Author Q&A: The Benefits of AAC for People with Down Syndrome

This book is groundbreaking because it directly addresses the need to support effective communication in individuals with Down syndrome throughout the lifespan and in a variety of settings, including life transitions and self-advocacy activities.

Often, communication interventions provided to people with Down syndrome focus solely on production and comprehension of speech. While this focus is critical and should of course continue, the reality is that for many individuals with Down syndrome, the spoken mode of communication does not meet all of their expressive or receptive communication needs—even with the benefit of excellent intervention. This is particularly true during interactions with unfamiliar people. It is therefore important to consider the many diverse and effective ways to augment their spoken communication. This book lays out the wide range of potential AAC possibilities and outlines many of their critical functions.

for many individuals with Down syndrome, the spoken mode of communication does not meet all of their expressive or receptive communication needs...

This book is needed now because people with Down syndrome are living rich lives in school, vocational, social, and community settings. Supporting effective communication in each of these settings is critical to promoting full participation and engagement.

This book directly addresses two very outdated misconceptions. The first is the misconception that most individuals with Down syndrome reach a plateau in their speech and language development early in life. The second is that AAC is only appropriate for individuals with very limited communication abilities. It is clear that people with Down syndrome continue to develop speech and language skills throughout their lifespan. Additionally, a substantial number of adults with Down syndrome develop Alzheimer’s disease, which affects their communication abilities later in life. Thus, the book includes chapters focused on all stages of development: early childhood, the school years and adolescence, and adulthood.

The book also provides specific strategies and methods for using AAC to support the communication of people with Down syndrome throughout their lifespan as their communication skills and needs change over time. These strategies include those that are considered aided—such as low technology notes and symbol books—as well as high-technology communication devices operated using eye gaze. Unaided communication strategies such as the use of gestures and sign language are also included. The book is designed to showcase the ways in which AAC may continually support the individual communication skills and needs of each person with Down syndrome throughout their lifetime.

The principles of self-advocacy and self-determination underlie all of AAC interventions and are addressed in virtually all of the chapters. When an individual’s expressive or receptive speech skills are not meeting all their communication and language needs, that person will be compromised in their ability to engage effectively in self-advocacy and self-determination. When we offer that person AAC-supported methods of communication, we promote their ability to engage effectively in decision-making about their lives, from basic minutiae of everyday life (what game to play after dinner this evening) to larger decisions about employment, health care, and the like.

When an individual’s expressive or receptive speech skills are not meeting all their communication and language needs, that person will be compromised in their ability to engage effectively in self-advocacy and self-determination.

As an example, the chapter on AAC in healthcare settings discusses the use of visual supports to promote independent reporting. The idea is that individuals with Down syndrome—rather than their accompanying caregiver—should be able to communicate with healthcare professionals about their current healthcare status, including pain symptoms, sleep activity, and eating habits. That chapter describes visual supports that could be implemented when a person with Down syndrome must undergo a medical procedure, such as an evaluation for sleep apnea. These supports could be used to help the person understand what to expect and engage in self-advocacy during the actual procedure. In all aspects of their lives, being able to engage in clear communication as independently as possible will provide people with Down syndrome the tools to advocate for themselves and to be a part of determining their own path forward.

Of course, we certainly hope that SLPs and educators, as well as administrators, family members, employment case coordinators, guidance counselors, social workers, nurses, and many more benefit from information presented in our book. Here are three main takeaways that we want everyone to gain:

1. Regardless of the stage of development and speech and language abilities, there are many AAC options to support the communication of individuals with Down syndrome.
2. The types and levels of AAC supports that people with Down syndrome need will likely change significantly over their lifespan, but should always be considered.
3. AAC supports both expressive and receptive communication skills, allowing people with Down syndrome to communicate more effectively and efficient.