Today’s featured domain discussion is around Domain #2.
The goal: To own an efficient and individualised communication system (often including more than one tool) with appropriate vocabulary to meet current and future communication requirements.
The key points for this goal are:
- individualised
- often more than one tool used, &
- appropriate vocabulary to meet current and future requirements.
Why is this domain important?
Although this domain is not specifically related to the skill level of the individual, a comprehensive or robust system is a key requirement for communicative competence. Without access to a system that meets their needs in all environments with all partners, communicative competence in all settings is not possible, nor is the ability to develop that competence. As Gayle Porter notes, a key challenge for those of us supporting individuals who use aided symbols to communicate, is to provide sufficient vocabulary to both meet their present communication requirements and to stimulate the further development of their communication and language skills. (PODD Communication Books Introductory Workshop Manual, 2018).
It is also important to consider the efficiency of communication in each setting. If a person has the vocabulary to ask for their train ticket but takes too long to create the message and they miss the next train, then the system is not really meeting their needs.
A common phenomenon is that when an individual, or communication partner, has access to a comprehensive system (one that has vocabulary available for all situations, settings and partners), there is a tendency to use this for everything. Yes, it may have the words, but is it the most efficient way to communicate for all messages?
It’s very important that we support people with communication challenges to use a multi-modal system (not just one device) and to have a range of strategies available for communication. In some instances, a non-electronic communication book may be more reliable and less fatiguing for the person to use, but at other times, it will be important to ensure they have voice output so that they can be heard when the other person is not looking or on the other end of the phone. At other times, a single card to ask for a train ticket may be more effective and efficient than using a communication device. Most importantly, we are always considering strategies that help the person to communicate for a range of purposes, environments and with varied partners.
Another key consideration with this domain, is that a person’s score may drop if their competencies in other domains increase.
Consider this…
As a person using AAC develops their language skills and begins to combine words as reflected in their score on ROCC Domain 6, they need their system to develop with them. A person may score 4 or 5 at first assessment if they own a comprehensive and individualised system that meets their needs. But… as their language develops and they are learning to combine words more readily, their score may drop (since the system no longer meets their current and future needs). If you notice this, it is probably an indication that you need to update their system. As current requirements increase, so do future requirements and you will need to expand their system to support further development of their language and communication skills.
The other key factor in this domain is that the system should belong to the person, and include the words that they want to say. Though much of our expressive language consists of core vocabulary, we all have specific words and messages that make us individual and are suited to our own personal environment. This includes our close family, friends, pets and community, as well as the things we like to do, places we go and some of the specific stories or phrases we like to say. This can only be achieved with a personalised system and one that suits an individual’s specific motor, linguistic, cognitive and sensory/perceptual requirements.
So, in ROCC Domain 2, the following descriptors would describe an individual as emergent, transitional or independent/competent.
Emergent
Has only limited access to a comprehensive vocabulary ranging from none to a comprehensive system that is available in their environment, but not their own system and so that system would leave the room if the person carrying it leaves the room. In this group, an individual may have their own system but one that has a limited vocabulary which restricts their language learning or the range of functions they are able to communicate autonomously.
Transitional
The individual has a system they can call their own, but it may not meet their needs in all situations, or their speech or signs may not be understood in all environments and with all partners.
Independent/competent
The individual is able to meet their current and future communication needs across varied environments, partners and for a range of purposes. By future needs, we mean that it supports next steps in development, rather than a system that may be too complex to support learning.
As you score this domain, be sure to consider whether this is the area that is impacting on the individual’s ability to become a more autonomous and competent communicator. Sometimes, if communication progress is not as expected, there is a tendency to intervene and change a person’s communication book or device because this is something we can easily do by prescribing or making something new. However, without the right goals or progress in the other domains of the ROCC, a new device will likely not have the impact that is intended. The person must then allocate their cognitive resources to relearn a new page set or symbol set rather than developing their skills required in the other domains.
On the flip side, giving an individual exposure to aided language within the environment is a great start to provide them with opportunities to learn. However if that system is not their own, or individualised to suit their requirements, then they can only use it when in specific environments and will not have access to their own specific vocabulary. It’s important that those who use aided language systems not only have a system available to them but that it is personalised to meet their individual needs.
What can I do?
First of all, consider the current and future communication requirements of the individual. Consider whether they need their own personalised system, and whether it has enough vocabulary to meet their communication and language requirements. Also consider adjunct systems to meet more specific needs such as environments, communication partners and purpose. Creating and/or prescribing an AAC system is not a once-off task. You must continually review, update and add to it just like we do with our verbal communication repertoire.
Robust (comprehensive) communication systems such as devices can be purchased from suppliers, or as apps on the iPad, you can also look at non-electronic communication systems such as PODD (Pragmatic Organisation Dynamic Display) books. You can make these yourself, or in Australia, can contact organisations such as Two Way Street who provide a PODD making service. You should always consider a non-electronic back up if the individual’s primary system is electronic. In Australia, all of these are eligible to be funded by the National Disability Insurance Scheme.
In addition to a primary system, also consider adjunct or supplementary AAC supports such as Community Request Cards, Aided Language Displays, sign language or key word sign, as well as gestures and body language. Additionally, if the person’s primary system is speech or sign, but does not meet all of their current and future communication requirements, this might be the time to think about adding AAC supports.
