This post tells of the obstacles that we faced when we decided to pursue high tech AAC for Maya, and the ways that it has shaped her academic path. Some of it is kind of a review, but there's a great new video at the bottom, too. This relates directly to the (amazing) "Myth of AAC Pre-Requisite Skills" blog post that circulated earlier this week.
My introduction to AAC came in a support group meeting (for
parents of kids with special needs). I was talking about how I really didn’t
know what Maya knew, or understood, and how I wish I could find a way for her
to communicate. One of the moderators said “You should go see
Mark, he does assistive tech” and the other nodded and agreed, and that night I went home and started
researching and was blown away by the different systems and devices (and a very
small number of apps) that were out there: a whole world that I didn’t know
about.
That was a kind of pre-obstacle in our path to obtaining AAC: no one told us about it. Too
many parents are left on their own, with a passing suggestion or random message
board encounter being their best chance at learning about AAC in the
years-before-elementary school.
The first real obstacle, for us, was Maya’s age. She was 2 when we started pursuing AAC at home, 3 when we pushed for a
DOE evaluation (useless) at her special needs preschool, and still 3 when the first
app with truly accessible, long term language possibilities (that could work
for a preschooler and grow with her through adulthood) burst onto the
market. We believed that she could
handle a big system, despite the DOE evaluator’s insistence that that was the
wrong choice. Her teacher sided with us,
and we decided that it was best to ignore the DOE (who had recommended a
boring, static, cumbersome, only-able-to-hold-32-words device) entirely.
The second obstacle was Maya’s fine motor skills. Namely, that she
had very little fine motor skills. At 6 years old, she still can’t hold a
pencil correctly and write letters, or use scissors. She doesn’t have the hand
strength to open a clothespin or to re-cap a marker. The idea that we wanted to
put her on a dynamic screen of any type didn’t compute with the evaluators
(“But how will she use this? You can see that she would have a lot of trouble
hitting those buttons, or not hitting others accidentally.”). I mentioned a
keyguard, which was acknowledged as possible, but the team seemed much more
comfortable with the idea of starting with a few big buttons and working up to
more and more (and shifting the vocabulary entirely around at each step).
Apparently
motor planning is a foreign concept in some circles. I was sure that
if we could get our hands on the right system, we could think creatively and
come up with ways to improve our direct access. (Spoiler: That’s exactly what
we did, first
with a glove and then
a keyguard and then
another keyguard.)
The third obstacle was Maya’s cognitive level. While her
cognitive evaluation (which placed her in the bottom 0.4th
percentile of her same-age peers) seemed laughable to us, and to her teacher,
it was a clear data point for an evaluation team. And if 99.6% of three year
olds are smarter than Maya, and they’ve never given a large AAC device to any
three year old, then you can go ahead and bet that my kid won’t be the one
breaking that streak.
Next, and perhaps most significantly (and frustratingly)
came the biggest obstacle: negative behaviors. Maya is stubborn. She is willful.
She is interested in doing only the things that she is really interested in doing, and
it’s very difficult to coerce any sort of obedience or compliance if you are
new to her (and “new to her” can mean that you starting working with her less
than 6 months ago, more or less). She would not “perform” during the AAC
evaluations. She would not show them what she could do (and, in a mindboggling
twist, the team declined to view the extensive videos that I have of her
independently using a communication book and apps). That led them to decide she wasn’t eligible
for a big device with the reasoning that either she didn’t understand what they
were saying enough to make sense of the device, or she wasn’t interested in it
anyway.
Four big “reasons” that she wasn’t ready for high tech
AAC.
Four excuses that we ignored.
Instead of figuring out ways to clear the hurdles that they
had laid before us, we walked away from their obstacle course and did it on our
own. (Not because we were heroic, but
because hurdles are exhausting.)
We pursued AAC early and doggedly, because Maya had a right to say
whatever was on her mind, whenever she wanted. No low tech system could provide
her with that, so high tech was the only option, as I saw it. We were excited
as she became able to request favorite objects, to make little jokes, to talk
about the weather. We were delighted when she was able to come home from school
and tell us who she played with, or what therapy she had, or what songs they
sang that day. But it wasn’t until a few
months later, as we went through the “Turning 5 Process”, that we realized how
fundamentally Maya’s early access to AAC was going to change her life.
“Turning 5” is the process in NYC
through which children with special needs are re-evaluated and then matched
with a school, and classroom, that fits the child. I am certain that without
her talker, Maya would have been sent to a classroom that had very low academic
expectations, and I witnessed this near-miss happen five or six times. This
story, from a former blog post, describes those encounters:
During this process we were sent (by the DOE) to tour many
schools, some of which requested that Maya also attend the tour. We
toured the facilities, heard about class sizes, and visited potential
classrooms. The school personnel looked over her case, watched Maya boldly
step into the classrooms, and smiled in a satisfied way that said
yes-this-will-be-a-good-fit. But when we returned to their offices, I put
the talker in front of Maya, then ignored her and spoke with the other adults.
It only takes a minute or two of ignoring before she starts speaking up
(although if you try to interrogate her she can hold onto a stubborn silence
for.ev.er.) . As she tapped out a full
sentence to request a snack or a drink, I could see a flicker---“oh, wait a
second . . . “---and as I gently led her into more creative territory (what
do you want to do today, who should go with us, what do you think we’ll see
there, hold on---what day is tomorrow, again?) the flicker grew, and
they were wide-eyed, surprised by this quiet girl who had tricked them.
And maybe (hopefully), surprised by their misassessment.
And, in a mere minute, a huge perception shift. In the following
minutes, the comments that Maya “was too advanced” and “wouldn’t be a good cognitive
fit here” and “clearly needs to be somewhere where she will be challenged” and
“is full of potential, wow!”
In the space of only three minutes Maya’s achievement with AAC
reshaped their perception of her as a learner which raised their expectations
for her academic potential and offered her the opportunity to not be relegated
to an ill-fitting, limiting classroom
Now Maya is 6 years old. She is starting a new year, in a new
classroom, in a new school. She is still
stubborn, and the new team is slowly teasing apart what she knows and what she
doesn’t know---which is, to varying degrees, a mystery to us all. Again, AAC is the
game changer here, the light that helps illuminate some of her more surprising
strengths. She is reading, although it’s hard to discern how much she reads,
because her speech is still so amorphous. If a skeptic listened to Maya read,
they could easily say “Well, that might not really be reading. I mean, I hear
the starting sound, but who knows if she’s really saying the correct word? She
might be saying ‘fish’ instead of ‘first.’” But when she uses her talker, it’s
clear. In this video she reads two
sentences with her voice, and then I prompt her to read it with her talker, to
check that she was actually reading the correct words.
She’s reading. The DOE said she was in the 0.4th cognitive
percentile, and I'm sure that they would not have placed a kid in the 0.4th
percentile on a track to be reading when she is five.They might not think that a kid who will lay
on the floor instead of following directions is actually listening and
learning, and no one would know that without the data that the talker provides.
AAC has given Maya a way to request and comment and give
directions to those around her, and a way to tell me about things she sees and
hears when I’m not around. And, in an unexpected (and surprisingly essential
way) it’s given her the power to prove to the doubters, the nonbelievers, the
skeptics and cynics and those who forget to presume competence, that a child
who in unique and complicated and doesn’t always look like she’s learning may
actually be quite clever, and capable of learning whatever you throw her way.