AAC Evaluation for Our Toddler

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I mentioned here when J was first diagnosed with childhood apraxia of speech that Mark and I were considering getting J an iPad with a speech app on it in order to help him communicate. However, the therapists here were against it, saying that he was too young and that it might discourage him from using his voice. I never felt quite comfortable with this though, and kept an ear out for research.

Enter the FB page of writer Robert Rummel-Hudson. He is an augmentative and alternative communication (AAC) advocate. His daughter, Schuyler, uses an AAC device as her primary means of speech. He posted a video of a child younger than J effectively using an iPad to talk, and then later on shared a blog post written by a speech therapist whose young child uses an iPad. (iPads are not the only type of AAC but due to the expense and bulk of other AAC devices, it is becoming perhaps the most popular one.) I started asking questions and ended up reaching out the to speech therapist directly.

Long story short, yesterday found J and I road-tripping 2.5 hours to meet with her for an evaluation. We started off using the LAMP app on the iPad. LAMP has 3 settings (they correspond to amount of words available to the user) and we started on the middle. I was surprised at how quickly J picked it up. Pretty soon we’d moved on to allowing him to use the full version of the app. The highlight was watching J use the program to label colors. He’d click the color button, then choose a color, which the program would say out loud. Then, he’d point to that color somewhere in the room, thus proving he knew what he was saying with the machine. J can not name any colors with his voice, nor have I seen him do well at picking out colors when requested. With the iPad though, he was correctly labeling them about 80% of the time. The therapist also explained that kids who use AAC do not become dependent on it; research is actually showing that some of them speak earlier than those kids with the same diagnosis who do not use AAC.

We left with the recommendation to get J an iPad or iPad mini, along with the LAMP program. I immediately started looking for grants online. An iPad mini is $329 and LAMP is $299, so obviously this is not an inexpensive venture. We missed a few of the grant cycles by a matter of weeks, so I’m looking for agencies that award them more frequently than quarterly so we do not have to wait until August for J to be able to take advantage of this technology. However, many of the grant applications I came across required a letter from the speech therapist, which meant I’d have to “fess up” to our local therapist about what we’d decided to do.

kid eating chicken nuggets

Lunch after the eval, before the long drive home


This morning was J’s weekly therapy appointment. Now, I like this therapist. She has little experience with verbal apraxia but has been willing to learn, and J likes her so that is good enough for me right now. I hoped that she’d be on board with our plan even though initially she’d expressed reluctance. As she worked with him on vocalizing “open,” I explained that PECS was not working for us. It felt like a step backward. The therapist agreed. Then I just dove into explaining that we’d gone in for an AAC eval, that it had gone well, and that we were pursuing grant money. She was enthusiastic, and went and got an iPad with LAMP on it so J could demonstrate what he’d learned.

His therapist started by asking him to tell her which color block he’d like. He correctly requested all the blocks in the pile. Then she showed him a stuffed red fruit.

“What is this?” she asked.

Understand that is not a question that J can answer verbally. His words basically consist of yah, no, hi/bye, more, go, uh-oh, and ew, and whether he is able to access these words on any given day is anyone’s guess, as part of verbal apraxia is that the ability to say a particular word comes and goes.

J pushed the eat button, which opened up a food screen. He selected fruits, then clicked tomato. “Tomato” the iPad said. Then, with no prompting, he found the word for like, and then grocery store, to tell us that he likes tomatoes and gets them at the grocery store. I had to rub my eyes to push back happy-sad tears: happy that he can communicate so well with an AAC and sad that there is so much he wants to say and can not right now.

Obviously J isn’t using this perfectly right now, but he’s doing a great job. His therapist agreed to write a letter on our behalf in order to secure funding for him. My hope is that we get the funding quickly so J can get communicating better quickly!

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9 Comments

  1. Wow! That’s amazing! What a massive difference, that must be so exciting for you all – especially J! Good luck with the grants x

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  2. Way to go J and way to go mom for advocating! Try Easter Seals for an IPAD loaner, we did that for Boo. She ended up not being able to use the IPAD for language. Signing worked much easier for her. But I have heard so many great advances kids make using it. Good luck!

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  3. (I guess my comment didn’t get saved in the move. ;)

    This is so exciting! I can imagine how much joy you felt when seeing him use the iPad to communicate. I’m hoping for a swift approval for a grant so that he can begin using it all the time!

    Have you been pursuing using ASL as well? I know we’ve very much enjoyed signing with Daniel…even now that he’s talking (TONS).

    I’ll be thinking of you all and hoping for the best!

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    marfmom Reply:

    Thanks! I love ASL and have since college, before kids. However, J has never taken to it. His difficulty remembering signs is most likely tied up with the apraxia somehow. I think there is disagrement on how the two are related, but several specialists have told me that it’s not uncommon for kids with verbal apraxia to have a very difficult time with ASL as well.

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  4. Brought tears to my eyes! I can imagine how wonderful it was to see him communicating yet sadness at knowing how much he wants to convey on a daily basis and cannot. Hopefully soon you will be able to get this technology and daily benefit from it!

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  5. That makes a lot of sense to me, actually (now that you mention it). It seems like the same part of the brain responsible for verbal word recall would be responsible for sign recall, too. I really hope you get a grant soon!

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  6. Wow! It’s amazing the technology out there and how it can be used to help people. I hope you’re able to get the iPad and LAMP program as soon as possible.

    Way to go doing what you thought was best instead of accepting someone else’s decision. We know our kids best.

    Visiting from SITS.

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  7. What a wonderful success story! It sounds like a lot of his success came from the fact that the LAMP Program provided all of the core vocabulary that he needed without having to search through a bunch of pages. I am so excited for you to get his own equipment! There is a wealth of information on the semantic compaction systems website–type minspeak.com in the search bar. There are lesson plans, children’s books and other materials free to download. You also can find support materials at prentrom.com. I wish you well on your communication journey with your son and would love to hear how he is doing! I can’t believe I almost forgot to mention this–the Pixon Project is an excellent teaching resource that would definitely be worthwhile looking at!

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    marfmom Reply:

    Thanks so much for letting me know about these resources! I’ll be sure to check them out! J is now sometimes making 2-3 word sentences with LAMP, and his verbal vocab has doubled since he’s been using it.

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