One Easy Way to Increase Vocabulary on AAC Devices

How do we add vocabulary when a child is physically limited to a few keys on a screen?

In the world of AAC, conflicts and compromises abound. We sacrifice battery life for weight, screen size for portability, budget for specialized access modes. We sacrifice the size of the vocabulary set for the number of buttons a child can access.

When children begin to use an AAC device, motor or cognitive challenges may limit them to just a few words on a screen. How in the world are we going to help them transition smoothly into a larger vocabulary accessed with more—and smaller—keys?

The secret is to use motor automaticity to our advantage.

Let’s step back and take a look a motor automaticity. Motor automaticity is the ability to carry out motor patterns without thinking about the movement. We all do this, all the time.

For example, walking is a skill many of us can do successfully without thinking about. Many of us can even complete other tasks at the same time as walking, such as talking to a friend, carrying objects, or looking for a misplaced coffee cup.

But someone recovering from a brain injury or stroke who has lost that motor automaticity must concentrate hard on the movements needed to walk. All their cognitive energy must focus on moving their legs correctly; carrying on a friendly conversation or looking out for that missing coffee mug is too demanding during the task of walking.

Another example of motor automaticity at work is touch typing. A typist can concentrate on forming words on the page without having to think about which finger to move to spell out the words. Remember this example; we’ll come back to it again.

When kids rely on AAC to communicate, motor automaticity allows them to access symbols on a screen without having to think about movement. This greatly enhances their rate of expression and makes conversation much more accurate and fluid. Kids can focus on the meaning of what they are trying to say rather than the motor mechanics of finding and targeting a symbol on the screen.

Without motor automaticity, locating a target and touching or eye-dwelling on it can be very demanding work. Communication is slow, exhausting, and creates a frustrating number of mis-hits.

We support motor automaticity by keeping buttons in the same location as much as possible. Just as we keep letter keys in a consistent arrangement on a QWERTY keyboard, symbols located in consistent arrangements are easier for kids to retrieve. They can find the symbols and letters they want easily, without having to scan through many keys.

To maximize motor automaticity...

Introduce screens with the end result in mind.

How many buttons on a page will a child be able to access in the future? No one has a crystal ball, so you’re just going to have to make an educated guess based on your child. With semantic compaction vocabulary sets, it’s hard to access a full vocabulary in less than 45 or 60 keys. Category-based pages might allow you to communicate with 30 to 42 keys on a screen, but fewer than that is going to mean a whole lot of tedious page flipping. The more buttons per screen, the fewer hits are needed, whether you are accessing words through categories or semantic compaction.

“But,” you say, “my child can only handle 8 buttons on a screen right now...”

You could offer eight buttons that fill the screen. However, what happens in the future when your child is ready to add more vocabulary? You would have to shrink the buttons and shake up their order to make room for more words or categories. Remember motor automaticity? Your child would have to learn their locations all over again. How discouraging is that?!

How naturally do these 8 buttons...

...become this? (Sono Lexis 9 x 6)
Not very!

Instead, take the screen that is your end goal and hide all buttons except the eight starter words/categories your child is using. He still has access to the same eight selections as the large keys filling the screen. Yes, these buttons will be smaller, but they are surrounded by plenty of null space that won’t activate if he hits it. You might be surprised how fast he can learn to target the smaller button size.

With this end goal in mind (Unity 45, full hit)...

...we start with these few word combinations.

When it is time to add vocabulary, you UN-hide hidden words or categories. They won’t change anything your child has committed to motor memory; they simply begin to fill in void space.

Child begins with these words and category...

...and ends with this 9 x 6 Sono Lexis display over time.

Remember learning to touch type in your keyboarding class? You started with the home row of keys:  asdf jkl;. It wasn’t much; you were limited to words like “fad,” “ask” and “lass.” But after a few days (weeks?), the teacher introduced “e” and “i,” and that opened up a huge new world of words! Now you had command of “alike” and “fleas” and “skidaddle!” The good news is that you didn’t have to relearn where the home row keys were located; they stayed consistent while new keys were added. Eventually, you mastered all 26 letters of the alphabet, along with some punctuation and formatting keys. That’s at least 40 keys...more for the kids who mastered the number row and got an A in typing.

This same concept is what I am asking you to try.

·        Start with the board set you think your child might be able to manage in a few years.

·        Select a few important buttons—the same ones you would have made up into a smaller set with large buttons.

·        Hide all the buttons around these select few.

·        Give your child time to learn to target these smallish buttons in the middle of large null spaces; it may take awhile, but trust that it will happen.

·        Then, when it is time to reveal a few more buttons, your child will be able to move forward with great confidence.

Want more information on hiding keys to support motor learning? Check out this comprehensive training material from Prentke Romich Company or sign up for one of their Language Acquisition through Motor Planning trainings. Although these are geared towards Unity's semantic compaction, the principles can be applied to most other language access software programs as well.