Student Communication: It Takes a Team

Imagine feeling uncomfortable or being hungry, and having no way to tell anyone. This is why HMS works diligently to help children with significant speech and language problems find other ways to communicate. Although there are many basic forms of Augmentative and Alternative Communication (AAC), such as facial gestures, pointing to symbols on a board or writing in a notebook, many HMS students use high-tech, speech-generating devices to interact with others and communicate their needs.

Not every AAC system works for every child, however. Determining what to use and precisely how the student will use it takes careful collaboration among an entire team, including the speech therapist, occupational therapist, teacher, assistive technologist, parent and others. “When we help children with complex disabilities to use AAC, we have to account for all factors that will help them be successful,” says Speech-language Pathologist Julie Conway. “As a speech-language pathologist, my area of expertise is language development and vocabulary. That’s an important piece, but it’s not whole piece. We need to consider whether the child can see the device, for example, and how they will access it, especially when functional upper body mobility is limited.”

Julie says speech-language pathologists work with occupational therapists to assess the child’s mobility strengths and recommend how to access the device. Some with good functional movement will use a large button-like device called a switch with their finger, head or leg. For others, using eye movements to select letters and symbols on an electronic screen is the best way to access the speech-generating device.

Parents are important team members because the most meaningful communication goals are family-driven, incorporating what they enjoy and how they interact with others in the community. For example, for one family, Julie programmed church youth group songs into the device for the student to sing. Practical considerations such as the weight of the device are also important, and Julie ensures that the family is comfortable using and moving any equipment that is under consideration.

At HMS, the interdisciplinary collaboration that leads to optimal student outcomes is a hallmark of all of our services. Our clinicians work in close proximity to one another and have well-honed team communication skills.
Given the importance of collaboration to successful use of AAC, Julie created a tool to help facilitate teamwork among practitioners in other settings, such as those on school therapy teams or in outpatient clinics. “I wanted to ensure that other clinicians felt empowered in their area of expertise and are reassured that it’s OK not to have the whole answer,” she says. The tool includes a checklist outlining when to bring in the physician and what OT, speech, PT, the special ed teacher and the parent should focus on. It’s designed with flexibility to meet the needs of every child, whether they need vision support, have reliable upper body mobility or are using eye gaze technology. For more information about this relationship-building tool, please contact