HOW do children who cannot speak communicate with the people around them?
This is a dilemma parents have to grapple with when their daughter or son is non-verbal. The speech impairment could be the result of cerebral palsy, autism and traumatic brain injury, among others. Surely there must be ways and means to achieve this.
This was what I wanted to learn when I attended a half-day workshop on Augmentative and Alternative Communication (AAC) together with 16 other participants. All but one of them were parents of children with cerebral palsy.
It was organised by the Alliance of Children with Cerebral Palsy (GAPS) and Step and Smile Conductive Education Centre Malaysia.
GAPS president Rafidah Rafizah Ahmad explained the purpose of organising the course: “This is one of the many programmes the organisation has lined up to educate and empower parents, other family members, caregivers and the children themselves.
“At the same time we want to create better awareness about cerebral palsy through collaborations with professionals, the government and other stakeholders.”
Nadwah Onwi, senior speech-language therapist with the Cheras Rehabilitation Hospital, facilitated the workshop.
According to her, AAC can supplement or replace speech and writing. Depending on needs and affordability, basic methods like gestures, pictographs and symbols can be utilised while sophisticated equipment like tablets and speech generating devices can also be employed for the same purpose.
We were taught how to use the Picture Exchange Communication System (PECS) which is a form of AAC produced by Pyramid Educational Consultants, Inc. Nadwah guided us step by step in an easy to understand way.
From learning to exchange a single picture for a corresponding object, we progressed to constructing complete sentences using a communication board replete with pronouns, verbs, adjectives and nouns.
We were taught to create the board using a dedicated software and laptop. The board was then printed out in colour and could be used immediately.
I noticed the reaction of the participants the moment their communication board came out from the printer. It must have been a light-bulb moment for them to discover an effective way for their children to communicate or even express their feelings to them for the first time.
I got in touch with some of the participants a few days after the workshop to find out if AAC had been beneficial for them.
Among the participants I managed to contact were husband and wife Mohamed Jazlan Arifin and Lailifiza Ishak who were there to learn to communicate better with their four-year-old son Muhammad Zarif Arifin.
“He speaks no meaningful words yet, other than mama and papa,” said Jazlan.
“Normally he will make soft sounds to call us or ask for something. Thankfully, he understands whenever we ask him questions and he can make ‘I want’ or ‘No’ signs.”
“I see AAC as an alternative for my son to speak his mind or opinion. Instead of just telling us what he needs or sees, it is best if he can tell us in full sentence about them. AAC will significantly help him to ask for things he can’t reach as he has mobility issues. AAC can also improve his vocabulary.”
Norhamimah binti Nazaruddin was the only participant other than me who is not a parent of a child with cerebral palsy.
She runs a programme called CP Class at Masjid that provides tuition for children with cerebral palsy. Fondly known as Cikgu Mim to her students and their parents, she spends her Sunday mornings with five volunteers conducting three classes for 20 students.
“It’s useful to my students,” Cikgu Mim said of AAC.
“Most of the participants are parents whose kids are my students. I am still thinking of effective ways to work with the parents using this method.”
She also noted that some of her students had motor skill limitations.
“It is challenging to ask them to hold an object, what more a small paper” she explained.
“I need to do a little modification to suit their ability. As usual, dealing with special needs always require creativity. My focus is to work on what is possible and allow the students to give feedback later.”
According to Nadwah, AAC is still not widely used in Malaysia.
“This may be due to the fact more parents and persons with disabilities want to speak verbally. Thus, the use of pictures to communicate seems disabling to them,” she said.
For parents with non-verbal children, she told them not to procrastinate in starting them on a vocabulary diary or communication book early.
“Start with a small set of core vocabulary for AAC and expand it when necessary. Introduce real things first and add more vocabulary using real pictures or line drawings. It will help the children to develop language visually.”
As October is the International AAC Awareness Month, she hoped Malaysians are willing to understand and learn more about this method of communication.
For people who are unable to speak, they can be provided with picture communication to get their message across.
Towards this end, she had this to say: “Let’s make people communicate and do not let their thoughts go unspoken!”
To know more about AAC, Nadwah Onwi can be contacted at [email protected]