Perspectives of Part-Time Augmentative and Alternative Communication Use in Adults and Implications for Pediatric Service Delivery

Abstract

Purpose: Speaking autistic adults who use augmentative and alternative communication (AAC) part-time increasingly share their experiences of insufficient, unreliable, or inconsistent speech. Their experiences detail how forced communication through verbal speech alone causes harm and how AAC systems allow them to communicate freely. The purpose of this clinical focus article is to (a) define intermittent, unreliable, and inconsistent speech as experienced by autistic adults; (b) discuss implications for service delivery of AAC to autistic children; and (c) present an example of a pediatric part-time AAC assessment through a case study. Method: This clinical focus article presents a case study of an AAC assessment completed at a university clinic for a speaking child who experiences intermittent speech. Data from the case study were collected through chart review, a semistructured interview with the parent, and short surveys sent to the family. The case study presents the background and history of the client, planning for the assessment procedures, and details of the assessment procedures and data collected, and summarizes the results of the assessment. Results: The results of the assessment led to the successful funding of an AAC system through a third-party insurance provider. A summary of the follow-up session with the family after the device was received is provided. Conclusions: Characteristics of the mother's advocacy for her child's communication and its implications for the case study are discussed. Future directions of this research include the development of communication choice–affirming assessment and intervention protocols created in collaboration with autistic adults to support children who experience insufficient, intermittent, or unreliable speech.