October 01, 2020
{Image Description: Beach sand with a bright light blue wooden table, seashells and starfish. There is a tablet on top of the table that is white with a black screen that has text on it. That blue and pink text reads: “It’s AAC Acceptance Month!”} Today is the start of AAC Acceptance Month! What is AAC? AAC stands for Augmentative and Alternative Communication. AAC was invented in 1920. The device itself was created by F. Hall Roe, and was known as the F. Hall Roe Communication Board. F. Hall had cerebral palsy and the device contains letters and words that a person can point to and construct words or sentences. AAC today is much more evolved, and AAC Devices are widely accepted. Two commonly used AAC apps today are Proloquo and Proloquo2Go, which are both made by AssistiveWare. They do discounts on the app every April for Autism Acceptance Month. FAA does not condone the use of ABA, so taking away AAC is the same exact thing as silencing someone who is verbal, which can lead to trauma and Complex PTSD. There are two types of restricted techniques in Therapy that are ableist: Facilitated Communication and Rapid Prompting Method. Both are harmful because they do not allow the child or adult to choose their own ways of communicating, simply because the hand is guided by someone else, and so that makes it more restricted as a result. A quote from the Disability And Society Journal is below: “In facilitated communication, a disabled person’s hand is held by – or, more accurately, it is directed by – another person, towards and onto a communication device. The (conscious or unconscious) power of the person guiding the hands to manipulate the other person is the key flaw in facilitated communication,” (Sherry, 2016).
The Therapist Neurodiversity Collective (TNC) is an organization of educators and therapists, as well as advocates that include neurodivergent Speech Language Therapists, Occupational Therapists and Physical Therapists. They have shared statements about why speech must be consenting. The client must be allowed to create their own ways of communicating, and receive assistance when they need and want it. The TNC advocates for freedom for use of AAC in children. How?”“Access” means having the freedom or ability to have unrestricted use of something. For someone who is dependent on AAC for communication, having continuous AAC access is a human right. AAC devices may be accessed via finger point, switch, eye-gaze, or through other access points. It is vital to determine the easiest and most convenient way for the user to access the AAC device so they may have a reliable method of communication across a variety of environments. Adequate AAC Access means having access to the AAC device at all times (just as a verbal speaker has access to their voice 24/7). We never take away devices for behavior, limit their access to certain periods of the day, or put them on a shelf. For families new to AAC, 24 hour AAC device access must become habitual,” (Therapist Neurodiversity Collective, 2018). Rapid Prompting Method (RPM) has also received criticism from the disability community, and yet ABA therapists do not claim it to be evidence based. Yet, ABA is not evidence based either. RPM is similar to FC; however, is a different technique and is not evidence based. “RPM bears considerable similarity to Facilitated Communication (FC)—also called “Assisted Typing,” “Facilitated Communication Training,” and “Supported Typing”—and FC is a pseudoscientific technique that has been discredited, disproven, and found harmful,” (ASHA, 2018; Schlosser et al., 2014). RPM, according to Amy Sequenzia of the Autistic Women and Nonbinary Network, is also ableist, alongside Facilitated Communication (she also explains why she supports FC and RPM in her own article). How? ASHA’s position statement on FC and RPM goes into detail as to how: “Both RPM and FC are “facilitator”-dependent techniques (i.e., techniques that involve the person with the disability being dependent upon a “facilitator” to produce a message; Tostanoski, Lang, Raulston, Carnett, & Davis, 2014). These techniques ostensibly are designed to provide access to alphabet/letter/word boards or speech-generating devices for communication or education. In RPM, the instructor typically does not physically guide the hands of the individual but, rather, holds the letter board and provides repeated verbal, auditory, visual, and/or tactile prompts,” (ASHA, 2018). RPM and FC, when used in the right environmental setting, are respected through autonomy and consensual. There are SLTs and other therapists that use RPM and FC ethically, but RPM and FC needs to be reformed. ASHA has also received criticism from orgs such as The Autistic Self Advocacy Network:”The Committee’s process has deliberately shut out input from people from disabilities. When the Autistic Self Advocacy Network attempted in 2017 to learn more about the Committee and offer input, we were denied the opportunity to speak directly to the Committee members or even learn the identities of Committee members. We are also alarmed that to our knowledge, the Committee has never, and never plans to, solicit input from people who use the methods of communication under review, or those who formerly used these methods of communication and then graduated to independent typing. The Committee has also never solicited input from a self-advocacy organization of any kind.” Source: The Autistic Self Advocacy Network While the ASHA is right in that it is harmful and can be, the Autistic Self Advocacy Network is correct in that the research is more of a generalization all across RPM and FC. “We do not take positions on individual communication support methods or techniques. Nevertheless, we believe each non-speaking person has a right to use the method of communication that works best for them, as determined by an individualized analysis. Moreover, we believe that no single method of AAC will work for all non-speaking individuals.” -ASANSource: The Autistic Self Advocacy Network For the SLT field to improve, as well as others, this must be understood that RPM and FC are reformable, unlike ABA. FC and RPM also must be consented with communication and touch in therapy for it to work effectively, and FAA believes that RPM and FC must be supported for folks who want to use it. The ASHA needs to address their own implicit biases in research. Please accept non-speaking autistics when supporting ACC this month!
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