When Should Your Child Need a Communication Device

Hey, so we're going to talk about whether your child needs. AAC is an assistive device, augmentative alternative communication device. Quite a long word. Anyways, so when do you need it? So basically we only use it when your child cannot effectively, like communicate verbally. So there are loads of definitions about whether a child can verbally communicate or not, Right? Different countries, different settings, different cultures is very difficult for me to tell you. Right. So in this video I'm going to lay out about what I personally think and what my clients are seeing results with communicative devices. I cannot say about other people. And obviously there are different scientific journals trying to outline whether communicative devices would help with children who are verbal. Right, so you can Google search that. It will make you even more confused if you're a parent. But anyways, let's dive in. The reason why we're doing this here is because a parent who I'm working with in Australia, she told me that daughter was already speaking, but the speech therapist asked her to get a communicative device, an iPad that she can bring around and talk to people and press buttons, right? So that one I actually disagree on. And the reason why is because, because I've been working with a kid and we're working on like two to three word sentences now. And yes, you know, like when she's at home playing with mom, she can speak like like two to three words, but at school maybe she doesn't really speak anymore, right? Maybe it's just one or two words or just some gestures, whatever. But let's say that if you bring in a tablet, right, to a setting, in a primary school or elementary school, depending where you are in the world, what's going to happen is like the kids are, you know, you and I, we've been kids before, right? We see an iPad, someone's different, and we're going to say, what are you doing? Like, why do you have a tablet? Why can't she just talk? And that's number one. Number two, is the kid gonna really use that tablet? Because what's more communicative is that the body language coming over and tapping the kid or like pulling them over or pushing them like lightly, of course, not violently. These are actually appropriate for kids. You know, they run around, they play catch, they do whatever. And these body languages are fair. And the thought of having a five year old holding out an iPad and press buttons and then showing the other children about what they want to say is kind of ludicrous because why, first of all, the five year Old herself needs to have the patience to press the buttons. Right. And secondly, the other person who's receiving the message requires that the same patience to wait for her to finish her message. And maybe it's like, I want to play with you then. And then like it's very difficult, right. So I would not recommend you to give a child who goes to school with, with like a. Who's verbal and have a lanyard with like a huge iPad on her chest. Right? That's not cool. Okay, so who is the communicative devices for? Okay, so there are two types. Number one are nonverbal children who have a lot of language communicative. Like they're very communicative, but they can't talk. Right. So we're talking about children with disabilities, maybe cerebral palsy, right. Maybe children who have sort of dysarthria. Okay. Maybe children who have some sort of paralysis in their focal folds. Right. Children who already have like general just physical disability and they have some sort of like disorder that cannot allow them to talk properly. So they have to use an assistive device. Right. So you might have severe apraxia of speech, these types. So you think about these things not being, trying to be offensive. But think about Stephen Hawkins, right? He can communicate, he has thoughts, he wants to communicate and he cannot, he doesn't have the means to. Therefore we will give them an iPad and they can press and they can communicate now. Right? That's the first type. The second type are children who don't have the communicative intent to talk to people. So we're talking about like children who are on the spectrum, children who are severely language delayed. Right. So these types of children, they might not have as much intent to want to communicate with others. Right? Right. And therefore we want to use this device as a step down from speech that is easier to create a system and a routine since they don't have much interest in like playing or interacting or whatever or, or reading stories and so on. So what they do is like they use the devices to help with their pre linguistic skills. So a lot of the things that, you know, we teach nonverbal children is with packs like picture exchange communication system. Right, The P. C. S. Right. So why we do that is because, number one, the ability to give someone a card, right? A card to indicate they want something is actually a part of turn taking. Right. I. I take my turn. I give you this one. I'll wait, I'll wait for my turn now and then I'll receive the thing. Right. So some, some turn Taking going on the same as communication. I tell you something, you listen, you give me a response and I'm waiting for that response. I listen to it and I take my turn and I talk again. Like a lot of times conflict happens when you don't take turns talking. Right. You speak over each other and it's not a good feeling. Right. So that's turn taking is one of the pre linguistic skills. Other than that there are loads. Right. For instance, matching, being able to match a picture to a real item in the real world. Right, that's matching as well. And matching in itself is also a pre linguistic skill. So we're using that to teach instead of using like, you know, a structured way or like through play or whatever means, we're using PACs or using like the iPad as a AAC to teach children how to pick up these skills and use language. Okay. And some people even go on using this to help children build sentences. Right. So it might be children who are on the autism spectrum, disorder on the spectrum. And basically they cannot say the words. They cannot form sentences. They only say like single words. So having an AC is actually easier for them to have that intent to say a full sentence. Right. So having said all of this, I think at this point in time, if you're watching this video, if your child is non verbal and your child is below the age of three, I will not recommend your child to get aac. I think you're below three. Your main focus is to get your child to start like communicating with you, whether with gestures, sounds of words or whatever. Okay. That's your main focus is to try to get them to understand the power of talking to you, whether it's verbal or not. Right. Increasing their communicative intent. Meaning when, whenever they want something, they, instead of pulling your hand, they like, they gesture to you. Right. They talk to you. Right. Like if children are between three and four, I think the, the biggest thing you should do there is, yeah, you can introduce some AAC or whatever and it could be PECs, it could be iPad or whatever. But, but then that needs to be the crux of how like the core of how he or she communicates with you at home. If you're not going to use it at home, don't, don't use it. Right. If you're not on board with it, don't use it. Right. Because if there's a disconnect between the clinician saying, oh, you, your child needs like a tablet or whatever, and you think, ah, no, I don't think so. Then you're both like, you're on the opposite side of teams, you know what I'm saying? Like the therapist is going to say ah, you know, like set up this AC for. But this parent, they're not using it. That's what we hear. A water room, you know what I'm saying? When you're getting water and in the school and then the therapist are saying, ah, they never, parents never listen to us. They don't use the AC or whatever. And then you do a consultation and then a parent tells you, oh, you know, like this. The therapist I used to work with, she wanted my verbal child to use like a ac. That's crazy, right? And then they're trying to get you on the side and they want to hear what you want to hear, what you want to hear. Right. So you're going to say and, and the therapist is obviously they want your business because they're private and then going to say, yeah, of course I would never use AC or whatever. So you guys need to be on the same page in order for this to work. If there's any doubt that you don't want to use this or it's not something you can implement, just say you can't. Right. And it's not going to be feasible. Right. If you're on board, be 100% on board. Okay. So between three to four is the time to start trying these kind of methods. And it would be supplementary. Right? Supplementary meaning you're using these to teach the kid some language functions. Right. And at three to four you still don't know whether they will. Speech will become their main medium for, for, for communication just yet. So use it as a supplementary just to teach them different language functions and also like pre linguistic skills and so on. But after four is like a serious time to really think about if your child isn't. It's still nonverbal. You cannot get them to imitate any sounds or speech that, that is coherent and makes sense. Then yeah, I think AC would be a good option for you to explore. All right. Not saying that it will be kept there forever. And a lot of parents will ask me, oh, does a kid stay at the stage forever? No, they don't. Unless they're physically unable to speak. And that's something that you have to work tirelessly to to find out whether this is the truth or not. Right. So if your child is. There's different diagnoses for, for speech disorders and most of them are trainable. Most of them. Right. I'm saying some of them are not you cannot talk. For a child who doesn't have vocal faults, it's just very impossible. Right? So what I'm saying is, as long as your child is anatomically like, structurally speaking, they can create speech, then, yeah, it should be trainable to some extent. Okay. And AAC becomes that relief for them because they can now talk. Okay, so let's talk about some. Some real examples here. So one of my students, mom would ask me, oh, do you think this AAC would help my kid? The kid is already verbal. The kid has a severe speech, and he cannot really speak very well, but he can read well. So would it make sense for him to have those words typed on the tablet or have some preset words that he can read off when he's anxious? Right. And then we ask the kid. The kid says, I don't want to because I don't want to look different. I can already talk, although it takes longer, but people are genuinely patient. And then the mom and I decided, yeah, then. Then don't. Don't do it. Because if you don't want that to. To affect how you look, how you feel included at school, then don't do it, obviously, because it'll make you look stupid. Right? That's the. That's the word. It makes you look stupid. Like sometimes when my mom brought me, like, a. Like a really nice water bottle, and it's. You know, it's. How to say, it's. It's green. There's like a frog on it. Although it does keep the, you know, like, it does keep the water warm and the food warm. It just looks not nice. And I don't feel nice at school. Right. That's the worst feeling you can have whilst going to school. You feel like people are picking on you. They don't think you look not nice. Right? You look like the words. Don't take offense when I say look stupid, all right? And what I mean is that's how you feel, right? That's how. How the kid feels. That's the real words that the kids use to tell me. So don't say that. I'm in this age of time. I got to be very careful for my words. At the same time, if it's not my words, then, you know, like, you think about it. Okay? So children are telling me, I don't want to look stupid. Right? I don't want to look different. Right. Those are the words that are coming out of the children who we ask. Okay? Don't take us the wrong way. Okay? Anyways, now that you know, let me just summarize real quick, all right? From below three, don't use it. Three to four, you can try to use it as a supplementary to teach some language functions, some different things, yada yada. Okay? A4 onwards, you can start using it even more. If your child is really nonverbal, you should explore it and think about it with your therapist, right? Serious talk. But only do it if you are on board 100%. If you're not going to use at home, school's not on board with it, and you're still going to continue what you're doing at home, it's not going to work, right? It's just the end of story. Because the mode of communication, people will go to the path of least resistance, right? So for instance, if a child has the habit of using aac, they will start using it because they find it's useful and it's communicative. Whereas if they find like pulling your hand or screaming or shouting or like just like doing hand gestures or whatever, that's also aac, right? Using different sign language, then that's. That's fair enough as well, right? So it depends what the. Your mode of communication, what you want it to be, and just stick to it, okay? And that's a huge thing because it involves the. The kid to be on board, you to be on board, the school to be on board, and the therapist working with you to think about how to implement it in all environments, okay? And the biggest and most thing is to care about the child's mental psyche, right? Think about their mental health. Think about how they would feel when they're using it. Okay? So that's it for this video. If you haven't, please go to agents of Speech.com checklist to grab free list of tools and toys we recommend you to get when you start home therapy. All right? So that's it. I'll see you next time. Bye. Bye.