Latest / AAC Access All Areas / What language should I add to an AAC tool?
Transcript
- Ruth: Hello and welcome to another episode of AAC Access All Areas. I'm Ruth Jones. Ali Battye: And I'm Ali Batty and today's question is, what kind of language do we need on an AAC system? So apologies to listeners because we're probably gonna have a bit of a time lag or some talking over each other today unless Ruth does like the amazing editing. But my wifi is really dodgy because it's a windy day. So any kind of weather seems to affect my wifi. And I couldn't personally hotspot it because my phone network is down too. So we're a bit compromised today. But we'll do our best. Ruth: Yeah, absolutely. We ⁓ thought we would do our best to talk about language for AAC because we use lots of words and phrases that people will have heard us where we've talked about robust, we've talked about core, we've talked about fringe. And so we thought we'd use the episode today to actually break down what do we mean by those terms? Like what kind of language should we be looking for and making sure is in an AAC user's system? I guess the first term feels sensible is to start with robust, doesn't it? Like, what do you kind of explain to people when you talk about robust language? Ali Battye: So there's a few different aspects, but the one that I always start with is that it has an extensive vocabulary, which includes core words. So core words are the sort of high frequency words that make up... 80 % of what we say. So they include things like pronouns like I and you and me. It includes like really common verbs like go and want and like. It includes things like it and there and here and but. And it's fairly, those core words seem to be fairly universal, you know, regardless of things like the gender of the people talking, ⁓ race and ethnicity, where you are in the world and sort of dialect as well. So core is really important that we give access to core vocabulary, but also we need access to fringe words as well. So fringe words are are the sort of topic specific words. So things like names of animals or names of food items or the places that we might go. And we combine call words with fringe words. So if I say a sentence like, I'll roof tomorrow, I'm gonna go to this new cafe and I've never been before so I'm really excited. That. long sentence is made up of a lot of core words but there were also a couple of fringe words in there as well so the the cafe and the excited probably would be fringe words and then the rest of it probably would have been core words. Ruth: Yeah, and I think there's also that bit, isn't there, when you're looking at some of the systems, because different systems will hold the core words and the fringe words in slightly different places. And so I guess there's something as well, thinking about when you're looking at, have you got a good, you know, set of those core words, which is so important for sentence building, but also when you've got the fringe, where is it sitting? So, you know, some... every time you open a folder, which would be kind of probably going into some fringe words because they are, you know, those kind of more the ones that add fluff rather than the beefy substance to a sentence. They're the ones that I think tend to be ⁓ sometimes in like topic folders. And in some systems, when you open a topic folder, the core vocabulary disappears. And in some systems, when you open the topic folders, the core vocabulary stays. alongside. ⁓ so I think there's something about making sure you've got access to core and fringe and the fringe is where we can really personalize and make language meaningful for AAC users but also looking at how it's put together because I find sometimes a core and fringe vocabulary setup can be quite slow if you've got to go through lots Ali Battye: Thank you. Ruth: folders to get core and then you've got to go into other folders to get some of the fringe. So I think, you know, it's something, it's not a problem thing. It's just a be aware of thing when you're thinking about AC and language is how do you toggle between fringe and core to make it as effective as possible? Because what we know is, is that AAC communication can be really slow. So we can do our best within programming, can't we, to make access to that language as effective and as efficient as possible. Ali Battye: Yeah. Yes, yes. Yes, and there's a couple of different solutions to that. So say proloquo to go, that has core words on the home screen. And then really cleverly, when you go into topic pages, the core words will still be there and they'll be in the same location at the top of the screen. So words like I, you, want, see will be in exactly the same location when you go into those topic pages. but they will also be accompanied by the fringe words. So, know, if you're clothing, if you're in the clothes page, and they'll be in the same page so that you're not having to go backwards and forwards to create a phrase which is made up of core and fringe words. If it's something like Supercore 50, which is in grid for iPad, the core words are on the home screen, but then, you've got a couple of options actually with Supercore 50, haven't you? because you can open up the sort of phrases on the right hand side of the screen and combine it with the core words that way and have both on the screen at the same time. But if you go into the topics in super core, you then don't have the core words displayed. And that's when it can feel a little bit clunky and needing to go backwards and forwards. And then there's a more pragmatic style of vocabulary organisation, would be ⁓ like VocoChat on Grid for iPad is like this and Pod was the original, I would say, that invented this style where you sort of have phrase starters on the same page as the fringe vocabulary. So say you went into ⁓ like animals and you might have some phrase starters like ⁓ I can see the or feed the or let's stroke the, ⁓ particularly in ⁓ versions of Vocochat that have been made more friendly for Gestalt language processors. I think the original Vocochat was already pretty good for that, ⁓ but you can also make edits or ⁓ I've created a version that people can download for Gestalt language processors where they've got those sort of more phrase starters. on the same page if they go into a topic page. Ruth: Yeah, because I think sometimes with the, like you mentioned, pod, that stands for pragmatic, organized, dynamic display. that kind of, it still has some of that core and fringe, but it just looks a bit different and how you access it is a bit different, isn't it? Like you say, it's sort of, you follow a pathway to get you to the end of your sentence, which usually is your fringe. So rather than pressing a symbol that says I, and then a symbol that says want, and then saying... play and then bubbles and then bubbles. So you would build the sentence that way going through something like super core. If you were going on to more pragmatic organized, it might be like, want to play something bubbles. And so it kind of jumps you through the folders in a slightly different way. And neither is better or worse, are they? It's just they are just slightly different ways of setting up vocabulary. Ali Battye: Yeah. Yeah, yeah, yes. And I would say, ⁓ particularly for Gestalt language processes, so that would be a child who really likes the sort of intonation and the musicality of language. My experience is that they tend to engage more with a sort of pragmatic display where there's sort of like whole chunks of language and those sentence starters. Whereas if it's a child who's more of an analytic language processor or has gone through the stages with Gestalt language processing and can use grammar more flexibly, then a layout like core and for a sort of more traditional and fringe layout like Supercore 50 can suit them absolutely fine. So it's sort of a bit of an experimentation, isn't it, to see what that child is really engaging with the most and what language they find the most interesting and appealing. Ruth: Yeah, and I think the other thing sort of with AAC as well, and I've been working with a special school local to me who've got some brilliant ⁓ NHS speech and language therapists supporting them and also sort of a communication specialist teacher. And ⁓ we've kind of developed a bit of a standard communication book as a starter for 10, you know, for teachers, they can have something that can get them going. And it's got core. But what we've then added to it rather than fringe is actually phrase based stuff. And I think that's something to think about as well, isn't it? When we think about wanting AAC communication to be as efficient and effective as possible, that often means that it needs to be speedy. And so we do want to have the capacity to build sentences and to have the core and the fringe, but also looking at, you know, quickfire messages. So are there things where you could really quickly open something up and when you tap the button, it will say a whole phrase. So for example, my device needs charging or something's wrong or I need help so that you're not having to build a sentence where potentially there's a level of distress or dysregulation that might make thinking and communicating even harder. What you don't want AAC to become in those moments is a barrier. So you have your core and your fringe and as part of robust language, think it's also then important we do think about not just for our Gestalt language processes, but equally for all AAC users is where and how are we using phrase based language. Ali Battye: Yeah. Yes, definitely, definitely. Because AAC users tell us that they need those sort of shortcut phrases. ⁓ And adults who are using a text-based AAC app where they're typing, and it's sort of like text to speech, that's called when you're typing, those users still have those pre-stored phrases so that they're not sort of wasting effort saying the same phrases. Because there are certain phrases that we all draw on. Ruth: No. Ali Battye: they just, you know, come out automatically like, how are you? I'm fine, thank you. ⁓ That is much more efficient to have that as a pre-stored phrase or say, you know, if I go into a Costa, I would probably want a pre-stored phrase to say, can I have a decaf, oat milk latte, please? That's much easier if you've got that as a pre-stored phrase than having to spell that out or to make it with symbols from scratch. Ruth: Yeah, and I think there's something in that, isn't there, that, you know, when we think about language development for AAC users, there has to be, particularly for children, I think that sort of balance between language and literacy and teaching the skills of grammar and sentence building separate to what I would think of as more communication, you know, that is about just interactions with other people because... Ali Battye: Yeah. Yeah. Ruth: building sentences might enable interactions with other people, it's slightly more academic. Whereas when we're thinking about it in the context of more social interactions with people, you're going to cross actually what is the benefit of somebody who can go into Costa and go through all the different folders and come back and forth, come back and forth to build that eventual sentence rather than being able to press one button. So, you you have maybe a topic folder of Costa, you open it, you press the phrase and it says, I'd like this particular coffee. Ali Battye: I'm sorry. you Ruth: please and then you might have a couple of phrases all in there that are relevant to that interaction that makes it faster and makes it more efficient for them because there are times where building sentences is part of learning language but equally when we think about what is AAC there for it's not just as a language learning tool is it really it's part of more about communication. Ali Battye: Mmm. Thank you. Okay. No. Yeah, no, that's a really good point. And also, I think it's helpful to develop those patterns of language because language is just, you know, pattern recognition with grammar, particularly. so children need to hear those patterns ⁓ enough to then be able to recognise them and then go on to use them flexibly themselves. So I think it can be really helpful, particularly for gestalt language processes again. to have patterns like ⁓ let's play versus let's go or I want to do something versus I want to play something. It really helps them build up that awareness of ⁓ we've got these chunks and we can use them flexibly. We can sort of like slot them together ⁓ in particular ways. So I guess because we're both working with children, children are always building up their receptive language as well at the same time as they're learning AAC skills. So that's where those sort of phrase starters can be really helpful. Ruth: Yeah, definitely. I think, I guess, you know, as we've said before, a lot of research and a lot of hard work goes into planning the language that is in an AAC device. And if you're going for one of those kind of main applications that we've talked about, you won't have to think too much about the language that's in it in that sense. But there is something, one, if you're creating paper-based tools, but also if you're kind of setting up and creating more bespoke pages within your Ali Battye: Yes. Ruth: ⁓ AAC, there is something, you I will work with some families who've given it a good go, but what they've often, what you often find is that maybe you have I and then want and then just a bunch of the things that they want. And this sort of that thing about we communicate for such a range of different functions. And that's why the pairing of core vocabulary with that fringe vocabulary is really important because we don't just want to say ⁓ Ali Battye: Yes. Yeah. Ruth: I want the thing, you might want to then say I like the thing or let's have more of the thing or I don't want that thing or I can see that thing or I'm thinking about that thing and so there is something I think it's important to know about setting up language because if you are creating bespoke pages for you know particularly if we're thinking about an AAC user's favourite things and we're programming to make it meaningful and you're setting up a brand new page you do need to be mindful of Ali Battye: ⁓ yeah. Yes, Yes. Mm. Ruth: what vocabulary and what language you're including alongside their particular favourite characters that you're trying to create something meaningful for. Ali Battye: Thank Yes, yes and if I'm creating a a personalised page around a child's favourite activity for instance, it can be really useful to just spend some time with them and watch what they're doing with it. So for instance, a teacher asked me if I could create a page around glitter because a child that I work with absolutely loves glitter. So I spent some time just watching what she did with the glitter and so that allowed me to get some like little phrases or phrase starters like gather it up, spread them out, mix them up and they're so and then we could have some sort of mix and match language they're so colourful, they're so pretty, they're so sparkly. So but I just I got that from watching her and just seeing what she was doing with it so that's that's where that person having that real personalisation can be helpful so that you are providing the fun language for that individual. Ruth: Yeah, and I think, you know, historical ways of practicing with AAC kind of get us a bit het up on requesting, don't they? And that's always been the thing of, just want to know what they want. And I want them to be able to ask for what they want. But actually communication is grounded in connection and attunement. And so there is so much importance, isn't there, when we're thinking about working with families and helping them set up AAC or getting to know children and... starting to program AAC for them is that tuning in and that noticing because what we want to do is give them language for what they want to say, not what we think they want to say. And so I think that that's really, you know, ⁓ really important. I've just started working with a new young person actually who's a proloquo to go user, but in very much in like the early stages of it. And I think it's really interesting thinking about Ali Battye: Yes, yes. Ruth: how to program and what we're looking at and what activities are they into and how do we scaffold language for them around those particular interests. They're really big into cleaning and so that means things like the broom and spray bottles and cloths are like the fringe vocab but also some nice phrases like this is fun and... ⁓ Ali Battye: Boom. Ruth: you know, they were spraying yesterday, the teacher and a peer and they were both really enjoying it. But then they were trying to spray a peer who didn't want them to spray and kind of having all that vocab there for adults to model, to practice like self-advocacy language around like not for me or not my turn or your turn and all those kinds of bits and pieces I think are really important for us to consider. And that comes, doesn't it, from actually observing the interactions that the child is having or Ali Battye: Yeah. Ruth: the joy that they're sharing and their non-verbal facial expressions and vocalisations and what might they be trying to say. If you could map language and spoken words onto their being, what do you think it would be? Because that's what we want to be programming into the AAC stuff. Ali Battye: Yeah. ⁓ Yes. Yes, and I would say the communication intentions or the language functions, they kind of mean the same thing. So why is the child communicating? The reason for the child communicating. The most common, I think, for like those early messages is shared joy. Like you said, to say something like, like it, or this is fun. I've had a few children where their first message has been around shared joy. I've had a few children where it's been around transitions like let's go or I'm not finished and I've had a few children where it's been around protesting. Ruth: Mm-hmm. Ali Battye: ⁓ like something's wrong or that's not it. So I think those are really powerful ⁓ to model. And then there's been lots of other children where their kind of first entry into AAC is something so unexpected that we couldn't possibly have predicted it, which is why we want to provide all the words, a really wide vocabulary. Because, you know, like I've had tambourine, that was the child's first word that they loved saying tambourine. Ruth: Mm-hmm. Yeah. Ali Battye: or a mum told me this week that they keep hearing their child say, I'm talking to myself, which is a little message on VokoChat and nobody's shown that child that message, they've just come across it themselves and it was meaningful for them. that's a good example of where having that access to all of the language is really helpful. Ruth: Yeah. Mm-hmm. I think in those early stages as well, when you're kind of wondering about what language should I be adding, noticing those moments where a child is experiencing feeling, like lots of feeling around something, whether that's positive or negative, I've definitely had experiences where if I've had the AAC device and a child's been, you know, getting frustrated, I wouldn't say that level of distress, because actually at that point, we're probably not at the right stage for modelling AAC, but where they've been getting frustrated about something. I remember particularly working with the child who was had been told they couldn't go through a gate, you know that they weren't allowed to go through the gate and this child really wanted to go through the gate and The team working with the child doing a really lovely job of trying to support them to say, know Like ⁓ it's okay like but the gates closed it's finished and I was just introducing like light touch modeling doing little bits and I just sat down on the floor next to them on the patio outside their classroom next to this gate and I found the word gate and I just said one gate open and they looked at me and then I was like, messages, I don't like it and then they think like, say it's not fair and they just looked at me like, huh. You get it. And it was like there was this moment of connection because actually the language that we had access to was really what they were trying to say. ⁓ And I think there's something isn't there about, as I say, it's that tuning in when you're thinking about what language and particularly if you're thinking about phrases, what kind of phrases would your child like to share? It is noticing those moments and what kind of thing would it sound like? You know, I've got other children I work with who, you know, will get really cross at somebody. Ali Battye: Yeah. Yeah. No. ⁓ Ruth: in like a, it's part of their sense of humor. And so they would say like, and so we've added a phrase that's like, I'm telling you off because they'll kind of do this thing and get very animated and they'll be shaking their finger. And, but then it gives them some language to go alongside it, you know, and we've got the reasons that they would normally play telling them off. So you can kind of say like, I'm telling you off because, and it builds it very quickly, but it enables that real connection because the language that's gone in there, Ali Battye: Yes. Yeah. Mmm. Ruth: is because we've noticed and we've observed the things that we think they would like to say. So I think there is, you know, there's really something about that. In fact, it's got me thinking about, um, Brian E. Rust, who's a speech and language therapist has written a really lovely book. Um, I think it's, it's something along the lines of supporting non-speaking children in the early years. Um, but I find myself recommending that book to parents of children of all ages because it Ali Battye: Yeah. Yes. Yeah. Yeah. Ruth: talks so much about that tuning in, that noticing, and can be quite a nice introduction to that particular set of skills to kind of think about. So often our natural reaction is to go into that reassurance, isn't it? And it's okay. And we don't necessarily model the language that the child needs and that they're experiencing. And I've worked with like some Gestalt processes. Ali Battye: Yes. Yeah. Ruth: where you can tell because their language in the moment when they're getting frustrated is, it's okay, it's okay, it's nearly all done, it's nearly all done, it's nearly all done. And they kind of get stuck in this echoing because that's the language they've been given. So I think just, yeah, I would recommend that book for families. Yeah. ⁓ Ali Battye: Yes, it is fantastic, yes. And humour, I think is important as well. So, yeah. Ruth: when. Ali Battye: I've seen so many children really engage with their AAC when they can make a joke and make other people laugh or like you say, get people's attention. ⁓ In Grid for iPad, there's something called Symojis where there's a little animation and a few children that I've worked with have really liked those animations. It's just like a little character and then there'll be bit of sound like wah, wah, wah or blowing a kiss. ⁓ Ruth: No. Yeah. Ali Battye: And a lot of children have really loved that because they can make other people laugh when they use that. Swear words is another, like I've met more than one AAC user that said their way into AAC was being able to say, shit, or something like that. Because that's quite powerful and quite attention grabbing as well. Ruth: Yeah, I'm just in a conversation at the moment for a young person that I work with about moving their vocab from the grid Supercore 50 child to teen and adult. We're kind of navigating while not wanting to gatekeep language because I think that's another important thing, isn't it? Like what language in that vocabulary package is actually important to have access to and what language is beyond? Ali Battye: I don't know. I don't know. Yes. Ruth: kind of where their age is, you know, there's some quite, quite like clear content in there around language for sex relationships, that sort of stuff. So I think it is sort of being mindful when you're choosing language that you're in a very powerful position that we're not with children, we're not normally in the position of power where we can choose what words they say and don't say. And so it is applying the appropriate amount of presuming potential. and of kind of dignity and ⁓ awareness of that position of power so that we're not just taking words away because they make us feel uncomfortable because you know for example a 14, 15 year old might well know and have access to swear words and if their speaking peers are saying swear words then Ali Battye: Yeah. Yes, absolutely. Ruth: there is very much an argument that that should be included on an AAC device for children of certain ages. So I think, there is a piece there, isn't there, as well, around. Ali Battye: Definitely, because we don't want to patronise. non-speaking children as well, because they need just as much, arguably more so, things like accurate anatomical language, language around gender and sexuality. And yes, it does make people, adults squirm a little bit, but we can't shy away from that because it's still needed and earlier than most people think as well. ⁓ I'm just aware of the time Ruth, because we have to go on to other things after this. Just one more thought that I've had is providing access to an on-screen keyboard. And it's sort of linked to what we were just talking about, because if that word that we need is not currently in the vocabulary, we always do then have the option of spelling it, of showing the child the spelling. ⁓ ideally, we can then add it to their Ruth: Yeah. No. Ali Battye: package but for whatever reason no if it's locked down and we don't have editing rights we still would be able to model it by typing it on the on-screen keyboard. Ruth: Yeah, definitely. That's a good one. And that brings me quite nicely into my glimmer actually, which is to do with typing. It's just been a really lovely set of sessions with a young person who is a... They are a speaking individual, but they experience periods of ⁓ not having access to their spoken language. And within our sessions, we might get some single words that they feel comfortable to say or short phrases, but... Ali Battye: Woo! Ruth: They have done so much typing in sessions to share lots of experiences ⁓ that they have. And it's offered space for real connection because there's that just total reduction on my part of expecting them to say everything. And they just, you know, it's just there. It's been there since day one when we started having sessions. Sometimes they'll use grid and spell on the keyboard. Sometimes we just open up iPad notes and they can type there. And it's just for me been a real reminder of how we need to always think about AAC for all people because it isn't just in that sort of non-speaking community. There is that sort of part-time AAC users, you know, and thinking about actually there might be children, young people, particularly around complex conversations around thoughts and feelings and complex social interactions and safeguarding and things. Ali Battye: Amen. Ruth: And so for me, it's been a real reminder in like a really nice way that actually everybody can and maybe does need access to AAC. Ali Battye: Yes, yes, that's lovely. Yes, yeah. Mine came from a parent this week, so I had a WhatsApp message last night and it's a child that think I've probably had three or four sessions ⁓ with and he is just... doing brilliantly with his AAC and his mum sent me a message to say that ⁓ he had got stuck on a, on the kitchen ⁓ worktop, on a stool on the kitchen worktop and he was able independently to say, daddy, help. So two different pages, he navigated between two different pages to do that. So she was absolutely blown away by that and I was absolutely blown away by that. And I have to say that is unusual that a child so early on would be able to navigate in that way. But ⁓ it's so special when you just see that ability that's just been sort of like when it's allowed to be released into the world. It's just magical. Ruth: you Yeah, there is, it? And a reminder that actually AAC, the functions of language are so important because it doesn't start with requesting, does it? There can be so much more. So I've been able to say like, help is just what a lovely thing for us to end on. Thank you so much for this chat today, Ali. It's been lovely. Ali Battye: Anyway. Yes. Thank you, thank you for putting up with my technological issues today. ⁓ Ruth: It's all good. It's windy with you. I might do it's windy here as well, windy Wiltshire. So we will look forward to you guys joining us for another episode and a reminder that if you've got any questions, please do send Ali or myself a message on Instagram because we're collecting all the questions and adding them to our list of things that we can cover in future episodes. So we will see you all soon.