What is AAC?

AAC refers to any form of communication that is used in addition to spoken language and can be used by anyone, of any age. It stands for Augmentative and Alternative Communication. AAC refers to objects, symbols, photographs, signing and electronic devices that help communication. There is a distinct difference between visuals used to support understanding of language and visuals used for AAC to support expressive communication. This blog is focussing on AAC.

How can AAC help my child to communicate?

AAC supports children’s communication in numerous ways. Children who have communication difficulties can know what they want to say but are unable to communicate it effectively. AAC can bridge this gap. It makes communication accessible and supports children to communicate their wants and needs, leading to independence. This also supports children’s emotional needs: to feel heard and connected with others, supporting  wellbeing and reducing frustration.

Types of AAC 

AAC comes in many forms, including but not limited to, signs, choice boards, communication books, Objects of Reference, switches, tablets with symbol based communication and eye gaze technology. AAC supports expression (the output of ideas and thoughts). It can use a combination of photos, objects, symbols and words. The choice of AAC should be dependent on your child’s interests, strengths and abilities. For example, some children may enjoy using objects of reference, others may prefer photos, pictures or symbols. If you think your child might benefit from AAC or you have any questions, ask your Speech and Language Therapist.

How do I help my child learn to use their AAC?

The specifics of how to use AAC vary depending on which one you have. However, all types of AAC supporting children’s expression are taught through modelling how to use their AAC. When modelling AAC you first want to familiarise yourself with their AAC. You want to be able to show your child how to find what they’re looking for, what they can communicate and what to do when something goes wrong.

When you feel ready to model:

1. Choose a familiar activity that you do every day
2. Choose key words or phrases to focus on
3. Speak alongside using the AAC
4. Reduce the pressure. They don’t need to copy you. 
5. Model to your child each time you do that activity, then try other activities.

Another aim in modelling the AAC is showing your child how it can create more connections and how it can help them communicate their wants and needs with ease. This is why it is important to keep it low pressure! Remember that all communication, whether it’s with spoken words or AAC should be built on foundations of connection, regulation and joy. When modelling the use of AAC, ensure that the activities you choose are child led and interest and strengths based. For example, if your child likes bubbles and enjoys playing with them throughout the day, you could use them as an opportunity to model the use of AAC. If you’re introducing signs you could model ‘bubbles’ or ‘more.’ If you’re using symbol based AAC you could point to ‘bubbles’ or ‘let’s have bubbles,’ each time you blow them. If you’re unsure, chat to your Speech and Language Therapist.

Things to remember:

• AAC provides the child with a voice and should always be available 
• The vocabulary used on the AAC should be individualised and what the child might want to communicate
• If you use an electronic AAC have a paper version available as a back up

Common myths around AAC:

•  Will AAC prevent my child talking?  No! Research shows that AAC can have a positive effect on children’s language development. A lot of AAC involves making language visual and this helps children remember words more easily. The goal of AAC is not to replace speech but to enhance the child’s ability to communicate.
• Is AAC just for children who have trouble with language? No, AAC can help children with speech sound difficulties too. This could be because a child’s speech is unclear and unfamiliar people have difficulties understanding them, or if the child benefits from support when trying to find words for talking.
• Is AAC just for children who don’t talk? AAC can support all children. The questions that needs to be asked areis can the child communicate their needs and wants in all situations and with everyone? Are communication breakdowns occuring? Could AAC reduce frustration? For example, communicating in difficult situations such in an emergency or when upset can be tricky for some children as processing language is harder when dysregulated or they might feel more pressure using spoken language with people they’re unfamiliar with.

What are concepts and why are they so important for children to understand?

Concepts are used everyday. They help children understand the world around them and enable everyone to include enough information for others to understand them. For example, if your child keeps requesting “dinosaur,” how do you know which dinosaur they want? The green one? The noisy dinosaur ? Two dinosaurs? Colour, sound and quantity are all examples of concepts. As children develop their understanding of a concept, this supports them to start saying them.

Did you know that pupils in schools, using strategies to target learning and understanding of concepts, have increased early numeracy skills.

Some concepts do not relate to a physical attribute, such as again, now and after. For example a child may be upset because they want a snack now,  but they are told to eat it after dinner. Understanding time related concepts supports children to understand the world around them and when things are happening. Some children worry when things are different and understanding time concepts supports them to know when things will be back to normal such as “after lunch you have speech therapy, then you have maths.”

.

How many of the following concepts do you use and does your child understand? 

Below there are some lists of early concepts and level 1 concepts. It’s likely that you use more of these when talking to your child than you may be aware of. Some concepts develop earlier, such as go and stop. Understanding and communicating these concepts is very important for not only communication but also everyday life. For example, understanding ‘stop’ is very useful when it comes to safety. After a child develops early concepts, such as stop and go, these develop further into concepts such as fast and slow. 

How can I help my child learn concepts?

Relate concepts to your child’s favourite toys or familiar experiences and talk about what’s in front of you. It is better to teach concepts with a familiar toy, so your child is not learning about the new toy at the same time as learning the concept.  For example, if your child loves building blocks, try the following. Have a big and a small building block in front of you and say “I want a big block” , pause and look at the two blocks, then pick up the big block (ignoring the small block) and say “I found a big block!”. Many concepts come as opposite pairs, such as big/small and hard/soft.  Having visuals and being able to compare to something which is the opposite supports understanding to develop. However, only teach one concept at a time. When referring to the big block, label the small block as “not big.”

Things to remember

• Teach one concept at a time.
• Understanding a concept comes before children use them
• Your children will learn concepts based on their experiences. For example, if you have a dog they might learn wet and dirty first!
• If you would like some support with concepts you can ask your MTW Speech and Language Therapist for more information!

Storytelling brings us together – whether it is cuddling up on the sofa and sharing a picture book, reading a chapter side-by-side with a teenager, or simply flipping through the pages with a toddler – there is something really special about it. It brings us together. Human beings have been telling stories since the beginning of time, ages before words were recorded and pen was put to paper. It slows the world down for a few moments, lets us dive into different worlds, meet new characters, and experience a whole variety of emotions. It isn’t a passive experience, it is a deeply human one.

As children grow, stories grow with them. They may not always remember the earliest stories they heard, but they remember the sharing of them. In a world full of screens, alerts and never-ending ‘content,’ children are often absorbing more than they are expressing. The digital world can entertain but without support it doesn’t always invite them to think, imagine or share their ideas. Telling and sharing stories helps children to create meaning, it is more than just hearing words. It is a way of using language to connect, communicate and build relationships.

From a developmental perspective, there are lots of skills that are nurtured through sharing stories. Shared joy and attention for one. Laughing together at the funny bit, realising at the same moment what wonderful or shocking thing is about to happen, or eagerly anticipating what will happen next, all build connections and strengthen relationships.

Books and stories expose children to rich vocabulary we don’t hear in day-to-day conversations and routines. Stories have a beginning, a middle and an end. Characters often encounter problems to be solved or an adventure to undertake. When we talk about the order of these events, we are learning to organise and express our ideas. These are all important skills for literacy and when children have been exposed to storytelling, the skills they are expected to demonstrate in their writing, often come easier to them 

Teachers play a powerful role in nurturing these early literacy foundations through the way they share and talk about stories. Simple strategies such as pausing to wonder aloud, asking open-ended questions, revisiting favourite books, or retelling a story together, all support children to deepen their understanding. Children need a framework for organising their thoughts – talking about characters, predicting what will happen next, or connecting a story to a real-life experience are all ways of offering them this. Literacy grows when stories are explored playfully and responsively – this doesn’t need to be scripted or formal. 

Stories are also a rich and meaningful context for using AAC (Alternative Augmentative Communication). Whether it is pointing to symbols, using a communication device or signing, AAC allows children to actively take part in storytelling instead of just listening. They can comment on pictures, choose favourite characters, express feelings or help retell events using their own communication system. When AAC is used alongside books, children see that their ideas matter and that stories belong to them too. This shared experience supports language development, comprehension and confidence, while reinforcing that communication, in all its forms, is valued. 

Within stories, we get to watch characters develop. They experience problems, feel deep emotions, make mistakes and find solutions .This gives children a safe insight into the world around them. It gives them an opportunity to explore ideas, topics and emotions. They can think about what they might have done differently, or what caused a character to end up where they did. They may be drawn to stories that resonate with their own lives or ones that take them far away from reality. The options are truly endless. 

Stories spark creativity. The cardboard box becomes a spaceship, the cleaning cupboard the time machine, the stick the magic wand. Children begin to imagine beyond what they can see, and this promotes writing, pretend play, and problem solving to name but a few skills. 

Some children may not be ready to sit and listen to every line in a book. That’s ok. We don’t need to read the text at all. Talk about the pictures – this can be just as rich and even more meaningful. Describe what you can see, talk about what the characters might be saying or feeling, or let your child tell the story! This goes for their school reading books too. It is always exciting when our kids bring home their first reading book but storytelling doesn’t need to stop when this happens. If anything, continuing on this journey of sharing stories will help with all the other stuff that they are doing in the classroom. 

So, next time you pick up a book with your child, let it unfold naturally. Forget about it being a task that needs completing. Get lost in the connection and joy that comes with telling a story and sharing the moment with someone you love. 

If you walked into one of my therapy sessions, you would probably think, ‘mmm, she is just playing.’ You would be absolutely right. It looks like play because that is exactly what it is. There will probably be dinosaurs, Mr Potato Head, or building blocks all over the floor, bubbles being blown and porridge oats finding their way into every nook and cranny. I will spend most of the time on the floor, and it will look like there is no method to the madness. But here’s the thing. All of this is rooted in purpose – in building communication, confidence, connection and empowerment. 

Those four words are at the heart of our approach at MTW Speech and Language Therapy. And they are not just values that we stick on a wall or on our website. They guide us through everything we do – each decision we make and each session we plan. They are the foundation of every relationship we have the privilege of building with the children and the families that we work with. 

Communication and Confidence – the real goals behind the games

By ‘just playing,’ we are creating opportunities – for words, for interaction, for problem-solving, for turn-taking and for shared joy. This is where communication grows best. Language becomes meaningful through play. When a child wants to take a turn with the toy, or giggles at our silly voices, that’s connection. Here is their motivation. It’s when the real work gets done. And how about confidence? Where does it come from? It comes from being understood. When a child sees that it is ok for them to communicate in a way that works for them, that they are accepted and that we are right there with them – celebrating every time they try a new sound or a sign or even an idea. 

Empowerment – for families as much as for children

A huge part of our job is supporting not just the child, but the people around them. We want to empower parents, carers, grandparents (and anyone else in the child’s life)  to feel confident enough to support their child’s communication journey. What does this look like? Giving them the tools they need, answering every ‘silly’ question (none of which are silly by the way) and celebrating each step no matter how tiny they may seem (they never are tiny)! 

Small changes can open up a whole new way to connect – this could be pausing a little longer or following their child’s lead in play. Or it can just simply be telling them that they are doing a great job. 

We often meet families during their most difficult times. When they don’t know what else to try, who else to turn to or how to move forward. It never ceases to amaze me how quickly we can have an impact, how these small changes can have such huge repercussions. I’ve seen a home go from a fractious, anxiety filled space, to one of hope, joy and positivity. No, I don’t have a magic speech and language therapy wand and I can’t take families off the path that they are on, or make everything better and easier overnight. What I do have is the time and space to be able to guide them to a place where there is a bit more hope, where they can see that they can make a difference to their child’s communication and connection to their world. 

Why do connection and trust matter so much? 
Before we can make any difference to a child’s communication, we need to build trust. Children learn best when they feel safe, seen and accepted. This takes time. We notice what makes a child’s face light up, what motivates them, what worries them. We get to know our families – what they are going through, what they are finding tricky, what matters to them most right now. Without this connection, all the targets and clever strategies in the world will remain redundant. But when there is connection, we see children go from silent to singing, unsure to unstoppable, frustrated to flourishing. So yes, all the ‘just playing’ that we do is part of a bigger picture. It’s powerful and it’s purposeful. And we’re not sorry. 

As a parent, it can be really concerning when we notice something isn’t quite right with our child’s speech, whether this be unclear speech, funny pronunciation or missing sounds. Speech sounds are highly noticeable so it’s completely natural to feel like this. We like to use the analogy of a tree when talking about communication – the leaves then would represent our speech sounds. But just as leaves need a healthy tree to grow on, speech sounds need strong roots and branches of communication beneath them. In this blog, We are going to explore how speech sounds develop, what difficulties look like and how you, as parents and carers, can support your child’s communication from the roots up. 

Lots of different skills support the development of speech sounds:

Hearing 
If you have concerns, it is important to get your child’s hearing checked. When seeking support, you will always be asked if this has been done. 

The Building Blocks
The building blocks for a child’s developing speech sound system is discrimination of initial sounds, understanding syllable structures and rhyme. We will often support children to make sure they have solid foundations in these areas before moving on to specific sounds and processes. For example, can they clap along to long words and identify how many syllables a word has? Can they hear the difference between sounds and sort words between the sounds they start with? 

Phonological difficulties 
This is when a child has difficulty using sound patterns in the correct way. Sometimes they can’t produce the sound at all and sometimes they can make the sound but have it a bit muddled or don’t use it consistently in the right places. For example, a child may say ‘nake’ instead of ‘snake.’ They can make a /s/ sound but are simplifying the sound pattern without realising it. We call this consonant cluster reduction. This is one of the later phonological processes that is quite typical for young children to use. As children get older there are different speech sound milestones we are looking for them to have reached. Starting this at about 3 and a half. As it is part of normal development if a child is doing it later than we expect we call it a ‘delayed’ process. 

Some children will need support to resolve these typical error patterns or they demonstrate some patterns that are less typical. An example would be what we call ‘backing.’ Sounds that are made at the front of the mouth, are produced at the back so ‘tap’ could become ‘cap.’ Although lots of children do use these processes they are not processes we expect to see in normal speech sound development. You may hear these referred to as a ‘disordered’ process.

Articulation difficulties
These happen when a child has trouble physically making a sound. They might not be able to place their tongue correctly for example. They know the word, they just don’t have the tools to say it properly. 

Attention and listening
Attention skills help children self-monitor their speech, and to listen for differences between their own speech and what they hear from those around them. We support children to tune in and listen to sounds while they play. Children do not need to be able to sit down and ‘work’ in order to make progress on their speech sounds.

Understanding language 
If children are struggling to understand concepts like ‘front’ and ‘back’ that relate to speech sounds we support children to explore these different concepts.

How can parents and carers promote speech sounds?
There is a lot you can do at home, to promote speech development. The most effective way is through a playful and no-pressure approach – children learn best when they feel confident and connected. Avoid asking them to correct their mistakes, try these ideas instead: 

Model clearly 
If your child says, ‘It’s a tar!’ you could repeat this back to them, modelling the error correctly – ‘Yes, it’s a car!’ They get to hear how the word should sound, without being corrected or made to repeat themselves. 

Develop attention and listening
Play! Games that encourage turn-taking, waiting, and listening are all super effective for underpinning so many skills, including developing speech sound awareness. Listen to the aeroplanes in the sky, the doorbell or cars driving past. Games such as ‘I spy,’ or ‘Simon Says,’ can also be played on the go, when we are limited on time!

Shared reading
Books are so important for exposing our children to robust language and vocabulary. It is such a great opportunity to connect and co-regulate with our kids –  with the added bonus of promoting skills for speech and language development. 

Play with sounds
Sound awareness is vital if children are to be able to use speech sounds successfully. Nursery thymes, rhyming games, silly sounds, syllable clapping are all great ways of developing this. 

Early support can make a huge difference, so if you have any concerns, reach out. More often than not we can put your mind at rest that everything is ok and ticking along nicely! If not, that’s what we are here for.