Literacy in Ireland Nearly 20 years after David Koppenhaver and David Yoder put the topic of literacy and augmentative and alternative communication (AAC) firmly on the research agenda, what have we learned? We have laid to rest the myth that children and adults who use AAC cannot learn to read and write (Sturm ... World Beat
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World Beat  |   August 01, 2007
Literacy in Ireland
Author Notes
  • Martine Smith, is a senior lecturer in speech-language pathology at Trinity College Dublin. She is past president of the International Society for Augmentative and Alternative Communication, and author of Literacy and Augmentative and Alternative Communication. Contact her at mmsmith@tcd.ie.
    Martine Smith, is a senior lecturer in speech-language pathology at Trinity College Dublin. She is past president of the International Society for Augmentative and Alternative Communication, and author of Literacy and Augmentative and Alternative Communication. Contact her at mmsmith@tcd.ie.×
Article Information
Development / Augmentative & Alternative Communication / Normal Language Processing / World Beat
World Beat   |   August 01, 2007
Literacy in Ireland
The ASHA Leader, August 2007, Vol. 12, 14-15. doi:10.1044/leader.WB3.12102007.14
The ASHA Leader, August 2007, Vol. 12, 14-15. doi:10.1044/leader.WB3.12102007.14
Nearly 20 years after David Koppenhaver and David Yoder put the topic of literacy and augmentative and alternative communication (AAC) firmly on the research agenda, what have we learned? We have laid to rest the myth that children and adults who use AAC cannot learn to read and write (Sturm & Clendon, 2004). We recognize the complexity of developing skills in reading and writing, in devising assessments that effectively tap underlying skills, and in constructing intervention programs that meet the needs of those who use AAC. We do not have all the answers, but our questions are becoming more focused.
Although many individuals who use AAC find reading and writing difficult, this struggle is not directly the result of speech impairment. Becoming a successful reader-writer involves many factors, and the resources the learner brings are important.
Individuals who use AAC face multiple challenges and potential barriers in learning to read and write. Probably the most significant yet poorly understood component relates to language skills and AAC. The links between spoken language skills and literacy development are well-documented. All aspects of language, including syntax, morphology, semantics, pragmatics, and meta-linguistic skills (especially phonological awareness), are important in learning to read and write. What is less clear is how use of aided communication influences language development (von Tetzchner & Grove, 2003), and hence literacy attainment.
Many children who use aided communication start the formal process of reading and writing when they are at the early stages of using formal systems of expressive language. Their experiences in speaking are very different from their peers and accessing many aspects of language may be constrained. Certainly the cognitive challenges of accessing language structure are far greater than for their speaking peers. Children using aided communication cannot easily match the levels of interaction of speaking children.
Identifying possible communication barriers is a necessary step. Using communication systems with combined potential at an early age allows children more opportunities to construct their own language systems. The result is refocused attention on the importance of language to the whole process of literacy learning.
Some skills involved in both reading and writing do not depend solely on learner resources. Unlike spoken language skills, these skills are linked closely to specific experiences and rely on explicit instruction. Interest in and research on effective reading instruction has exploded over the past four decades (Snow, Burns & Griffin, 1998). Two things are now clear. One is that good literacy instruction is good for all children. No evidence demonstrates that children who are struggling to read require radically different teaching approaches from their peers, although instruction may require more intensity. For children using AAC, we may need to adapt materials and presentation, but the fundamental principles of effective instruction do not change. Second, learning needs change over time.
Early literacy experiences that allow children to become familiar with the form and purpose of print—through shared reading, storytelling, creation of text, familiarity with letters, and early sound-play games—are critically important for children who use AAC (Light & Kelford-Smith, 1993). Progressing to the next stage of reading requires explicit instruction. Strong evidence suggests that this instruction should include specific attention to the sound structure of language (Snow et al., 1998). It should make explicit the links between sound patterns and written forms, as typified in a phonics approach, and supported by access to voice output. However, it is not at all clear that all children access or use these skills in the same way, or to the same extent. Children may have access to strategies that they do not use in their reading and writing. Children and adults who use AAC may be predisposed or biased to pay attention to visual forms at least as much as to analytic strategies. Fluent readers and writers have access to a range of skills. Individuals who use AAC need at least the same opportunities to develop a full repertoire of skills.
Literacy proficiency is attainable—but that does not make it easy. We are still at the early stage of developing intervention programs that meet the needs of children and adults using AAC while also accommodating the educational opportunities and challenges implicit in service delivery models. Approximately 8% of all children are estimated to present with specific reading difficulties. Unfortunately the presence of one disability, such as dysarthria, does not provide immunity against other difficulties, such as dyslexia. It is important to recognize that a sizeable minority of individuals using AAC face additional challenges acquiring literacy skills that may be unrelated to their use of AAC. If these individuals were speaking, the difficulties likely would be identified. The need to use AAC does not cause these difficulties—but it does make the identification process much more complex!
Finally, we can gain some insights from successful AAC users. Erickson, Koppenhaver, & Yoder (2002) and Fried-Oken & Bersani (2000) present essays by or with augmented communicators reflecting on their journey to literacy. A number of key characteristics of successful intervention programs are common across many of the writings:
  • Integrating all aspects of communication, and encouraging independent communication from an early stage

  • Harnessing motivation of all participants and stakeholders, and raising expectations that literacy can be achieved

  • Providing intensive input over extended periods of time in functional, real, and meaningful activities

  • Integrating reading, writing, spelling, and communication across activities and goals

  • Using voice output and other technologies

  • Having a willingness to adapt, take risks, use trial-and-error, and maintain an open and questioning attitude to intervention.

These are sound principles for all our interventions. As we embrace the challenge of building the evidence base to guide our practice, these principles provide a good starting point.
AAC in Ireland: Population Surge Challenges Service Delivery

In Ireland, a small country of slightly more than 4 million, most health and education services are publicly funded. The majority of SLPs work in the public health system, providing services to children attending mainstream and special schools, but they are not formally linked to the Department of Education and Science. The separation can be difficult, particularly for complex educational challenges such as with children using AAC.

Complicating service provision is the seismic shift in the country’s population size and demographics over the past 10 years, fueled by an economic boom. In 2006, the population reached the highest recorded level since 1861, and immigration accounted for almost 15% of that increase. The boom presents significant challenges for all health and education services, including services for individuals who use AAC. Language and literacy learning are socio-cultural processes, embedded in interaction contexts that may differ significantly across different ethnic groups (Harrison-Harris, 2002). Understanding and adapting to the diversity of philosophies surrounding these processes, as well as to socially modulated concepts of disability, will be key challenges to all working in this area in the coming years.

AAC is well-established in Ireland. In the late 1980s, clinicians and teachers established a special interest group, which became a chapter of the International Society for Augmentative and Alternative Communication (ISAAC) in 1996; Ireland hosted ISAAC’s biennial conference in Dublin in 1998. ISAAC-Ireland continues to offer support through mini-conferences, seminars, and a range of educational activities.

Concurrent with Ireland’s significant growth in ethnic and cultural diversity are ongoing and exciting developments in AAC, including two related to literacy. In 2006 SLPs and educators came together to review the National Primary School Curriculum and explore how it could be adapted to meet the needs of children using AAC.

The curriculum is divided into three strands: oral language, reading, and writing. Each strand is subdivided into four units:

  • Receptiveness to language

  • Confidence and competence in using language

  • Developing cognitive abilities through language

  • Emotional and imaginative development through language

The group identified the barriers and facilitators in each of these strands, and developed educational and intervention strategies to promote access to the curriculum for children using AAC. This ongoing project represents a significant step in collaboration across traditional administrative boundaries.

A second collaborative project, launched in 2006 with the National Adult Literacy Association, focuses on training literacy tutors to work with adults who use AAC. A series of workshops developed by Trinity College Dublin and Enable Ireland services promoted skill development for interested volunteers. In 2007 programs were initiated to support two adults who use AAC in acquiring literacy skills, within mainstream adult education services.

Both these initiatives reflect a firmly held philosophy—that children and adults who use AAC should be supported to develop literacy skills across the lifespan, in contexts that are as close as possible to those of their peers without disabilities. Accommodations are necessary for this integration to be successful—and that is the challenge we all face, whatever our location.

References
Erickson, K., Koppenhaver, D., & Yoder, D. E. (2002). Waves of Words: Augmented communicators read and write. Toronto: ISAAC Press.
Erickson, K., Koppenhaver, D., & Yoder, D. E. (2002). Waves of Words: Augmented communicators read and write. Toronto: ISAAC Press.×
Fried-Oken, M., & Bersani, H. (2000). Speaking up and spelling it out: Personal essays on Augmentative and Alternative Communication. London: Paul Brookes Publishing Co.
Fried-Oken, M., & Bersani, H. (2000). Speaking up and spelling it out: Personal essays on Augmentative and Alternative Communication. London: Paul Brookes Publishing Co.×
Snow, C., Burns, M. S., & Griffin, P. E. (1998). Preventing reading difficulties in young children. Washington, DC: National Academy Press.
Snow, C., Burns, M. S., & Griffin, P. E. (1998). Preventing reading difficulties in young children. Washington, DC: National Academy Press.×
Smith, M. (2005). Literacy and Augmentative and Alternative Communication. London: Elsevier Press.
Smith, M. (2005). Literacy and Augmentative and Alternative Communication. London: Elsevier Press.×
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August 2007
Volume 12, Issue 10