Promotion of Communication Access, Choice, and Agency for Autistic Students

Abstract

Purpose: Families and professionals often consider augmentative and alternative communication (AAC) a “last resort” for persons with communication challenges; however, speaking autistic adults have reported that they would have benefited from access to AAC as children. This tutorial discusses the history of this “last resort” practice and its perpetuation within the medical model of disability. The tutorial focuses on communication access, choice, and agency for autistic students. Method: We provide a brief overview of the AAC community and their preferred terminology, review the history of traditional approaches to research on AAC and autism, and then examine the relationship between disability models and ableism to views of spoken language as a priority of intervention. Studies on this topic are rare, and resisting ableism requires acknowledging and honoring disabled people's experiences and expertise. Therefore, we promote autistic expertise within the framework of evidence-based practice and discuss the experiences of autistic people and spoken language. Finally, we consider the role of the speech-language pathologist (SLP) in assessment and offer autistic-based strategies and recommendations for communication support. Conclusions: Speaking autistic students who could benefit from AAC may not have access to AAC due to the prioritization of spoken language and lack of awareness of the benefit of AAC. We recommend that SLPs and school-based professionals support and facilitate access, communicative choice, and agency by implementing multimodal communication strategies to include AAC use for autistic students regardless of their spoken language status. Promoting all types of communication and ensuring opportunities for communication across multiple modalities are paramount to a child's agency and self-determination, as is normalization of AAC.

“I Have a Different Perspective as I Am Working Through This”

“…As an example, AMD specified access to AAC as a focus in her current school district that had been well received. The importance of communication choice and access to AAC has been a common theme within neurodiversityaffirming efforts (see Donaldson et al, 2023). Specific accommodations, such as access to AAC, can be explicitly written into goals, which helps build in a level of accountability that often is missing in other aspects of the Individualized Education Program (IEP; Dorsey, 2022).…”

A commentary on children's books about autism: What messages do they send about neurodiversity?

“…Approximately 30% of autistic individuals are non-speaking or minimally speaking (Rose et al, 2016), yet AAC is rarely portrayed in children's books about autism. This sends the presumably unintended message that spoken language is the only or the best option, which is not consistent with the neurodiversity-affirming perspective that all communication modalities should be equally valued (Donaldson et al, 2023;Donaldson, Corbin, McCoy, 2021;Smolkin & Young, 2011;Zisk & Dalton, 2019). When AAC is portrayed, the systems are often minimal and inconsistently used.…”

Measuring and validating autistic burnout

“…Despite this, research is in its infancy, with studies indicating that autistic burnout is characterized by debilitating mental, physical, and emotional exhaustion (Arnold et al, 2023b; Higgins et al, 2021; Mantzalas et al, 2021; Raymaker et al, 2020), which occurs because autistic people experience more difficulties in everyday life than non‐autistic people (Gillott & Standen, 2007; Moseley et al, 2021). For example, social communication between autistic and non‐autistic people can contribute to frustration, and loss of agency, resulting in unmet needs and a lack of accommodations (Donaldson et al, 2022; Sarrett, 2018). This disparity, known as the ‘double empathy problem’ (Milton, 2012) and, more recently, ‘perspective disconnect’ (Arnold et al, 2023b), refers to mismatched understandings among autistic and non‐autistic people about each other's points of view that leads to miscommunications and a seeming lack of empathy and compassion from both parties.…”