A Study in Augmentative Communication in Distance Learning

JA is an eighth-grade student who is both verbal and uses augmentative communication. He is diagnosed with autism and presents with significant sensory needs and a mixed receptive-expressive language disorder. He thrives on a written schedule, visual prompts, and consistency. When his routines are altered, he can become very upset, which often leads to negative behaviors. JA is a kind and sensitive teenager who needs reassurance, consistency, and intellectual stimulation to be an effective communicator and participant in teletherapy.

His verbalizations are sufficient for basic requests and needs, but other communicative functions are difficult for him to access verbally. He uses the app Proloquo4Text to communicate in addition to his verbalizations. With this augmentative and alternative communication (AAC) app, he is able to use pre-programmed phrases, a full keyboard with word prediction, and quick phrases. Within this customized robust app, personalized messages have been programmed to allow for quick communication. He also uses the Zones of Regulation curriculum to communicate his feelings. These emotions are programmed by color in his talker for quick access.

Transition to Distance Learning:

I spoke with his mother at length about triggers that lead to negative behaviors. JA has had previous virtual sessions with other therapists that ended with negative behaviors (aggression). His mother was very apprehensive about moving forward with any more virtual sessions.

I have been working with JA for approximately two years, so I already have an established rapport with both JA and his mother. I discussed how the sessions will run differently from JA’s previous virtual sessions. The most important way that they would be different is that we needed JA’s consent. Also, he would be given choices throughout the session to improve overall motivation. If JA did not give consent to have the meeting, the clinician would work only with his mother in a parent coaching session. So far, JA has chosen to participate in each session, with his mother present.

During conversations with his mother, we reviewed motivating activities that he can do, not that he can’t do. Due to the current pandemic, JA is not allowed to go to restaurants, shop in stores, etc. He thrives on these activities and when they’re discussed, it triggers negative behaviors. These topics need to be avoided. Activities need to incorporate and target writing, expanding vocabulary and communication, while focusing on motivating activities that can be completed safely during the pandemic (e.g., baking, going to the drive-through, visiting his country house, etc.).