AAC

"Nonverbal doesn't mean I have nothing to say. It simply means you will have to 'listen' to me with more than just your ears" 

"Augmentative and Alternative Communication (AAC) includes all forms of communication (other than oral speech) that are used to express thoughts, needs, wants, and ideas." (www.kennedykrieger.org) Using gestures, pointing to picture cards, writing a note, or using a app/device that speaks are all forms of AAC. You may not realize how much nonverbal communication you use, for example, pointing when giving directions, writing a note, or nodding your head. In this post, I want to talk about speech-generating devices.
I downloaded the a program called Snap + Core First on 10/10/18. It is available on a Tobii Dynavox or as an APP on iPad. I personally prefer the app on iPad because I am more familiar with iPad vs Windows on the Dynavox. This is the only program we have tried, so my experience is limited. Drew hasn't ever really spoken words. Words come and go, but nothing consistent. His early intervention (EI) SLP discussed the option for a speech-generating device. We had a Rep from Tobii come out and demonstrate the Tobii Dynavox. He showed how easy it is to customize and Drew took to it immediately. We started with 2 large buttons with choices of play items and would ask Drew what he wanted. He started using it right away. The Rep said Drew was one of the youngest he had seen that took to the device the way he did. So I downloaded the App while we waited for the Dynavox to be ordered.
At first we started with choices of play and food because they were motivating. We also used it for labeling items. We kind of got in a rut because the way we were using it wasn't functional. After he aged out of EI, we started speech therapy outpatient. This SLP was familiar with using devices and our use of the iPad has taken off. I don't have an exact number of words on the app, but I will include some photos of how it is set up.
So we have been using it for 2 years 2 months. In July, a year and 9 months into using the device, Drew used his iPad to order his own dinner at a restaurant. I am so proud of the progress he is making with communication. It is definitely a work in progress, but I believe it will help him communicate better down the road. Of course I hope that one day he can verbally communicate, but I have worked with kiddos (who were double digits in age) with no verbal communication and no constant form of non-verbal communication. There were behaviors and frustration with the lack of ability to communicate their wants and needs. So even though I hope he can talk one day, I want to set him up for successful communication now. At school, Drew sometimes uses picture cards and although that is a great way to communicate, it can be very bulky to carry around a lot of picture cards. You also have to make sure you have any pictures you might need with you. With the iPad, I can edit/add/change any button, anytime it is needed.
Another question I have heard is will a communication device hinder speech. The article:

"The Impact of Augmentative and Alternative Communication Intervention on the Speech Production of Individuals With Developmental Disabilities: A Research Review" by Diane C. Millar, Janice C. Light and Ralf W. Schlosser in Journal of Speech, Language, and Hearing Research, April 2006, Vol. 49, 248-264 states that "The present research review provides important preliminary evidence that augmentative and alternative communication interventions do not inhibit speech production; instead, AAC may also support speech production.” 
This program comes set up with preprogrammed folders of language, but starting at age 2, I found that a lot of the folders didn't apply to him. I cleared everything out and started over for him and added things as we needed them. I spend hundreds of hours programing his device but it is totally customized for him. I can back up the program to the cloud, so even if a device gets broken, I can upload it to a new device.