AAC for Individuals with Autism Spectrum Disorder: Assessment and Establishing Treatment Goals

An area of great interest to clinicians, holding promise with current technology to support the individual with autism spectrum disorder (ASD), is that of augmentative and alternative communication (AAC) as part of a comprehensive intensive treatment approach to address communication needs. Although great strides have been made in the area of technology to support the use of AAC with individuals with communication disorders, the use of AAC with the ASD population is often the least understood by the practicing clinician in terms of efficacy and how to establish a foundation for developing an effective language and communication system that sustains over time. Due to the many behavioral challenges found with ASD, basic pre-linguistic behaviors necessary to benefit from AAC are often overlooked in the early stages of assessment and treatment, and the advanced AAC systems put into place frequently become abandoned due to the lack of engagement with the technology on the part of the individual with ASD, resulting in minimal improvements in functional communication. Despite the challenges that exist when introducing AAC to children or adults with ASD, establishing a foundation for where to begin, promoting successful engagement with the device as a communication tool, and developing a true language system for the child are all attainable goals if comprehensive evaluation of behavior and language are completed prior to the introduction of any AAC device. The remainder of this chapter will focus on evaluation and development of language and communication skills necessary to support the introduction of AAC, emphasizing the introduction of technology to young children with a diagnosis of ASD, although a similar approach can be taken with older adolescents and young adults as well. Given what is known about the plasticity of the brain early in development (Dawson 2008; Helt et al. 2008), and given current