Q: I struggle in using alternative and augmentative communication devices (AAC’s) with my early childhood clients. It seems that the kids can just as easily point to or gesture toward the objects, as point to the words or pictures. Also many of the kids get distracted by manipulating the device. What are your thoughts on this?

I have had this same struggle many times. In fact, I actually hate using AAC devises, but I have used them when necessary.

Most therapists who work with little children seem to like Picture Exchange the best. The child must hand you a picture of the object he wants. He hands you the picture, and you hand him the object that he otherwise could not access. My experience is that you have to be very direct with the kids. Tell them, “I know you want the ___. Give me the picture… Now I can give you the ____.”

AAC’s can be burdensome and inefficient. But, as you know, sometimes it is all we have.

You should ask this question to someone who LOVES working with AAC’s; they will have many more ideas than I do.