Keep Your Eye on the Prize:
Implementing AAC Within the
Broader Context of Communicative
Competence
Laura Segebart DeThorne, PhD,
Julie Hengst, PhD, and
Kim Fisher, MEd
University of Illinois, Champaign
Amie King, PhD
Southern Illinois University, Edwardsville
yec
Springtime sunlight spills onto a sea
of 18 preschool children gathering
around their teacher for circle time.
A small storm of laughter, squeals,
and child-sized limbs swirls on the
light blue rectangular rug. A couple
of children situate themselves along
the perimeter, one of whom, Sam,
sits in a blue cube chair with a green
electronic device across his lap.
“All eyes on me,” directs their
captain, as she points and begins
to count by twos the pairs of eyes
that linger in her direction. “Two,
four, six, eight . . . ”
Among the chatter, many children
shout out numbers as they redirect
their attention, a glint of hope for
teacher recognition in their eyes.
The emerging quiet is broken by
an electronic tenor, “macaroni,”
radiating from Sam’s device; a grin
spreads across his face.
Laughter erupts from the children.
“He said macaroni!” one classmate
narrates.
The teacher chooses to ignore this
reference to macaroni along with
the associated laughter, while a
paraprofessional, seated behind
Sam, silently pushes a button on
his device, presumably to turn
down the volume of its insolence.
The teacher flashes all the children
a quick peek at the cover of “The
Cat in the Hat” while explaining
today’s group activity: finding
Vol. 17, No. 1, March 2014 YOUNG EXCEPTIONAL CHILDREN
words that rhyme. One child
interrupts with a tale about his
cat, to which the teacher reminds
him with eye gaze and a finger to
her lips that this is not the time for
his story.
After reading the first page, the
teacher raises a query, “What
rhymes with play?” A few hands
fly into the air, while one child
blurts out a spoken response.
“Remember to raise your hand,”
the teacher reminds him. He
immediately raises his hand, and
she calls on him for response.
“House!” he offers with
enthusiasm.
“House . . . play,” the teacher
muses aloud, “not quite. Who else
has an idea?”
Again hands fly into the air like
seagulls at the surf. Teacher and
pupils fall into a rhythm as
seemingly familiar as the tide—at
least for some of them. Sam,
though seated near the group for
the entire activity, does not take
part in the question-answer
routine. One gets the sense that
perhaps he is tethered to port
somehow, never quite making it
out to the open sea.
DOI: 10.1177/1096250613485453
http://yec.sagepub.com
© 2013 Division for Early Childhood
39
 Implementing AAC within the broader context / DeThorne et al.
Introduction
E
lectronic technologies are
playing an increasing role in
mediating patterns of social
interaction within the classroom.
This trend includes augmentative
and alternative communication
(AAC) systems, like the device used
by Sam from the opening vignette.
The advent of lightweight smart
tablets with a diversity of
communication-oriented
applications at a fraction of the
price of traditional AAC devices
increases the accessibility and
potential application of such devices
in the classroom.
AAC in general has proven
effective for many children in regard
to decreasing challenging behavior,
enabling communication of wants
and needs, and supporting speech
development (Millar, Light, &
40 YOUNG EXCEPTIONAL CHILDREN Vol. 17, No. 1, March 2014
Schlosser, 2006; Mirenda, 1997;
Schlosser & Wendt, 2008; Snell,
Chen, & Hooever, 2006). However,
evidence of successful AAC use is
tempered by sobering statistics
regarding limited communicative
functions, barriers to successful
implementation, and system
abandonment (Johnson, Inglebret,
Jones, & Ray, 2006; Lund & Light,
2007). One area that remains
particularly challenging is the
successful integration of AAC
systems within sustained social
interactions for children with
speech-language impairments (cf.
Mellman, DeThorne, & Hengst,
2010). Given the increasing
availability of AAC systems and the
documented limitations in regard to
successful implementation across
everyday contexts, this article aims
to highlight the importance of
integrating AAC within a broad
communication framework. In direct
relation to the Initial Special
Education Professionals in Early
Childhood Special Education/Early
Intervention (Birth to Eight)
Standards (Council for Exceptional
Children, 2007), this article provides
a theoretical framework (Standard I,
ICCKI) to guide special education
practices toward embedding learning
opportunities in everyday activities
(Standard V, ECSES3) by
structuring social environments to
promote successful communicative
interactions (Standard V, ECE5S4)
particularly for children who utilize
AAC (Standard VI, ICC6K4).
The field of communication
sciences and disorders has long
differentiated speech and language
as separate but related processes
that refer to the sensory-motor and
linguistic skills of an individual,
respectively. This stands in contrast
to communication, which refers
 Implementing AAC within the broader context / DeThorne et al.
more broadly to an exchange of
ideas among individuals (cf. Pence
& Justice, 2008). To highlight this
distinction, consider a child alone in
his or her room repeating lines from
a movie. This child is using speech
and language skills, but is not
communicating with anyone. In
contrast, consider a child who
points to a cookie jar and looks to
his or her mother. This child is
clearly communicating but is not
using speech or language to do so.
In our communications with
“
caregivers of children who are
largely “nonverbal,” parents often
tell us they want their children to
If you think of your own speak so that they can share ideas
and know what their children are
experiences, you have thinking. One mother shared with
us that in her dreams, she and her
probably noticed that the son with limited verbal abilities can
“know each other’s minds.”
degree of success in your Inherent in these messages from
caregivers is a longing not so much
communicative for speech and language, per se, but
for successful communication.
To help us understand what is
interactions depends on involved in supporting successful
communication for all children,
what you are doing, whom including those who use AAC
technologies, we draw here on
you are interacting with, sociocultural and practice theory
approaches to child development
the resources available to and learning (e.g., Bruner, 1996;
Cole, 1998; Wells, 1999). These
you, and the nature of the approaches offer a useful theoretical
framework that defines
relationships you have communication as a social
accomplishment, not as an isolated
individual ability or a set of testable
built up with people over skills. Seen as a social
accomplishment, we understand
time. communication as always occurring
”
within specific activities for specific
purposes (e.g., answering a teacher’s
question, sharing small talk with
friends). Successful communication
is then tied to how well those
Vol. 17, No. 1, March 2014 YOUNG EXCEPTIONAL CHILDREN
activities are accomplished. Thus,
communication is also shared by all
participants in the interaction and
accomplished through their use of a
wide range of resources (e.g., talk,
gestures, joint attention).
Within any given interaction,
there are multiple ways for
individuals to communicate and
coordinate with others, so successful
communication often depends on
people flexibly shifting the ways they
coordinate with each other during
the interaction (Hengst & Duff,
2007). For example, when a speaker
in a conversation stumbles over a
word, he or she may substitute
gestures or actions for the missing
word, or listeners may fill in words
for the speaker, or in some cases, the
word is simply left out and the
conversation goes on without it.
Among familiar communication
partners, this happens so smoothly
that, as long as the point gets across
and the conversation continues, we
do not even notice how such success
was achieved. Successful
communication depends on the
coordination of people and resources.
Finally, understood as a social
accomplishment, communication is
supported through the shared
histories people bring to their
interactions with each other (e.g.,
best friends, strangers) and to the
activities at hand (e.g., playing a
video game). In this sense, successful
communication grows out of
repeated opportunities for people to
work together. If you think of your
own experiences, you have probably
noticed that the degree of success in
your communicative interactions
depends on what you are doing,
whom you are interacting with, the
resources available to you, and the
nature of the relationships you have
built up with people over time.
41
 Implementing AAC within the broader context / DeThorne et al.
Adults readily focus on
prioritizing communication success
through whatever means are
available as they communicate with
others during everyday work and
social activities. However, in school
settings during interactions with
children using AAC devices, there is
a tendency to lose sight of successful
communication as the overarching
goal. As an example, Mellman et al.
(2010) reported a scenario from her
classroom observations of Alex (a
4-year-old boy who utilized a
speech-generating AAC device) in
which a paraprofessional held up
two crayons toward Alex and asked
him which color he wanted. The
paraprofessional specified, “Tell me
with your device,” as opposed to
giving Alex the flexibility to choose
his form of response (e.g., using a
42 YOUNG EXCEPTIONAL CHILDREN Vol. 17, No. 1, March 2014
pointing gesture to select the color
he wanted). Here, the
paraprofessional appeared not to
recognize and value all the resources
available for communication,
making AAC use the end rather
than seeing it as one of many means
to successful communication.
In this article, we outline four
principles, grounded in the
framework of communicative
competence, that encourage us all
(parents and professionals) to “keep
our eye on communicative success
as the ultimate prize.” Specifically,
the four guiding principles,
summarized in Table 1 are (a)
support social interaction within
meaningful activity, (b) share
responsibility for successful
interactions, (c) encourage multiple
forms of communication, and (d)
draw on shared histories and
prepare for future interactions. In
the sections below, we will describe
each of these principles and apply
them to the opening vignette. Our
goal is to encourage professionals
and caregivers to reflect on their
own communicative practices with
children who use AAC and to foster
successful communication and
participation within classrooms and
communities at large.
Support Social Interaction
Within Meaningful Activity
When taking up a framework of
communicative competence,
consideration of context becomes
paramount. Word production is not
considered an isolated skill but as a
potential message deployed for a
particular communicative purpose.
To highlight the important role of
context (i.e., activity), consider how
Sam’s production of the word
“macaroni” would likely be
 Implementing AAC within the broader context / DeThorne et al.
Table 1
A Summary of the 4 Principles and Guiding Questions Associated With a
Framework of Communicative Competence
Principle
1. Support social interaction within
meaningful activity
2. Share responsibility for successful
interactions
3. Encourage multiple forms of
communication
4. Draw on shared histories and build for
future interactions
“
perceived and “taken up” very
differently depending on whether
Within the framework of the activity is book reading during
circle time versus a group sing-along
of Yankee Doodle Dandy, with the
communicative lyrics “Yankee Doodle went to
London, just to ride a pony, stuck a
competence, caregivers, feather in his hat, and called it
macaroni!” In the sing-along, Sam’s
teachers, therapists, and production would likely be taken up
as direct participation in the activity,
peers are all seen as whereas during the preparation of
book reading, Sam’s production
partners with the child, appeared to be taken up as an act of
silliness by many of the children and
working together to as a potential disruption by the
paraprofessional. Note that in this
accomplish activities and book reading versus sing-along
example, the actual word being
produced (i.e., macaroni) is not
communicate messages. different, but its meaning is
”
interpreted differently based on the
activity. Consequently, the guiding
question for those of us supporting
a child who uses AAC is “What is/
are the relevant activities at hand?”
When thinking about the
relevant activities, it is important to
note that multiple goals and
activities are always at play. In
thinking about the opening vignette,
the guiding question leads us to ask,
“What is the teacher trying to
accomplish here? What are the
Vol. 17, No. 1, March 2014 YOUNG EXCEPTIONAL CHILDREN
Guiding question
What is/are the relevant activities at hand?
How do I collaborate with this child to support
successful communication and participation?
What resources are available to us in this
moment to support communication?
How can we draw on familiarity to support
current and future communication?
children’s goals? How can we better
align the children we are supporting
with the activities taking place?” As
an example, one of the teacher’s key
activities was shared book
interaction during circle time, which
included transitioning and engaging
the children in book reading.
Consequently, her responses to the
children were shaped by her goal of
fostering successful interaction and
participation within that activity. In
this example, the primary goal is
participation in the circle time
activity, not ensuring “correct device
use” or even “making sure everyone
is quiet.”
For children who use AAC, one
advantage of identifying participation
in the activity as the goal is that it
maximizes the options for how
successful communication can be
accomplished. Looking again at the
opening vignette, the children are
participating in the activity in a
variety of ways, both verbally and
nonverbally: for example, shouting
out numbers, looking toward the
teacher, and raising their hands. There
is no one correct way to participate in
the activity. Recognizing the diverse
ways children can participate in the
meaningful activities at hand (e.g.,
speech, eye gaze, gesture, device use)
43
 Implementing AAC within the broader context / DeThorne et al.
“
When the focus is on
successful
communication, the form
is reduced to its proper
place of being a means
toward an end, rather than
the end itself.
”
44 YOUNG EXCEPTIONAL CHILDREN
also affords us as caregivers and
professionals flexibility in how we
support our children in those
activities, which takes us to the
second principle.
Share Responsibility for
Successful Interactions
Once the relevant activities are
identified, then it becomes clearer
how to support the child’s successful
participation. Within the framework
of communicative competence,
caregivers, teachers, therapists, and
peers are all seen as partners with
the child, working together to
accomplish activities and
communicate messages. As partners,
our actions should be guided by the
question, “How do I collaborate
with this child to support successful
communication and participation?”
Taking the opening vignette as an
example, Sam selected the word
“macaroni” on his device, but it did
not appear to be interpreted as
communicative by his teacher within
the carpet time activities. Instead,
she chose to ignore his production,
even though when a different child
later spoke out of turn she reminded
that child to raise his hand. When
applied to the opening vignette then,
this principle of collaboration leads
us to ask, “What does the child
bring to the interaction? What do
his or her communication partners
bring, myself included? How can I
help align what the child brings to
the expectations of this
community?”
A framework of communicative
competence encourages us to assume
relevant meaning from children’s
actions and respond accordingly,
something that parents are often
willing to do even with the youngest
of children (cf. Dunst & Lowe,
Vol. 17, No. 1, March 2014
1986). Consider the infant who
babbles “mama,” and the mother
who responds excitedly to the
possibility of being called by name.
Her response helps create shared
meaning and joint activity between
the two of them. Because of the
mother’s response, the interaction
becomes a conversation! So too
must children with AAC devices and
their partners go about the
collaborative work of interpreting
communicative acts within the
activity, whether the form of that
communicative action is a spoken
syllable or a selected symbol.
Recognizing the shared
responsibility for successful
interactions highlights the need for
communication partners of children
who use AAC to receive explicit
time and training on the relevant
device(s). Such training often takes
the form of basic familiarity with
the system, including how to
program it, and how to support its
use. Given enough familiarity with
his device, the paraprofessional in
the opening vignette could have
supported Sam’s participation by
helping him raise his hand and
finding a relevant response to the
rhyming task on his device.
Providing relevant models of
message-focused AAC use is
commonly viewed as best practice
within the recent AAC literature
(Binger & Light, 2007; Harris &
Reichle, 2004; Mirenda & Brown,
2009; Romski & Sevcik, 2003),
often referred to as “aided language
stimulation” or “augmented input.”
A framework of communicative
competence suggests that children
need to be socialized into using and
responding to AAC, and this
requires opportunities for them to
observe AAC being used to
communicate. In sum, the process of
 Implementing AAC within the broader context / DeThorne et al.
supporting a child who uses AAC
can look very different depending
on the child and the context. For
example, an experienced AAC user
in a familiar context may primarily
need a patient and engaged
communicative partner, whereas a
beginning communicator may also
require multiple models of device
use with verbal and physical
prompting. However, the goal is
always to provide whatever support
is necessary to ensure successful
communication and participation
within the activity at hand.
Encourage Multiple Forms of
Communication
For all of us, including children
who use AAC, successful interactions
are contingent on the ability of others
to read, recognize, and value all forms
Vol. 17, No. 1, March 2014 YOUNG EXCEPTIONAL CHILDREN
of communicative actions. By
communication form, we are referring
to the multiple means and modalities
through which we communicate (e.g.,
gestures, speech, facial expression,
eye gaze, computerized devices).
When the focus is on successful
communication, the form is reduced
to its proper place of being a means
toward an end, rather than the end
itself. Consequently, the associated
question we should ask ourselves is
“What resources are available to us in
this moment to support
communication?”
When applied to the rhyming
activity in the opening vignette, this
guiding question leads us to ask,
“What communicative forms could
Sam readily use to participate?
What additional resources (e.g.,
pictures, objects) are available in the
immediate environment? What
forms of communication most
readily meet the needs of this
interaction?” By considering all
available resources, it becomes
clearer that Sam’s nonverbal
behavior could be interpreted as
communicative. For example, if he
looks at or points toward the book,
the teacher could acknowledge that
behavior as a response by saying
something like, “Sam, I saw you
look toward the page. I wonder if
you saw the word, day; Day rhymes
with play!”
When valuing all forms of
communication, the AAC system
becomes a critical resource that
should be available to the child
throughout the day. Decisions to
take a child’s device away, leave it
behind, or turn down its volume are
not made without recognition that
communication resources are being
restricted, often in very invasive
ways. Limiting a child’s access to his
or her device fails to value its critical
45
 Implementing AAC within the broader context / DeThorne et al.
“
In addition to drawing on
shared histories, our
current interactions should
be paving the way for
successful future
interactions.
”
46 YOUNG EXCEPTIONAL CHILDREN
role in facilitating social interaction,
restricts his or her opportunities to
learn how to manage his or her own
“voice,” and runs the risk of limiting
a child’s willingness to invest in
learning to use the AAC system in
the first place. We often find that the
temptation to limit a child’s access
to his or her own device becomes
most pressing when the child is using
it in a way that is disruptive, such as
when Sam blurted out “macaroni”
in the opening vignette. However,
instead of immediately restricting a
child’s access to the device, we
would encourage caregivers and
professionals to consider the device
as one of many important
communicative resources within the
interaction and consequently turn to
other options for shaping the
interaction, such as reminding him
that it is not time to talk about food
(see revised vignette at the end of
this article).
In addition to implications for
device accessibility, recognizing
multiple forms of communication
also diversifies opportunities for
caregivers and professionals to
support Sam’s participation in the
group. Device use, though powerful
in certain contexts, can be
burdensome in others (Johnston,
Reichle, & Evans, 2004; Sigafoos &
Drasgow, 2001). Recognizing the
legitimacy of multiple modalities
allows the AAC user and his or her
partners’ flexibility to use other
communicative forms as the
circumstance allows.
Recognizing AAC as one of
many available resources also helps
highlight the potential benefits of
AAC for children who have already
developed, or are expected to
develop, spoken language.
Specifically, there may be clear
advantages in using AAC for children
who have developed spoken language
Vol. 17, No. 1, March 2014
but have limitations in speech
intelligibility, word finding, and/or
fluency. When the multimodal nature
of human communication is paired
with evidence that AAC may enhance
speech development (e.g., Romski
et al., 2010), the population of
children who may benefit from
access to AAC widens substantially,
and concerns that access to AAC
will negatively affect speech diminish.
In sum, requiring any individual to
rely on one form of communication
is “unnatural” and limits his or her
ability to be a flexible and robust
communicator. Consequently,
children who use AAC and their
communicative partners are
encouraged to use all available
resources to foster successful
interaction and participation in the
activity at hand, including their
familiarity with one another.
Draw on Shared Histories and
Build for Future Interactions
One of the key resources
communication partners often have
at their disposal, particularly
caregivers, is familiarity and
sustained relationship. In addition to
being distributed across people and
resources, communicative
competence is also distributed across
time. Present interactions are
influenced by memories of the past
and plans for the future, which can
make familiarity a critical asset. As
such, our interactions with children
who use AAC should be shaped by
the question, “How can we draw on
familiarity to support current and
future communication?”
For all of us, familiar
communication partners are able to
complete our sentences, anticipate
our needs, and read our seemingly
idiosyncratic behavior. Such
familiarity should be viewed as a
 Implementing AAC within the broader context / DeThorne et al.
resource to draw upon within social
interactions, rather than a form of
support to extinguish. Applying the
importance of repeated interactions
to the opening vignette leads us to
ask, “What do we know about Sam
that can help us interpret his
behavior? How can we react to this
situation to help support interactions
in the future?” For example, when
Sam selected the message “macaroni”
in the opening vignette, a familiar
partner might know that this is the
time of day during which Sam tends
to get hungry, and macaroni is one
of his favorite foods. Such familiarity
should be used to shape the
interaction. Perhaps the teacher or
paraprofessional might respond by
saying, “Sam, I know you’re getting
hungry. Only thirty more minutes
until lunch.” Or perhaps the class
knows that Sam tends to be a
prankster. In such a case, the teacher
or paraprofessional might respond by
saying, “Sam, it’s not time to joke.
We can joke during recess.”
In addition to drawing on
shared histories, our current
interactions should be paving the
way for successful future
interactions. Again turning to the
opening vignette, the
paraprofessional’s and teacher’s
responses to Sam’s production of
macaroni may have minimized the
present disruption, but it did not
appear to pave the way for more
positive future interactions. For
example, by ignoring his production
(particularly when she did not
ignore other children’s disruptions),
the teacher may have inadvertently
communicated that Sam’s actions do
not matter, are not meaningful, or
cannot be helped. Along the same
lines, by controlling the device’s
volume herself, the paraprofessional
may be communicating a similar
negative message, as well as missing
Vol. 17, No. 1, March 2014 YOUNG EXCEPTIONAL CHILDREN
an opportunity to teach Sam control
over his own “voice.” In contrast,
by reminding Sam that it is time to
be quiet and helping him learn how
to adjust the volume himself, the
paraprofessional and teacher are
acknowledging his communicative
competence and shaping future
interactions to be more successful.
In conjunction, if the production of
macaroni was considered an act of
playfulness, one could build on this
social strength by adding goofy
sound effects and explicit jokes to
Sam’s AAC messages, or perhaps by
returning to the topic of macaroni
during lunchtime when joking is
more consistent with the activity.
Realizing that our current
interactions are learning
opportunities for everyone involved
challenges us to make more
intentional and proactive choices to
shape future patterns of interaction
and to work toward building
positive relationships.
In closing, we have revised the
opening vignette to be more inline
with a framework of communicative
competence, including all four
related principles. Related revisions
are underlined for quick
identification. As it did for us, we
hope this illustration and the
associated four principles serve as a
means to encourage caregivers and
professionals to reflect on their
interactions with children who use
AAC so that we can all work
together to achieve the ultimate
prize: successful communication.
Springtime sunlight spills onto a
sea of 18 preschool children gathering
around their teacher for circle time. A
small storm of laughter, squeals, and
child-sized limbs swirls on the light
blue rectangular rug. A couple of
children situate themselves along the
perimeter, one of whom, Sam, sits in
a blue cube chair next to the teacher,
47
 Implementing AAC within the broader context / DeThorne et al.
a green electronic device situated in
his lap.
“All eyes on me,” directs their
captain, as she points and begins to
count by twos the pairs of eyes that
linger in her direction. “Two, four,
six, eight . . . ”
Many children shout out
numbers as they redirect their
attention, a glint of hope for teacher
recognition in their eyes.
The emerging quiet is broken by
an electronic tenor, “macaroni,”
radiating from Sam’s device; a grin
spreads across his face.
Laughter erupts from the
children. “He said macaroni!” one
classmate narrates.
The teacher pulls out a “time to
be quiet” card, showing it first to
Sam and then the rest of the group.
The card offers a photo of the
teacher making the “be quiet”
gesture with her finger to her lips.
“It’s not time to be silly,” she
reminds them all.
Sam selects “macaroni” on his
device again, and a few children
release muffled giggles. The
paraprofessional, seated behind
Sam, reminds him that it’s “time to
count eyes,” and assists him in
accessing a selection of numbers on
his device. Sam chooses, “twelve,
ten, nine.”
The teacher claims, “Yes I see
ten, twelve eyes,” and continues
Authors’ Note
You may reach Laura Segebart DeThorne by e-mail at lauras@illinois.edu
References
Binger, C., & Light, J. (2007). The effect of aided AAC modeling on the
expression of multi-symbol messages by preschoolers who use AAC.
Augmentative and Alternative Communication, 23, 30-43.
doi:10.1080/07434610600807470
48 YOUNG EXCEPTIONAL CHILDREN Vol. 17, No. 1, March 2014
counting by twos until most in the
group appear attentive.
The teacher flashes all the
children a quick peek at the cover of
“The Cat in the Hat” while
explaining today’s group activity:
finding words that rhyme. One child
interrupts with a tale about his cat, to
which the teacher reminds him with
eye gaze and a finger to her lips that
this is not the time for his story.
After reading the first page, the
teacher elicits a prompt from the
children, “What rhymes with play?”
A few hands fly into the air, while
one child blurts out a spoken
response.
“Remember to raise your
hand,” she reminds him. He
immediately raises his hand, and she
calls on him for response.
“House!” he offers with
enthusiasm.
“House . . . play,” the teacher
muses aloud, “not quite. Who else
has an idea?” Again hands fly into
the air like seagulls at the surf.
The paraprofessional navigates
to a page on Sam’s device with
animals on it and points to three
possible options. She repeats the
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in Sam’s ear and gently ushers his
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Teacher and pupils, Sam
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