In November 2019 we met Olivia. She attended our space accompanied by her family on three occasions, she was looking for a professional opinion regarding her communication system. They told us about the journey they went through in communication and their school career. A short time ago, Olivia had started to use an alphabet (in low technology), as the main media, this resource had been prepared jointly with their speech therapist. In the consultation, we gave them our opinion and made suggestions that we consider important for their communication, which is fundamental in the girl’s school career.
During the encounters, Olivia It showed itself smiling and expectant. It is very expressive and its communicative intentionality can quickly be observed. For the transmission of his messages he used a alphabetical display (both in low and high technology through the application “Talk it”) which he accessed by direct-manual selection, from the physical support he needs to access this resource (support provided by his mother). Olivia and her family shared us their experiences, their interests and desires for the new stage that they were beginning to go through.
The existence of limitations in expressive language, however serious an articulatory disorder may be, does not imply that the person does not have a communicative potential that can be developed.
Human communication implies participation, diversity, exchange and sharing, which is why it is complex and requires certain basic qualities that must be considered in order for it to develop: intentionality, shared significance, joint care, temporality, among other. In people with severe communication disorders – called by the International Society for Augmentative and Alternative Communication (ISAAC) people with complex communication needs (NCC) – these qualities are limited or inaccessible to their possibilities of interaction with the environment.
The absence or unintelligibility of oral expression limits all the communication needs of the person, which affects the development of language functions from the point of view of general development. However, the existence of limitations in expressive language, however serious an articulatory disorder may be, does not imply that the person does not have a communicative potential that can be developed and an inner language that must find an alternative means of exit.
Many children with NCC have a good understanding of language compared to his limited speech skills. Therefore, the establishment of appropriate approach strategies is essential to enable communication in them.
The systems augmentatives Communication, complement oral language when, by itself, it is not enough to establish effective communication with the environment. The systems alternative Communication replace oral language when it is not understandable or is absent. That is why both systems of Alternative Augmentative Communication (CAA) enable people with NCC to access meaningful exchanges with the environment and the possibility of engaging efficiently and effectively in a variety of interactions that constitute fundamental elements of cognitive development and consequently of communicative potential.
The AAC favors, through appropriate strategies and resources, the development of the communication skills of the person. It is not only capable of developing its cognitive potential but also giving an account of it, manifesting its opinions, feelings and making personal decisions to face and control your own life. In short, to be able to participate in society with equal rights and opportunities as other people without disabilities, the spirit of the Convention on the Rights of Persons with Disabilities.
Alternative communication systems replace oral language when it is not comprehensible or is absent.
Facilitated communication (FC) is a form of Alternative Augmentative Communication from which people with NCC express themselves pointing out (for example, pictures, letters or objects) and, more commonly, writing (for example, on a keyboard and / or template with an alphabet). The method involves a communication assistant who can provide a variety of supports: verbal (encouragement, confidence, security) and / or physical. This point is important since CF is frequently brought into play when the difficulty of people to move considers a picture of dyskinesia-dystonia. This implies that when you think of a posture or a movement, and you try it, that motor act is intercepted by another movement that interrupts the original direction. It is in this instance where the assistant offers physical support, perceiving and accompanying, the first direction that the person provokes and prevents the involuntary movement that bursts in and interrupts the desired action. The assistant only lends his voice without adding or removing anything that the person expresses through his communication system the same way you do an interpreter in Sign Language.
Broadly speaking, this is what support that enables Olivia to express her interests, needs, and opinions is all about. Although the use of other types of systems or resources and, fundamentally, of technology are the indicated and recommended path to achieve greater autonomy in the performance of the person (without any type of external assistance), we must also consider and recognize that the CF is a method used by many people with disabilities in the world.
Beyond the controversy that FC can be considered as a method, it is undeniable that having accessed an alternative means of communication, people like Olivia have been able to find themselves and others from “the word”. In this way they can participate and transform their environment by making decisions and accounting for everything that exists within them.
María Celina Gondar and Paola D’Ambrosio are teachers in Educational Sciences and specialists in Alternative Augmentative Communication.