eye gaze system from a field of two and consistently chose the item on the left. He did somewhat better if you arranged his two choices vertically, but not much. Fast forward five years. He is now using a speech generating device with 25 buttons per page. He can hit the smallest targets I have ever seen on his device, buttons only centimeters in size. Why can he communicate via eye gaze on an eye tracking device and not using low tech?
Who knows? It could be that having a person in his space to hold up his choices distracted him. It could be that he was bored with the two choices he was being given. It could be that two choices being held up in space did not have a clear enough figure ground for him to visually distinguish them. It could be because secretly he was saying, "I hate you and your two ridiculous choice cards!" I honestly don't know why he cannot respond accurately to low technology eye gaze choices yet he can communicate on a high technology system. More over I am not sure it matters. What matters is that his TEAM at the time, especially his parents and his augmentative and alternative communication specialist decided to try high technology eye gaze anyway. And thank heavens they did! AAC through high technology eye gaze changed his whole world.
Access to augmentative and alternative communication is not a hierarchy, though so many of us in the field want it to be. We want to believe our students will work from using objects to photographs to picture symbols. We want to believe we start with two choices and move to four and then eight and then sixteen before we try dynamic display. We desperately want to believe less is more with emergent communicators.
The problem is what if we are wrong? What if our stubbornness leads to us creating individuals who cannot communicate, not because of their disabilities, but because we never let them! Because we never gave them the correct tools for them? Living the least dangerous assumption means that we don't restrict our learners because of our own belief systems. We assume that they can. We presume competence. Using a hierarchical system of AAC is not living the least dangerous assumption. It, instead, is making a very dangerous assumption. It is assuming that the child in front of you is going to use a prescribed series of steps with mastery at each step sequentially to learn to communicate. (Which, I should note, is NOT how typical communicators develop!) It also assumes that if the child cannot master a certain step then they cannot go beyond it - EVER. Additionally it assumes that low technology communication skills are transferable to high technology communication - which is not always the case. Using partner assisted auditory or visual scanning is NOT the same thing as using auditory or visual scanning with a switch. Using PECS or pointing to pictures or using a "Go Talk" is NOT the same as using a conductive touch screen with dynamic display. Using eye gaze to look at objects or photos or picture symbols is NOT the same as using an eye tracking computer system. Just because a student can do one does not mean they can do the other and just because a student cannot do one does not mean they cannot do the other!
This hierarchy is our construction as professionals and sometimes it is right. The worry is that sometimes it is very wrong! We have so many more tools now that we did when I started in this field. We have so much more research. We have research that says that just one or three weeks of intensive aided language stimulation generally increases AAC skills (and we get to have 22 weeks with our students! Why aren't we embracing this?). Yet we still "drill and kill" with field of two choices for beginning communicators.
There is so much high tech can do that low tech cannot, such as:
- be explored with visual and auditory feedback independent of a communication partner
- be used to call for someone or say something when you aren't expected to (when your communication partner isn't standing at the ready)
- get immediate feedback visually and auditorially
- access highly motivating games and activities to train access skills
- be completely consistent in response no matter where you are and who you are talking to
- be precisely calibrated just for the individual and his or her best means of access
- allow different means of access depending on the day and the student's status
- be understood by unfamiliar listeners instantly
- instantly create respect in unfamiliar listeners in a way low tech cannot
- a "cool" factor that just can't be beat
There are, of course, many things low tech can do that high tech can't as well, but since I have never, ever heard anyone argue that all AAC users should "prove themselves" on high tech first I am not going to enumerate them here!
Long story short it is time for a new paradigm. It is time to scrap the hierarchy that is so pervasive in AAC. It is time to BELIEVE in our students. It is time to give them a chance. It is time to allow them a chance to try, really try, high technology AAC even if they haven't "proven themselves" with low technology first!