AAC Rules of Commitment

Compliance with the following rules
distinguishes those who hold in the highest regard
the interests of the individual who relies on AAC.

Rule 1: Be committed to the most effective communication system for the individual being served.
The AAC assessment may be the single most important event in the life of a person who relies on AAC. Where that person goes in life will be influenced by communication effectiveness.

Rule 2: Be committed to following your professional code of ethics.
All members of the team must not only agree, but be motivated to provide the system and services that result in the highest level of personal achievement. In addition, the team must be working toward helping the child develop communicative competence which results in a spontaneous, interactive exchange of information, feelings, and thoughts. Parents should be asking team members how their educational plan and recommendations are going to help their child communicate effectively.

Rule 3: Be committed to involving the consumer and family in the service delivery process.
Children and parents have rights to assistive technology under the Individuals with Disabilities Education Act (IDEA). Family involvement in the Individual Education Plan (IEP) process should be motivated by what is best for the child. Parents may need to remind team members that the reason for all these procedures is because of their child. A Consumer-Centered Service Delivery model places the team members and processes in proper perspective. The consumer and family are the focal point and parents may even decide to request outside supports. Each person on the team has a contributing role in achieving the identified outcomes. Outcomes are influenced by the environment. Defining the roles and responsibilities of the individual team members in this model can have a positive influence on Rule 4.

Rule 4: Be committed to achieving the maximum outcomes for the individual.
Stakeholders are those with an interest in the outcomes of the process. Stakeholders in the AAC service delivery process include the service delivery team and others, including administrators, funding agencies, etc. Parents need to realize that because of different roles and responsibilities, some stakeholders are vested in achieving different outcomes. Clinicians and therapists tend to be more concerned with outcomes related to clinical results and functional status. Whereas, administrators and funding agencies will be more concerned with best use of staff time and cost effectiveness for service delivery. Consumers and family members have concerns connected to quality of life and satisfaction issues. Acknowledging differing interests can help teams reach a better understanding of contrasting positions and swifter resolutions to any disagreements.

Rule 5: Be committed to advocating for language.
If the team agrees on the central goal of AAC as being the highest possible personal achievement, then language becomes the focus of assessment and intervention. Unfortunately, many AAC strategies and programs focus on modifying behaviors, such as providing for classroom vocabulary, rather than real communication. The technology is used to promote responses to environmental cues and the child is limited to activating scripted messages. Little language learning is possible when no provisions are made to explore and create self-generated utterances. Parents need to ask questions about the ability of the language representation method and technology to facilitate language acquisition and growth and not just foster routine behaviors and compliance to tasks. A sure sign of a behavior focus to therapy is the prevalence of nouns, colors, and other words that would be considered extended vocabulary. The mastery of basic core vocabulary words should precede the introduction of vocabulary specific to daily activities and academic subjects.

Rule 6: Understand the merits of ALL language representation methods.
The three commonly used language representation methods are single meaning pictures, spelling, and semantic compaction. The outcomes an individual who relies on AAC is able to achieve depend heavily on the language representation method(s) being used. Ease of use at first encounter may not be most effective in the long run. For example, analysis of logged samples from individuals who rely on AAC have indicated that communication rate using semantic compaction can be four times the rate using spelling.

Single meaning pictures involve the use of graphic or line drawn symbols to represent single word vocabulary or messages (phrases, sentences, and paragraphs). Reading skills are generally not required for using this method. However, recognition of symbols (especially abstract concepts) is facilitated by the presence of words associated with the symbols. These words, however, are useless and possibly distracting for anyone who cannot read. By the very nature of the system, a large vocabulary also requires a large symbol set. Consequently, having quick access to any symbol can become an issue for augmented communicators needing more than just a very limited number of words or messages.

Spelling, sometimes referred to as traditional orthography, involves the use of the alphabet. Generally, spelling and reading skills are required. Although the symbol set is small, spelling letter-by-letter is a slow and inefficient AAC strategy. Acceleration techniques such as abbreviation systems and word prediction are commonly used with spelling to reduce the number of keystrokes. However, disadvantages in increasing the memory and reading demands for these acceleration techniques can outweigh any advantages. Research has shown that word prediction is no faster than spelling.

Semantic compaction or "Minspeak" involves the use of a relatively small set of multi-meaning icons that does not require spelling and reading skills. The specific meaning of each icon is a function of the context in which it is used. Minspeak is perhaps the most commonly used AAC language representation method, because of its ability to handle both vocabulary and rules of grammar, and support the notion of a core and extended vocabulary.

Rule 7: Support the language representation method(s) for core and extended vocabulary access that best serve the interest of the individual.
Vocabulary selection and organization has been one of the most widely researched topics in AAC. Access to a vocabulary based on the notion of core and extended categories is more important than vocabulary frequency lists to support vocabulary selection. The vast majority (approximately 85%) of what we say in daily situations consists of a few hundred core words. Most of these core words are determiners, verbs, adjectives, prepositions, indefinite pronouns, etc. They are not familiar nouns typically associated with given activities or situations. Rather situation-specific nouns would be considered extended, or fringe vocabulary.

Rule 8: Advocate for the AAC system that supports the chosen language representation method(s).
Most individuals reaching the goal of AAC are using multiple language representation methods with the AAC system. Observation of their achievement indicates the use of semantic compaction for core vocabulary access and spelling for extended vocabulary words. Single meaning pictures appear to have limited use for when the individual only requires access to a small core vocabulary set or for access to extended vocabulary when the individual cannot spell.

Rule 9: Be committed to using AAC performance measurement to support clinical intervention.
"The most useful and beneficial evidence on which to base decisions regarding educational and clinical AAC services is analyzed performance data (language samples taken from clinical and natural settings). This is done using automated language activity monitoring. Tools to facilitate the collection and analysis of language samples for individuals who use AAC devices are now commonly available for clinical use. Use of language activity monitoring provides team members with detailed information from spontaneous language samples to measure changes in communicative performance. An objective, quantitative record of how the individual is using technology in different settings can provide the basis for clinical intervention. Easy comparisons between vocabulary use, amount of communication, and methods used can be made over time and across activities.

Rule 10: If unable to adhere to any of these guidelines, be truthful about it to the individual, family, and advocates.
If parents are in doubt regarding the commitment of a team member, they must feel empowered to question the continued participation of that member on the team. Not every professional will have the same level of commitment, motivation, and willingness to learn new technologies and strategies. Rule 10 provides an opportunity for any team member to express discomfort with what is being expected of him or her. It also provides for disclosure of being "between a rock and a hard place" relative to making recommendations that may be contrary to administrative directives, such as "Don't write that into the IEP, or the school will have to buy it."

The AAC Rules of Commitment was first published in a three-part series in Exceptional Parent magazine on choosing and using augmentative communication systems. October through December 1999.