Counseling Needs of People who Use AAC

Speak Up Project 2004

1. People who user AAC, because of their disability and their barriers to communication, may face isolation, poverty, increased vulnerability, dependence on caregivers, demands to comply with authority, and may be medicated, disempowered, devalued, with resulting issues of low self-esteem. They have a history of negative experiences relative to respect, relationships, choice, skill development, personal worth, potential etc.


2. Communication is the foundation of counseling and AAC may pose a major barrier. Users of AAC have unique and idiosyncratic ways of communicating, and counselors may require a third party facilitator in order to allow the counselor to focus on “deep listening” and counseling (Millar and Butson 1998).


3. AAC users may not have the words they need to communicate about abuse, or they may require co-construction of their messages by a person skilled in interpreting AAC communication.


4. AAC users have individual skills and needs and use AAC in different ways. Counselors need to understand that people who use AAC who have limited vocabularies may use a vocabulary item available to them that is close but does not convey their full intention (e.g. “sad” to mean “anxious” “worried” or “nervous”). They may have difficulty sequencing words into sentences and omit verbs, pronouns etc. which may lead to the need to clarify what is intended. Some AAC users need an interpreter who knows how to co-construct their messages without disempowering them (e.g. guessing) and others need an interpreter who knows them well and can link up their communications with events in their lives.


5. Many AAC users have compounding issues that impact on their ability to access counseling services – language comprehension, cognitive impairment etc. The need for a transdisciplinary approach is often indicated with input required from a speech language pathologist/AAC consultant to support the counselor and AAC user in communicating effectively with each other.


6. People who use AAC may lack the knowledge, skill and means to communicate about abuse and rights, may be unaware of the role of counselors, may not be able to locate accessible services and may fear that a counselor will not understand their communication.


7. Due to the lack of accessible counseling services, people who use AAC may access friends or support personnel e.g. attendants service providers or consumer advocates who may not be qualified to provide the necessary counseling support.


8. People who use AAC have the same range of counseling needs as people who speak and who may or may not have physical disabilities, however they have additional challenges based on their perceived vulnerability to abuse, inability to communicate about what happened, lack of credibility in communicating what happened, lack of services etc.