Participatory Help-Giving AAC Practices: Bridging the Equity Gap in Family Centered AAC Services in Early Intervention

Introduction

Early intervention (EI) services in the United States are publicly mandated under Part C of the Individuals with Disabilities Education Improvement Act (IDEIA, 2004) for children with developmental disabilities from birth to three. These services are designed, delivered, and monitored via the Individualized Family Service Plan (IFSP). Under the IFSP, augmentative and alternative communication (AAC) services are provided for children with complex communication needs (CCN) where speech and language are compromised (Lin & Gold, 2017). AAC systems consist of both unaided (e.g., gestures, manual signs, facial expressions) and aided (e.g., speech-generating devices, voice output communication aids, communication books, communication boards, or written words) communication modalities to improve communicative success (Barbosa et al., 2018; Bondy & Frost, 1994; Crowe et al., 2021). The combination of the two (e.g., aided and unaided) is to augment and be an alternative form of communication modality.

Young children with CCN are in the early stages of communication development by acquiring the rudimentary skills to participate in daily life (Beukelman & Light, 2020). Without appropriate intervention and support, children with significant communication disabilities are at risk of educational and social isolation, with vital repercussions across most aspects of development (Light et al., 2004; Light et al., 2007; Sevcik et al., 2004). The use of AAC in EI is to support language development by (a) augmenting existing speech, (b) providing a communication output mode, (c) serving as both language input and output modality, and (d) utilizing as a form of speech and language intervention (Lorang et al., 2022; Romski & Sevcik, 2005).

Although some families are hesitant to introduce AAC to their children with the concern that it will inhibit their speech and language development, numerous studies have suggested otherwise. Using AAC in EI supported language development for children from ages one to three (Branson & Demchak, 2009; Solomon-Rice & Soto, 2014), increased conversational turns and expressive utterances (Romski et al., 2010; Wright et al., 2013; Yoder & Stone, 2006), and promoted morpho-syntactic development in their expressive language repertoire (Binger & Light, 2007; Brady 2000; Drager et al., 2006; Kasari et al., 2014). Due to its visual modality (e.g., pictures, graphic symbols, scene-based, etc.), AAC has also shown evidence to aid receptive language skills (Dada et al., 2020). Overall, evidence has repeatedly suggested that using AAC does not adversely impact the development of natural speech (Hustad & Shapley, 2003; Johnson et al., 2009; Light et al., 2002). To expect this outcome, family involvement is a vital element in the process. Collaborative teaming with families throughout the decision-making process, the AAC system selection, and the introduction process have a significant impact on the prognosis of AAC intervention (Goldbart & Marshall, 2004; Hunt et al., 2002; Robinson & Solomon-Rice, 2009). The purpose of this chapter is to address service providers who works with AAC in early intervention to implement an equity centered approach when working with families (e.g., participatory help-giving practices).