing language skills should not be put on hold because the current system is not powerful enough to say all that the child wishes to, or is not meeting the child’s need to be heard out loud.

For many children, the desire to have an audible voice keeps the quieter methods of AAC from ever being effective. The quiet methods simply don’t go along with the child’s understanding of communication. After all, everyone else makes a noise when he talks, why shouldn’t I? This is a legitimate concern for the child, and should be considered every time a child is not motivated to use a quiet communication system. The child should not have to “work his way up” to a voice output system through years of a quiet system. He should be evaluated as an individual for an AAC system that works for his individual personality and skills.

There is no magic age when a child should receive AAC. Ideally, each child would be considered for AAC soon after a serious delay in speech is observed. However, this may not have happened. AAC can still be introduced to children much older than this, and they will benefit from being able to communicate to the world around them. Equally important, the world around them will be able to benefit from a deeper understanding of what the child is thinking and feeling inside.

This might be a good time to revisit the AAC Rules of Commitment. This set of "ten commandments" was first published in a three-part series in Exceptional Parent magazine on choosing and using augmentative communication systems. October through December 1999. Over the years we have heard how several families have shared this resource with professionals, teachers, and school administrators to help guide AAC intervention services.

I always value your feedback. parents@aacinstitute.org.