Augmentative and Alternative Communication and Socialization
Many children who have disabilities are now being included in regular education settings with their non-disabled peers (American Speech-Language-Hearing Association 36). This is due largely to the passing of the Individuals with Disabilities Education Act (IDEA) in 1975. The inclusion of these children is aimed at achieving two main results: the improvement of social interaction of the disabled students, and the understanding of disabilities by their non-disable peers which leads to tolerance and acceptance of disabled peers in the classroom and throughout life. However, research has shown that by simply including these children in the same classroom, the desired results are not achieved (Saninato & Carta 94).
For the proposed results to be achieved, there must be programs in place to target classroom practices including the structuring of activities and groups to meet all of the children’s needs, the education of the teacher on the needs of each child, and the knowledge of non-disabled peers as to how to interact with their disabled peers. This is especially true of children who use Augmentative and Alternative Communication (AAC). AAC covers a broad range of techniques and strategies, from simple picture boards to sophisticated, computer-based communication devices with synthetic voices. Other examples of augmentative and alternative communication may include facial expressions, gestures, body postures, eye-gaze, sign language, drawing, and writing. Due to the fact that many of their peers may be unfamiliar with the technology they use to communicate, this leads to negative attitudes towards the child and a tendency to avoid interaction with them.
Many children who have severe speech and language deficits rely on some form of AAC to supplement or to substitute their ability to communicate orally and increase their interactions with peers and others in daily life. The problems that students encounter with AAC are that it is not natural speech and is produced at a rate that is much slower and less intelligible than normal conversation. This leads to interactions that seem tiresome and boring for users who are not familiar with the process and for many children turn taking is hard enough, let alone when patience must be involved to have even a conversation with a peer. This causes child AAC users to come in contact with fewer opportunities to communicate with their peers, and often leaves them to communicate mainly with adults (Light 67). Because of a lack of interaction with their peers, these children are further isolated in social situations amongst peers, such as the classroom.
It is believed that because many children are not given the opportunity to interact with disabled peers on a long-term basis that they are never given the opportunity to learn about disability or why their peer must make use of an AAC device to communicate (Rosenbaum et al. 520). Since non-disabled children are not exposed to and properly educated about disability, they are left to form their impressions of people with disabilities from various encounters and snippets of information from educators.
Suggestions for educating children about disability include simply telling children about the use of AAC devices and what to expect when encountering someone who uses them, role-playing games to have speaking children pretend to be non-speaking to allow then the chance to see how it feels and the challenges they face. It is proposed that role-playing will allow the child to better understand the causal and attributional characteristics of the other person and to allow them to explore their own thoughts and feelings about the person and their situation (Meyers and Jones). Because the attitudes of children are being influenced by what they are learning from teachers, it is important to know what kinds of information and situations in which it is presented they will best respond to the information.
To look at what scenarios would be best and to see what the attitudes of children were to peer users of AAC, Ann R. Beck and Heidi Fritz-Verticchio designed a school-based educational program to look at several related factors (Beck and Fritz-Verticchio 56). They wanted to know if role-playing would be the best way to teach information regarding AAC to children versus solely providing information, if the children’s grade level makes a difference in the preference to information alone versus information coupled with role-playing, and if gender influenced from which method the children retained more information.
They set out to get the answers to their questions by conducting a 2 year study of ninety-five children in grades 2, 4 and 6 who all attended the same elementary school in a small suburban town where the majority of the students were white, non-Hispanic; however each minority group was represented. The school had no attendees with significant disabilities and 76% of the students involved in the study said they did not no anyone their own age with a disability (Beck and Fritz 53). It may seem strange to do a study on the communication and socialization patterns of children towards disability when they have never encountered it, but the researchers felt this would be the type of group of children that an educator would try to educate about a new student with a disability who used AAC and would best test out the various methods of communication and education.
In this study they had on group of children watch a videotape on AAC and its uses and then had the other group saw the video and participated in a game of Go Fish while using only communication boards to communicate during the game. The communication boards were 81/2 inches by 14 inches of paper and had four rows of eight pictures that related to how to play the game. These pictures included things like numbers and the words “go fish” and “do you have a.” The children were asked to role play as if they were an AAC user and then were asked to answer the Assessment of Attitudes Toward Augmentative and Alternative Communication (AATAAC), a series of questions about how they felt about AAC, its users, and their experience. The results of the answers to the AATAAC showed that those children who had the opportunity to role play in addition to watching the video had much more positive attitudes towards AAC users than those who had been exposed to the information video only. In addition, the older children were much more likely to have a more positive idea of AAC when they were allowed to role play than younger children.
This suggests that older children’s attitudes are more easily influenced when they can personally relate to the AAC user and what they feel. This was further supported when during testing older children who had played the game responded to questions about AAC with comments on how they found it difficult to say what they wanted and felt held back whereas children exposed to the video only commented on how the devices they had seen in the movie worked. This study also showed that although boys’ attitudes towards AAC are usually poorer than those of girls, those boys that had role played during the study had attitudes that were closer to the girls, and had a more positive idea about AAC and its users.
This study shows that just the presence of a disability hinders social interactions between children. However, once an AAC device is added into the mix, the situation becomes that much more awkward and uncomfortable for both children. Because the non-disabled child has never been exposed to a thorough education on disability or on AAC, they are made to feel uneasy around their peer simply because they have no idea of what to expect, how to act, or if it is alright for them to interact with this “sick” child in the same way they would a non-disabled peer. Many stereotypes about disability are taught inadvertently to children when adults refer to disabled persons as “sick” in order to avoid a long explanation to the child, or because they simply do not know the answer themselves. This approach may seem to be appropriate since adults may feel the child would not understand the explanation, but it is not the best approach. It is better to have the child know that the person is disabled in a different way than a friend who is ill with the flu. A better approach would be to explain the disability, even if only a bit of information is known, to the child and discuss questions the child has openly. If adults pass off disabled people as sick, a child will too, and when they encounter a peer who is disabled, they will be less likely to socialize with them on a basic level, let alone making time for conversation.
When adults who are also teachers are taught how to interact with disabled children, improvements in interaction in school-aged students with intellectual disabilities increase interactional opportunities for the student with peers. Mirenda and Donnellan (1986) found that conversational exchanges with school-aged students with intellectual disabilities were improved when teachers were taught to adopt a more responsive interactional style. In other words, when a teacher is properly trained, and personally invested, in the ways in which these children’s specific disabilities need to be approached, the child has a better experience. Likewise, if the child is having a better experience in the classroom with their teacher, they are more likely to interact with other students since there is an example of behavior set by the teacher for the class.
Peers can also play a significant role in facilitating and developing communication. They form part of the regular opportunities for positive social interaction and can provide reinforcement of the disabled child’s skills. Teacher prompting and reinforcement can be intrusive in some activities among students and hinder the socialization that is occurring; therefore peers can effectively support social interaction in these situations. In addition, a recent study by Ostrosky and Kaiser (1995) reported improvement in the patterns of social interactions of school-aged children with developmental disabilities and peers, following the training of peers in interaction skills. However, if children are not given the educational background and skills necessary to interact with their disabled peers as communication facilitators, a major portion of the disabled child’s socialization and communication skills are impeded.
Communication is fundamental to almost every aspect of daily life. AAC for students with severe physical disabilities has the potential to facilitate language development, organization of thoughts and ideas, and most importantly, social interaction. However, it cannot be supposed that the simply setting up an AAC system for the disabled student will necessarily result in increased or satisfactory interaction with their peers. Implementation of programs to teach peers to facilitate communication with AAC users, as illustrated in this study, may be one useful approach to increasing social interaction and hopefully enable better social exchanges to occur in settings where the children have been integrated in eth classroom, and elsewhere.
This is especially important to myself as a future Speech Language Pathologist specializing in AAC, and perhaps more importantly, as the parent of a young child. Knowing the ways in which children’s attitudes about communication and people who communicate in different ways are shaped is vital to knowing how to educate my son, and my clients about AAC and disability. Having an idea of the challenges faced by young children who use AAC and are learning to socialize will also benefit me in prescribing AAC devices for children and in designing the best device for them to use and in educating their parents on how to educate their child’s peers on their disability and the device they must use.
I have a vested interest in determining the best ways to help children with and without disabilities develop the ability to communicate by whatever means they have available to them. In order to make the biggest difference in the lives of these children I must be aware of the issues they face, both medically and socially. I am confident that with larger education programs targeted at teaching young children about disability and its related issues, like AAC, our children will grow up with a tolerance much greater than they have in the past and will be able to influence their futures towards one with fewer prejudices towards disability.
Works Cited
American Speech-Language-Hearing Association. “Inclusive practices for children and youths with communication disorders: Position statement and technical report.” ASHA 38.16 (1996) : 35-44. Beck, Ann R., Heidi Fritz-Verticchio. “The influence of information and role-playing experience on children’s attitudes towards peers who use AAC.” American Journal of Speech-Language Pathology 12 (February 2003) : 51-60. Light, J. “Interaction involving individuals using augmentative and alternative education: State of the art and future research directions.” AAC: Augmentative & Alternative Communication 4 (1988) : 66-82. Meyers, C. and T. Jones. Promoting active learning Strategies for the college classroom. San Francisco: Jossey Bass, 1993. Mirenda, P.L., A.M. Donnellan. “Effects of adult interaction style on conversational behavior in students with severe communication problems.” Language, Speech and Hearing Services in Schools 17 (1986) : 126-141. Ostrosky, M.M., A.P. Kaiser and S.L. Odom. “Facilitating children’s social-communicative interactions through the use of peer-mediated interventions.” Enhancing children’s communication: Research foundations for intervention Ed. A.P. KAISER & D.B. GRAY. Baltimore: Paul H. Brookes 1993. 159-185. Rosenbaum, P., R. Armstrong and S. King. “Children’s attitude toward disabled peers: A self-report measure.” Journal of Pediatric Psychology 11 (1986) : 517-530. Sainato, D. and J. Carta. “Classroom influences on the development of social competence in young children with disabilities.” Social competence of young children with disabilities. Ed. S. Odom, S. McConnell and M. McEvoy. Baltimore: Paul H. Brookes 1992. 93-109.
