Augmentative and Alternative Communication
What is AAC?
AAC or Augmentative and Alternative Communication is any method of communication used to add to or replace verbal speech. Like verbal speech, AAC utterances should come from the communicator. Just like no one touches or manipulates the mouth or lungs of the verbal speaker no one should be touching the body or the communication system of the AAC user. AAC can included writing, spelling, pointing to pictures, using literacy based or pictorial language systems in book form or on an electronic device. It can include facial expressions, eye pointing, gestures, sign language, vocalizations, and other systems. These systems can be accessed by direct selection such as pointing with a finger, eye gaze or any other body part, or indirect selection by using one or more switches to scan options and make selections.
Autonomous Communication
The focus of AAC should always be on autonomous communication, meaning the user of AAC is able to say what they want, to whom they want, whenever they want and where ever they want. The methodology of communication used is to be chosen by the user of AAC at any given time, but should always be without the possibility of anyone influencing what the AAC user says. That is to say, a user may choose to point to letters, but neither they nor their letter board should be touched while they are doing so.
It is absolutely vital that that the user of AAC not be physically or emotionally manipulated. The AAC system should also be held by the AAC user (not the communication partner), placed on a surface or mounted for easy access. The AAC user should not be physically touched as they are communicating. Methodologies that call for physical prompts should be avoided for a variety of reasons including allowing physical autonomy, preventing influencing the AAC user’s message, lowering the chance of learned helplessness and decreasing the potential impact of non-consented touch.
It is true that all communication, including all communication through AAC, is influenced. We influence each other through or responses to each other such as facial expressions, body language, and verbal responses. It is important to clarify normally occurring influence at all people experience while communicating versus undue and invasive physical and emotional influences which diminish or eliminate autonomy. One way to ensure communication partners do not influence in a way which diminishes or eliminate autonomy is to eliminate physical touch of the individual or their communication system. Other ways to ensure autonomy include videotaping interactions and watching with an educated, neutral party who can provide feedback, establishing criteria for when to check back with the user because a message is unclear, for example if a physical disability makes it hard to distinguish between gestures, ensuring the AAC user has as many trainer partners as possible, and other methods.
Another important consideration when we talk about autonomous communication is bodily autonomy. People without disabilities do not generally tolerate touch without informed consent or invasions into their personal space, nor do they generally tolerate having someone they are communicating with physical block them into a corner or portion of a room. AAC users are entitled to the same rights to bodily autonomy, protections from invasions into their personal space and physically being restricted from free movement. When touching someone or their AAC system, standing very close to them or blocking them into a space is a know and expected part of a means of teaching communication it is in its very nature a violation. We must remove intrusions like this from all aspects of communication.
FC, RPM, S2C...
Research has shown, repeatedly, that Facilitated Communication, Rapid Prompting Method, Spelling2Communicate and similar methods, impact the utterances of the person who is supposedly communicating. This essentially removes agency from the very person that AAC should be giving agency. Furthermore, use of FC had lead to many instances of unfounded abuse allegations and at least two publicly known incidences of people with disabilities being said to have given consent through FC which could not be verified. Research has also shown Rapid Prompting and similar methods lead to prompt dependency. Proponents of these methods promote limited "studies" claiming that they "prove" autonomous communication is happening. As of this writing all of these studies have significant flaws, among them lack of one or more control groups, lack of transparency around data analysis, bias of study authors, conflict of interest and more. One study, which claims that eye gaze tracking analysis validates authorship also fails to acknowledge that the human eye will fixate on and track movement, therefore if the letter board was moving because it was being held and moved by a communication partner and the hand was being held over it the eyes would fixate on the relative movement the eye sees, which invalidates the proposal that these fixations confirm authorship. This is to be compared with dozens of studies which show these methods to be ineffective.
Abuse Risk
Additionally, individuals with disabilities are at a much higher risk of being abused - physically, emotionally, financially, sexually. Using instructional methods that insist that a person with a disability allow someone to touch them, especially without consent, is in essence “grooming” them to be abused. Just using these methodologies that are so well known as fraudulent puts these individuals in a position where they may not be believed if they were to try and report abuse. Using instructional methods that avoids hands on/physical manipulation, that teaches cooperation instead of compliance and focuses on learning how and when to consent to touch can help decrease the possibility of abuse. The implementation of autonomous communication with a robust language system can help reduce some of the risk of abuse facing AAC users by enabling to say, “no” and to report instances of abuse. Additionally, some methods, like S2C do not allow spellers to decline participation in a discussion (especially during the acquisition stage of spelling) which can create learned helplessness which can be a precursor to being victimized.
Autonomous Communication
The focus of AAC should always be on autonomous communication, meaning the user of AAC is able to say what they want, to whom they want, whenever they want and where ever they want. The methodology of communication used is to be chosen by the user of AAC at any given time, but should always be without the possibility of anyone influencing what the AAC user says. That is to say, a user may choose to point to letters, but neither they nor their letter board should be touched while they are doing so.
It is absolutely vital that that the user of AAC not be physically or emotionally manipulated. The AAC system should also be held by the AAC user (not the communication partner), placed on a surface or mounted for easy access. The AAC user should not be physically touched as they are communicating. Methodologies that call for physical prompts should be avoided for a variety of reasons including allowing physical autonomy, preventing influencing the AAC user’s message, lowering the chance of learned helplessness and decreasing the potential impact of non-consented touch.
It is true that all communication, including all communication through AAC, is influenced. We influence each other through or responses to each other such as facial expressions, body language, and verbal responses. It is important to clarify normally occurring influence at all people experience while communicating versus undue and invasive physical and emotional influences which diminish or eliminate autonomy. One way to ensure communication partners do not influence in a way which diminishes or eliminate autonomy is to eliminate physical touch of the individual or their communication system. Other ways to ensure autonomy include videotaping interactions and watching with an educated, neutral party who can provide feedback, establishing criteria for when to check back with the user because a message is unclear, for example if a physical disability makes it hard to distinguish between gestures, ensuring the AAC user has as many trainer partners as possible, and other methods.
Another important consideration when we talk about autonomous communication is bodily autonomy. People without disabilities do not generally tolerate touch without informed consent or invasions into their personal space, nor do they generally tolerate having someone they are communicating with physical block them into a corner or portion of a room. AAC users are entitled to the same rights to bodily autonomy, protections from invasions into their personal space and physically being restricted from free movement. When touching someone or their AAC system, standing very close to them or blocking them into a space is a know and expected part of a means of teaching communication it is in its very nature a violation. We must remove intrusions like this from all aspects of communication.
FC, RPM, S2C...
Research has shown, repeatedly, that Facilitated Communication, Rapid Prompting Method, Spelling2Communicate and similar methods, impact the utterances of the person who is supposedly communicating. This essentially removes agency from the very person that AAC should be giving agency. Furthermore, use of FC had lead to many instances of unfounded abuse allegations and at least two publicly known incidences of people with disabilities being said to have given consent through FC which could not be verified. Research has also shown Rapid Prompting and similar methods lead to prompt dependency. Proponents of these methods promote limited "studies" claiming that they "prove" autonomous communication is happening. As of this writing all of these studies have significant flaws, among them lack of one or more control groups, lack of transparency around data analysis, bias of study authors, conflict of interest and more. One study, which claims that eye gaze tracking analysis validates authorship also fails to acknowledge that the human eye will fixate on and track movement, therefore if the letter board was moving because it was being held and moved by a communication partner and the hand was being held over it the eyes would fixate on the relative movement the eye sees, which invalidates the proposal that these fixations confirm authorship. This is to be compared with dozens of studies which show these methods to be ineffective.
Abuse Risk
Additionally, individuals with disabilities are at a much higher risk of being abused - physically, emotionally, financially, sexually. Using instructional methods that insist that a person with a disability allow someone to touch them, especially without consent, is in essence “grooming” them to be abused. Just using these methodologies that are so well known as fraudulent puts these individuals in a position where they may not be believed if they were to try and report abuse. Using instructional methods that avoids hands on/physical manipulation, that teaches cooperation instead of compliance and focuses on learning how and when to consent to touch can help decrease the possibility of abuse. The implementation of autonomous communication with a robust language system can help reduce some of the risk of abuse facing AAC users by enabling to say, “no” and to report instances of abuse. Additionally, some methods, like S2C do not allow spellers to decline participation in a discussion (especially during the acquisition stage of spelling) which can create learned helplessness which can be a precursor to being victimized.