Latest / AAC Access All Areas / How to manage AAC overwhelm?
Transcript
- Ali Battye (she/her): Hello everybody and welcome to AAC access all areas. My name is Ali Bhatti. Ruth Jones: I'm Ruth Jones, and our question today is: how do I manage adult AAC partner overwhelm? Which is so real for so many people in terms of like families, teachers, the people who are supporting communication all day, every day. I think it's overwhelming for speech therapists too, but particularly those people who are there when the responsibility is on you. How do I manage that overwhelm? Ali Battye (she/her): Yes, yeah, yeah. we, yes, like you say, we come across this all the time, don't we? And it's probably one of the most important parts of our job to sort of try and contain that and lead people through a path that feels manageable for them at that time. And I guess surrounding one child who is using AAC for the first time, there are multiple adults. So there's going to be parents or carers, TAs, teaching staff, siblings, peers. And everybody is going to be at slightly different points, aren't they? And have different sort of like feelings and attitudes towards AAC and previous experiences as well. So it's nuanced and it's complex, this one. Ruth Jones: I think isn't that like as everything I feel like so often find myself saying like well there's nuance and it really depends and I think that is so much isn't it because first and foremost is thinking about where each individual that is going to be a communication partner where their firstly where they're just their awareness and understanding of what AAC is before you even get to how they're going to use it is kind of like what do they know it to be and we talked a little bit in a previous episode didn't we about what their expectations are of what it should look like because if we lay that foundation then that can be a really good place to then build their skills to use AAC on. But to begin with it is sort of thinking about if you are listening to this as a parent going, I'm so overwhelmed, I've got this device, what do I do with it? It's kind of thinking about what's your expectations for your child or if you're a teacher, what's the expectation and what do you envisage it looking like Ali Battye (she/her): Yeah. Ruth Jones: Because from there you can then almost take those steps back to go, right, how do we get to that place then? What what skills do I need? What opportunities do I need to offer to the child and myself to learn and train? Because there is an element of this, isn't there, where it's about making it small and manageable chunks for each adult involved. And that will be at different paces for different people. Ali Battye (she/her): Yeah. Yes, yeah, and I think sort of people fall into two very broad categories. This is a huge over generalisation. But there are people who... sort of just want to know the next step, otherwise it's overwhelming. And there are people who kind of like want to know everything, want to have the overview of it. And it's sort of like for us to be sensitive to that, that both avenues are valid and we respect that. when we're first sort of like showing an AAC system, I do like to sort of do a quick tour but I'm trying to gauge that level, that person's level of capacity which is a really difficult thing to gauge I think and it's probably easier if I just ask them like is that enough for now, do you want some more? But I think it is useful for them to sort of like see things like what does the home screen look like, what you know maybe a couple of pages where we might start. Ruth Jones: Yeah. Ali Battye (she/her): So it might be around that child or young person's interests and things that really engage them and bring them joy, that that's gonna be a good place to start. And like you say, it depends on their previous expectations. So some people might have had previous experience of things like PECs or request heavy AAC. So some of those sort of like legacy Ruth Jones: Yeah. Mm-hmm. Ali Battye (she/her): AAC practices where it was all about the requesting, that might be that person's understanding of what AAC is. And so sometimes we're sort of completely blowing that up, aren't we? changing that perspective. No, actually, this is going to be so much more fun than requesting and having, it's going to be so much more fun than having a predefined idea of what this child is going to use their AAC for. This is the start of an adventure. We don't know where we're going. Ruth Jones: Yeah, that's it, isn't it? And like what an exciting adventure to be on because you're basically becoming a language teacher. And language is so rich and so varied and it offers so much to people who have good access to it and that's kind of where we want to come at it with AAC. Ali Battye (she/her): Mmm. Ruth Jones: But I think I find I actually created a little journal for my families and the teachers I worked with where it's like a a week in a on a page. You're like, right, this week, what's gonna be our little mini goal? And I think some families have found that really helpful just to have something written down where they're like, okay, let's let's almost team around the table, it's Sunday night tea, what we're gonna focus on next week with that child's AAC. And so we've just captured little mini goals. So whether it's like, we're gonna explore the messages section. Ali Battye (she/her): Yeah. Ruth Jones: On super cool, and we're just gonna focus on one page there, and that doesn't mean that they're not using it at other times, but it is about managing their overwhelm with the amount of vocabs. So their child has still got access to their AAC all day, every day. The adult communication partners will still be doing other bits of modelling, but if they're not, it's giving themselves that space and that kindness to go, this is a lot. So if I haven't done lots of modelling this week, have I at least done the one? Ali Battye (she/her): Yeah. Thank Ruth Jones: Thing that we said we were going to do, and I think that's sometimes it fits quite nicely, doesn't it? I I love the way you talk about that kind of offering lightly, and I think it fits quite nicely with that. Lightly offering a bit of AAC so that you can not feel so overwhelmed because otherwise, you can always feel like you've got to model every word that you say, and then you get lost in folders and you just go into a dithery wreck. Ali Battye (she/her): you Yeah. Yes, yes, yes. And we're aiming for AAC to just be part of communication, aren't we? Because communication is already there before we introduce AAC. So children already have ways of communicating. We're just adding another modality to that. And I think I have seen this in the past, that sometimes when AAC is introduced, all of the focus goes into AAC and modelling the AAC. And sometimes that feels like it ignores those other beautiful ways a child was communicating. And, you know, family might have been able to communicate with their child really well and know things like their regulation and almost like doing that mind reading that if someone knows you really well, they they can often sort of like do a best guess as to what might what you might be thinking because you've got all of those shared references through life. And I think in the past, sometimes the way AAC was implemented didn't honour that. It almost didn't believe families when they said, we understand everything that they say. And I think now we're sort of like back into more of an appreciation of, yes, this child who we're introducing AAC to does already have a lot of communication through the way they move, through their vocalisations, through things like stims and glimmers, and they might also have some spoken language in there too. And so we don't want to stop in any of those things, those things are still really important. And there might be times when AAC is not welcome to that child. They don't want to use their AAC in that moment and that is fine. I'm sure I've talked before, I'm sorry if I repeat myself on this podcast, because I do forget what I've already said. But I think I've probably already said that there are sort of like natural rhythms of engagement and where sometimes AAC suits the moment perfectly. And sometimes it doesn't. Sometimes our non-verbal communication suits the moment perfectly. You know, it might be a look, it might be leaning in, and we don't want to interrupt that moment with AAC if it's not kind of welcome in that moment. Ruth Jones: Mm-hmm. Yeah, my brain's gone to two places with what you've just said. One I'm thinking about is a very concrete example. A couple of weeks ago, I was with a student, and lots of the schools in Wiltshire and Somerset closed because of the heat wave, and I was with them for their regular session, and the school was shutting early, so I then was sat with them in the classroom while they were waiting for the transport. And they were the last one, and they'd waited for ages and they were so fed up, and you could just tell they just wanted to go. And I programmed and I was like, waiting is so hard. And they looked at me and I was like, I was like, I know, you know, and I'm signing while I'm chatting to them. And I got their AAC and I went into I was like, hmm, we don't have the words. So I was like, messages, say, and then I was like, edit, and then I talked through as I was typing and they were watching. And I was like, waiting is rubbish, exclamation mark. And I saved it and then pressed it, and they looked, and then they were getting everybody in the class's attention, all the TAs that were still. left 'cause the other students are gone to be like a and say, like waiting is hard. And that would be you know, that student in particular is the kind of student where they're like, they don't really use their AAC much because all of their other communication is so Ali Battye (she/her): Yes. Yeah. Ruth Jones: brilliant and their multimodal is is on it so much that people find it hard to know when to capture those moments. But that was just one of those beautiful bits where AAC really fit because that validation I offered with my spoken language and sign meant that Ali Battye (she/her): Yeah, yeah. Ruth Jones: they connected with me to go, you see what's going on here. And then when I gave them the AAC language, which they didn't have in gesture and vocalization, they were really on it. And the other place my head then went to was thinking back to like my earliest job when I would stand and deliver training around the picture exchange communication system and talk about how we could implement it in classrooms. And I would be that therapist that said if a child points to something or gestures Ali Battye (she/her): Yeah. Ruth Jones: And you know what they want, you need to redirect them to their PEX book because somebody somewhere in the future won't know what they want, or if that thing is not available for them to point to, they need to know there is another way to ask for it. And I just think back now to how many moments of what could have been beautiful, real attuned connection were lost because of that adult perception and almost like that overwhelm of. Ali Battye (she/her): Yeah. Ruth Jones: I need to I need to redirect them back to the thing because that's what the the manual said. Do what the manual said because I am a robot doing my robot duties. And I think then when you kind of like rip up that manual of whatever it is and go, how can I really honour and affirm? And that's the thing, isn't it? I think to manage your overwhelm is to really think about what communication is and Ali Battye (she/her): Yes. Yes. Ruth Jones: I use the word lot, but that richness, because it isn't just about putting into practice the AAC and you know, we talk, don't we sometimes about modelling without expectation and I think that can in in itself be quite an overwhelm but what do I model? When do I model? How do I model it? And we've talked about that in previous episodes. And so I think it is just about noticing what's showing up for you when you're feeling overwhelmed with AAC, why is that? And is it because you don't have a tangible goal? Ali Battye (she/her): Yeah. Yeah. Yeah. Yeah. Ruth Jones: And I don't mean like a smart child, I mean just the thing to focus on to help the overwhelm. Is it because you have kind of your child is not necessarily responding how you expect them to? And do you need to maybe challenge what your expectations are? There is so much about being a communication partner generally, but specifically with AAC, that is about our own awareness of ourself and our regulation and our learning and always like being attuned with our Ali Battye (she/her): me. Ruth Jones: ourselves. Ali Battye (she/her): Yes, yes, yes. And I think as well, it is helpful to have a speech and language therapist on board if that is possible, because I wouldn't expect parents and teachers to have that sort of like granular knowledge of what is language versus what is communication. versus speech. So most people get those, you know, like what is the difference between speech and language? So speech is the mechanics of how do we get the words and the phrases that are in our head out using our mouth, lips, tongue? So that's just one tiny part. And language is the actual what's going on at a brain level with what are the words that we need, how do we put the words in the right order to make a phrase and a sentence? So that would be grammar. So we've got vocabulary, we've got grammar, and we've got why we communicate. So sometimes that's called the pragmatics or communication intention. there's kind of like three broad strands that I would be thinking of. And that wouldn't have occurred to anybody else probably but a speech and language therapist. So sometimes it is really useful to have someone on board who can guide that journey a little bit and think about, OK, what vocabulary might your child be interested in? How could we put that vocabulary into a couple of short phrases? you've got Gestalt language processor, go back to previous episodes if that is a new term. But if you're working with or your child is a Gestalt language processor, we might want to start with phrases rather than single words. And the place that I really, really like to start is what are the reasons for communication? So those communication intentions. And we really want to be very person-specific or child-focused in thinking what would they delight in using this AAC? What would they find fun and engaging? And that is a lot. recognize that that is a lot. So having someone to sort of like coach you or, or, you know, guide you through that process, I think is really helpful whilst also recognizing that a lot of people don't have access to speech and language therapy. And that's kind of like why you started this podcast Ruth, wasn't it? So that we can sort of talk you through things. But yeah, those are the three elements that I really think about with AAC. vocabulary, the grammar and the communication intentions. And so if I was to be doing a sort of like little tour for a parent or a teacher or teaching assistant, I would be sort of like showing them the rough areas of the AAC app from the home screen. So maybe going into things like my messages, which might have a range of communication intentions. So it might have some like sharing ideas, messages, it might have some protesting. messages, it might have some self-advocacy messages. And then I would be thinking about the vocabulary. So we might go into topics. So most AAC apps would have some sort of topics area where you've got things like your food and drink, your animals, transport, clothes, parts of the body. And then I would be thinking about showing them how can we build phrases like either word plus word type phrases or if we're thinking about a gestalt language processor, having some pre-made phrases there that we hope are going to appeal to them. So that would be my quick tour. And if people's eyes are glazing over and just going, what the... I would like cut that short and perhaps say, right, what does your child love? Let's go into these two pages. Let's aim to model a few words or phrases from these two pages. And then the next time we talk, we'll find out how that's gone. And we might have a couple more that we'll explore. So, yeah, that is how I often approach things if I'm sensing a bit of overwhelm. Ruth Jones: Definitely, and I think it's you know it's important, isn't it, that we recognise that not everybody will have access to a speech and language therapist to support with this, but that and I think we both advocate, don't we, that if you can't get a therapist on board, that doesn't mean don't do it. Equally, it's sort of managing your own support network, isn't it? And finding other people. I think that's one of the the there are dangers around social media and some of the information that's shared around autism support strategies. Strategies, but I also think there is so much good that can come from if you are going it alone because you don't have financial privileges to pay a therapist, or in your local area, there isn't kind of a access to therapy through independent or through you know sort of healthcare services. or even I've got some children who are in special schools, but their SLT service there can't provide AAC. Ali Battye (she/her): Yeah. Ruth Jones: So, whatever your journey is with speech and language therapists, I think finding a network of people where you can listen and you can learn, not compare, because that is the thief of joy, but kind of listen and learn from other parents and teachers who are thinking about how do they embed and integrate AAC. as I say, it's kind of knowing where is it where what are you seeing and how do you know if what you're seeing is a good way of doing it and not so good, and that is where speech Therapists come in with a particular set of knowledge and skills that we have to add to the knowledge and skills of the other people that are in that child's life. But I think there is something about community and network with AAC, and whether that's even at a family level, you know, I've met with families where it's been that initial AAC, we want to set it up. Do you think it could work for our child? What does that look like? And I've met with grandparents with the parents, and we've all talked about it together. Ali Battye (she/her): Thank Anyway. Yeah. Ruth Jones: And so I think looking at who else in your family could be a little AAC ally. So when it is feeling a bit much, you might not have a speech therapist on speed dial, but you maybe have your parents or your siblings who are your child's uncles and grandparents that you'd be like, they did this today, or god, it felt a bit much, or I don't think I did enough today, you know, so you're sharing the load together. Ali Battye (she/her): Yes, yes. Okay. you. Yes. Yes, and the beautiful thing about having different people involved in an AAC journey is everybody will bring something different because they will have different ways of interacting with that child or young person and different interests that they share with that child and young person. So, you know, like one person might really love physical play, so they might explore the actions page. Another person might enjoy baking with that child or like do a messy play or something. So they will explore some different pages. They might go, you know, like use a lot of describing words or go into the baking page, say. And another person that might be their worst nightmare, they hate getting sticky fingers. So they might enjoy exploring the TV page and like what can we choose to watch? And is there some more language like play it again or not that one that they can be exploring? So it is, it is a, there is a real beauty in having lots of different people doing slightly different things and adding to that richness. And I loved what you said, Ruth, about finding out about other families because that can be a real source of inspiration, can't it? Like there are, there are accounts on Instagram that occasionally I will see a little reel. So there's one called AAC brothers and I love seeing what they're doing cause they will, you know, share what they're thinking about this week and it might be around books or it might be around, I don't know, I can't actually think, say Star Wars or something like that. And it just, you know, sows that little seed of like, yeah, that's what AAC can do. I think they did one about the calculator page that one of their boys was like really engaging with the calculator this week. So yeah, just exposing yourself to real families' experiences of using AAC. not thinking, I've got to get my child to do that, therefore, but using it as a bit of an inspiration of I wonder whether they might like something similar. And I do like that question of like, I wonder what else they might like, rather than how do I get them to do X. So it's sort of like offering new experiences, but with no obligation that they have to do something as a result. Ruth Jones: Which I think is where that phrase kind of model without expectation. So you might be showing them a page linked to something that they're doing, and if it doesn't catch them, no big thing, because you you need to be doing that without an expectation. And I think holding that in mind, and also I've talked a lot about this as well lately, that that the concept of sort of your locus of control. So if you're in the middle of a circle, you are in control of what is just around you, and the next Ali Battye (she/her): Yeah. Ruth Jones: circle out you're not in control of. And so the next circle out is actually that child's uptake of AAC. You're in control of how you deliver it, of what you deliver and when, but their uptake you're not in control of. So you could be doing your best thing, but if they're not in the mood, they're not in the mood and so there is something I think holding on to holding on to that. that feels important. Ali Battye (she/her): Yeah. Yeah. Yeah. Yes. Yes. Yes, and we want to be sensitive to when they're not in the mood because that will only sort of like build that connection and trust in us as communication partners. If we were to sort of like carry on relentlessly modelling and they're really giving us strong signals like not right now, we potentially are going to break that trust in us as attuned communication partners and reduce their interest in AAC. So it is sort of like really, I suppose monitoring their levels of interest and responding accordingly. And I don't think you can go far wrong with that. If you are finding that a child is just like constantly disengaged, then coming back to the question of, I wonder what else they would find interesting or I wonder what they would find interesting. And also just thinking about, am I losing the connection? am I not honouring their multimodal communication because I'm so focused on the AAC. So that might be a couple of like troubleshooting things to think about. Ruth Jones: Yeah, I think so, because I think at at the heart of it it has to be about that kind of relationship and that connection, doesn't it? which leads us quite nicely on to this week. We we had a little chat, didn't we? And and we quite often share glimmers and they are things from our day to day clinical therapy practice, which always sounds really medical. I need to stop saying that. I don't really know what else it should sound like. But you when we talk about ourselves as clinicians, I sort of think like Ali Battye (she/her): and therapy experiences or something like that. know what you mean because it makes clinical practice instantly sets up a power dynamic doesn't it? Like in my clinical experience and it makes us sound like we are trying to prove something, we're a bit insecure and we're trying to restate our status here because I found it in clinical practice. Whereas like in my therapy experience I don't think has quite Ruth Jones: Does Yeah. Ali Battye (she/her): that same, I'm going to stamp my authority on this situation. Ruth Jones: Yeah, that's it. I thank you for reframing that for me because as it came out of my mouth I thought, I'm not I'm not sure. I don't like this. but we thought we'd share a joint glimmer this week because Ali very kindly emailed me a research article that's come out and I am just gonna read the title of it and then we can kinda get into the glimmer of of what it was. So the The title of the paper is Affective Resistance in Augmentative and Alternative Communication, A Reflexive Case Study in Autism. And it's written by Gomba and Bach and it was published in twenty twenty-five. Ali Battye (she/her): 2025 I think. Yeah. Ruth Jones: In December. So the I'm going to read a bit from the abstract actually, and then we can kind of have a little moment to recognize the glimmer. Does that feel helpful? So the objective was to examine how effective resistance in AAC technology emerges within parent and child interaction and how effective communication and play influence communication engagement. So they they use the reflexive case study to look at observation and diary entries of AAC. Ali Battye (she/her): No! Ruth Jones: Users an autistic individuals. And basically the conclusion was that they massively advocate for a paradigm shift when we're working with AAC from it being about the tool and that that AAC tool and compliance with the tool, which is what I was talking about, how I used the practice with PEX. You know, it wasn't about what the child was wanting and talking about, it was the tool, and we must have compliance with the tool and use the tool. Ali Battye (she/her): Mm. Ruth Jones: And they are they basically found in their kind of study, and they're now advocating for a shift that we contribute to AAC discourse by integrating embodied caregiver experience with communication theory. And I think that so beautifully aligns with what we've been talking about today. But I think perhaps for the other people, we know what we're hearing when we read those words. But Ali Battye (she/her): Yes, yes. the title in itself, so it's called affective resistance. What does that mean? Because it's affective with an A. It was basically what when a child pushes away an AAC device or system. Ruth Jones: Bit of the the translation. Ali Battye (she/her): So they are rejecting that and historically in speech and language therapy that might be seen as a negative and the child's problem, like they're not ready for it. I've heard a lot. But what one of these authors who is also a parent of a child using AAC has said is that they now see that as a positive communication act. That child was saying, no, this isn't the right communication mode for me right now. Ruth Jones: Mm. Ali Battye (she/her): I was just busy leaning into your body and getting some co-regulation, or I was busy copying your faces or copying your vocalizations and having fun with you on a sort of like bodily level, non-verbal level. And then you have just interrupted that connection by refocusing my attention onto the AAC device and that was not what I wanted. So now I'm gonna push it away. So they're sort of talking about these instances where that happens. and they're reframing that not as a negative, but as a positive that that child is able to express that. So in that moment, their communication intention is protesting and self-advocacy. And I think it's really interesting that they're sort of like noticing what happens in real life. This is the joy of having a parent and researcher who can say, is our lived experience of what happens when you push an AAC system. and forget about all the beautiful multimodal communication that's happening. And so they are adding to our awareness of we don't want to do like talk programs where we learn about nouns and then we learn about verbs and then we learn about adjectives and we we do call words in this order. First we start with more and then we go with look or go and we always do it like that. They're basically saying please don't have a predefined list of skills that you're going to tick off in the same order for every single child or young person. This has to be personalised for what this individual is interested in and it has to respect the multimodal communication alongside. Ruth Jones: Isn't that so beautiful? And I think brings us quite nicely to coming back round into our question today about managing overwhelm is offering yourself as an adult communication partner that same grace that you should let yourself lead. If your energy feels low, if you're feeling overwhelmed, lean into that and notice that and think, let's not push myself to do lots of focused AAC modeling. Or if, like you were saying, if you're a baker, model. Ali Battye (she/her): Mm. Yeah. Ruth Jones: Baking because that's probably where you're gonna have a lot of joy with your child, or you know, if it's bath time, then model bath time because that might help, you know, with your your own reduced overwhelm as well as the child, and just so much of it comes back to that tuning in, doesn't it, and really noticing a child in their whole communication being those little looks, those little facial expressions, the the way that their body's moving, the Ali Battye (she/her): Yeah. Ruth Jones: the tone of their body and that's quite a difficult thing to describe, but you know, like we'll talk about tone of voice and picking up one like that. But actually I think with some non speaking children you can almost tell their tone by the the speed of a movement, the force of a movement, the the gentleness of a movement, you know, all of those things. So Ali Battye (she/her): Thank and Yes. Ruth Jones: I will put a link in the show notes to that research article. I don't know if it's open access, but you can usually request things from the authors if you're desperate to read it. But the abstract is definitely available. So I will pop that in the notes for everyone. Thanks. What a good chat today. It's been lovely. Ali Battye (she/her): Thank you, Ruth. It always is. Ruth Jones: We will see you again soon. Ali Battye (she/her): Take care everybody, bye bye.