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Posted on February 1, 2024

We’re welcoming Ashley Mohesky (M.S., LPC Associate), a Licensed Professional Counselor Associate, specialising in mental health, and AAC user who has written this guest blog drawing on her experience.


Mental health barriers and solutions for AAC users

While there is an increased awareness of mental health as a whole, it is still a hidden subject within the AAC community. According to the Center for Disease Control, 32.9% of adults with disabilities experienced 14 or more mentally unhealthy days within a 30-day period in 2018. Since AAC users do not communicate with traditional verbal speech, many believe that mental health struggles merely don’t exist within this population. However, this belief is simply a myth.

Barriers AAC users may face

When an AAC user is having difficulty expressing themselves, they may engage in “negative” behaviours, which can lead to the assumption that the person is being naughty, causing the rise of mental health struggles. For example, when I am having a hard time communicating because I am not being heard, I become frustrated and I want to scream in order to get my point across. Although I am able to effectively communicate once I take a deep breath and collect my thoughts, not every user has this ability.

Another reason that someone who uses AAC may be struggling with mental health is they don’t necessarily have the vocabulary to communicate how they are feeling. While AAC softwares do have premade pages specifically for discussing feelings, they are only at a surface level. For example, not having words such as “anxiety” “depression” or “panic attack” to accurately describe their mental health. Also, there is a lack of education for people who use a device on how to communicate their feelings on a deeper level, simply because they don’t communicate traditionally.

Providing support for AAC users

Now that I have covered the various reasons why AAC users may struggle with mental health, the question becomes how can professionals and caregivers support them. Honestly, it is as simple as listening and validating, as well as creating a plan to improve mental health. Another way to assist AAC users with mental health is to always presume competence. For example, if a teenager who uses a device tells a teacher that they are feeling depressed and wants to seek help, it is imperative that the teacher takes the teenager seriously and tries to help them in the best way possible, instead of automatically assuming that the teenager doesn’t know what they are talking about. Unfortunately, mental health doesn’t discriminate against anyone, but with the right tools and support, it can be overcome.

Similar to other areas of life, the disabled population is an afterthought when it comes to mental health services. While in graduate school to become a mental health therapist, it became apparent that there were not many therapists who knew how to work with AAC users. A few examples of these discrepancies are: only allowing phone calls for initial consultations, not having a way to schedule appointments online, and not including interventions that incorporate AAC (I.e. using games on the device as part of therapy).

Remarkably, graduate counselling programs do not address working with AAC users. However, there are ways to provide effective counselling to those who use AAC. Aside from making initial consultations and paperwork more accessible, it is important that therapists check in with their clients to make sure that interventions and treatments incorporate using the device during sessions. The therapist must also adapt in order to meet the needs of clients who use AAC.

Although there is a large gap in mental health services for AAC users, there is hope that the gap will close in the future. People who have a different means of communication deserve the right to seek help for their mental health. As a mental health professional, as well as an AAC user myself, it is my mission to ensure that access to mental health care for AAC users increases. Mental health is just as important as physical health and everyone deserves the right to be mentally healthy as much as possible.


Ashley Mohesky (M.S., LPC Associate)

Ashley is a licensed Professional Counselor Associate, supervised by Mark Rehm (LPC-S) in the state of Texas, who researches the use of AAC in psychotherapy with mental health patients. Ashley is also an AAC user herself. Meet Ashley to read more about her personal journey with AAC and connect with her on LinkedIn to see what she’s up to.


Learn more: ‘Supporting AAC users and Mental Health’ course

With input from Ashley and other experts, you’ll find even more practical tips and references to the latest research which helps you champion the well-being of AAC users.

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