22q.11 & AAC

Question

Answer

We do recommend augmentative and alternative communication occasionally in kids with this syndrome.  We often reserve it for those who truly have several autistic features. They might be struggling with expressive communication or they are older, like late school age to early adolescence, and they're severely unintelligible and have not made good progress with speech. We really need to help them be a better communicator.  I think the one caution I have with augmentative communication as a whole is that I have often seen kids that were given up on too early in terms of their articulation and speech sound skills. I have seen people jump off the articulation and speech therapy bus and jump on to AAC instead of pushing harder and pushing longer on more oral communication. Each year that goes by that we don't improve their speech, their prognosis for oral communication will go down dramatically.  So I think you have to assess what is best for that patient and ensure that you feel that is the best option and the best use of any therapy time. If there is a way to integrate AAC and not take away from treatment time, especially in a younger patient, I think that would be ideal.  Unfortunately, there are patients who are more severely affected from a cognitive or social interaction standpoint. They are older and not responding to treatment and we're getting to the point where they're so limited from social interaction and communication that they require nonverbal approaches to augment communication. 

Adriane Baylis, Ph.D., CCC-SLP, is Speech Scientist and Speech-Language Pathologist for the Section of Plastic and Reconstructive Surgery at Nationwide Children's Hospital (Columbus, OH). Dr. Baylis serves as Co-Director of the 22q Center at Nationwide Children’s Hospital and also provides clinical services to the Cleft Lip and Palate Center.