In the field of speech pathology, our focus is often on preparing the person with communication disorders for real-life needs such as accessing the community and public spaces. This is understandable in that it is challenging to adapt every environment to meet every conceivable need—there is no one-size-fits-all intervention.
However, should the onus be entirely on the person with communication needs? Shouldn’t we make public spaces as accessible as possible for everyone? Not having a wheelchair ramp or handicap stall in a public institution would be unheard of, but what about those who encounter barriers to spoken and written language?
The Americans with Disabilities Act of 1990 (ADA) ensures equal opportunity for persons with disabilities in public settings (1). Much like hearing and visually impaired or physically disabled people, individuals who have complex communication needs and rely on visual support, or alternative augmentative communication (AAC), experience significant barriers to accessing public spaces.
The US National Joint Committee on Communication Disorders’ Communication Bill of Rights states that people with communication disorders have the right to access environmental contexts that promote participation as full communication partners (2).
In the interest of providing “equal access for all, ” the needs of people with complex communication disorders must be addressed.
Many people with communication disorders rely on visual supports to communicate or navigate their environment. The Center for Disease Control reported that 1 in 68 children were diagnosed with ASDs (Autism Spectrum Disorders) in 2014 (3). Over 50% of people with autism demonstrate no functional communication (4). This means that this group of children cannot communicate with spoken words—they depend on a visual language (AAC) to communicate.
AAC is the use of any other form of communication other than speech; this includes unaided strategies such as sign language and aided strategies such as paper-based communication boards and high-tech speech generating devices. Spoken words are augmented or replaced with icons or pictures.
AAC is a successful tool because visual processing is often much stronger than auditory processing for people with ASDs (5). For these people, AAC is often the most viable means of attaining communication. According to recent studies, 3-5 children per 1000 may need AAC (6). While there are no figures on the number of people who use AAC, given the aforementioned statistics, it can be posited that at least 1 in 132 benefit from AAC and other visual supports.
While people with ASDs represent a considerable percentage of the population, there is an even higher percentage of people with communication disorders who may benefit from visual supports and staff who are trained to meet their needs.
When it comes to community access, the focus has traditionally been on equipping the person with complex communication needs with the ability to access community settings.
Despite this, organizations can meet individuals with communication barriers “halfway” by enriching the environment with visuals and assistive technology.
Paul Simeone, MA, CCC-SLP, ATP
4. Prizant, B.M., & Wetherby, A. M. (2005) Critical considerations in enhancing communication abilities for persons with autism spectrum disorders. In F. Volkmar, A. Klin & Paul, R. (Eds.), Handbook of autism and pervasive developmental disorders (3rd Edition).
5. Shah, A., & Frith, U., (1993) Why do autistic individuals show superior performance on block design task? Journal of Child Psychology and Psychiatry, 34, 1351-1364.
6. Matas, J., Mathy-Laikko, P., Beukelman, D., & Legresley, K. (1985). Identifying the non-speaking population: A demographic study. AAC, 1, 17-31.