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Posted on January 26, 2017

Moving beyond cause and effect to communication

Following on from Kerry’s blog about extending activities beyond the screen, I want to talk more about how important this is for developing language and communication.

I am often asked how to ‘move on’ from cause and effect to communication, by professionals and families. Once a user understands that their actions cause something to happen on the screen, it can be difficult to know where to start in developing this into functional communication.

It may seem like an enormous leap to move from cause and effect to communication, but actually, a lot of typical early communication is cause and effect and we can apply the same ideas to AAC.

Very early spoken communication

For example, very early spoken communication starts off as babbling. When we respond to this babble as meaningful – even though this might just be ‘vocal play’ (playing with speech sounds) – our response reinforces the sounds that are made, and we are encouraging this babble to develop into meaningful strings of sound and become words.

If we then look at AAC, we often see the same play happening, just in a different way. One key difference is that when an early AAC user makes a selection on their device, they are often saying a meaningful whole word or phrase to start with. To begin with, they might make lots of selections without understanding what those selections mean. This is okay – this is babble!

There are different ways we might respond to this AAC babble – the first way might be to say, “oh they’re just playing” or “oh they don’t know what they are saying”. Whilst this might be true initially, it just isn’t helpful in teaching communication.

A much more valuable response is to respond to everything that is being spoken as though it is meaningful. If we respond like this, every time the user makes the same selection, they are learning not just that what they have chosen is meaningful, but also what the meaning is.

Shifting attention from the screen

Another benefit of responding like this is that we can encourage early AAC users to shift their attention between the screen and what they are selecting, and us, their communication partners.

This shifting of attention can be really difficult for some early AAC users, and attention is a skill which takes time to develop. I often see one of two ends of the spectrum – one, where the user focuses all of their attention on the screen and it is difficult for them to engage with the environment around them and see the result of what they are selecting on the screen. The other, is where the user is so interested in the people and environment around them, that it is difficult to shift their attention to the screen for them to make a selection.

For the first scenario, it is up to us as the communication partner to be more exciting than what is happening on the screen through our responses to the selections that are made. For this, I love the thinking of Gina Davies and her work with autism.

Integral to her approach is the idea that when we are trying to teach a new skill or something someone finds difficult, we need to make the activities we present “absolutely irresistible”. This idea is also based on the knowledge that learning anything – including communication – happens best when we are motivated and having fun!

For the second scenario, when the people in the environment are far more interesting already than what is on the screen, it is up to us to be as boring as we can possibly be, doing absolutely nothing, until they make a selection on the screen, and we spring animatedly into action!

So, where do we start? Here are some ideas and resources!

Choice making

1) Making Choices

Choosing or asking for something is often a starting point for AAC, and there is a good reason why.

It is really powerful to ask for something and be given it, especially if it is something you really want! It can also be quite powerful to be given something that you really didn’t want, and we can use this with our early AAC users.

You can start by offering a choice of two things, with something you know they will really like and something you know they won’t be interested in. One idea might be offering a choice of a fun toy…or a sock! If they select the item you know they don’t want, you can still give it to them, and say “you chose the sock, here’s the sock”. If they keep on choosing the item you know they don’t really want this is a great opportunity to model the correct choice on their device to show them how to choose what they do want.

Choice making grid set

It’s easy to set up a basic page in Grid 3 for choosing, but I have also made a template with 2, 4 and 6 choices, to quickly add to using word lists.

Choice making grid set

Download Choice Making Template

It’s also good to remember that the choices don’t have to just be an object to play with or eat. Making choices involving people is something that can also help with developing the attention shift between the screen and the environment.

Pre AAC grid set

I really like these choosing grids made by my colleague Keira for choosing between a ball, a balloon, tickles or a squeeze. There are two versions of the grid, a simple one with just one page, and an extended one with a further choice for each selection. So the user can choose what type of ball they want, or where to be tickled!

Pre AAC simplified grid set

Download Pre AAC grid – simplified

Pre AAC extended grid set

Download Pre AAC grid – extended


Make a fruit smoothie

Another example I came across was in a special school where they created a grid for users to make a fruit smoothie. The first page showed a choice of fruit and when the fruit was chosen it was put into a blender. The next page allowed the user to turn the blender on using the environment control built into their Grid Pad!

I’ve recreated this activity here, but also added a page for users to say Stop or Go for anyone without access to environment control on their device.

Make a fruit smoothie grid set

Download Make a fruit smoothie

There are lots of other reasons for communicating, and it’s important we teach those too, but asking for something is one of the first communication functions we all learn, so it’s good place to start!

2) Environment control – and the reactions of people!

The Grid Pad Pro and Eye range all have built in environment control (EC), which can be great for teaching users that something you select on the screen has an impact on your environment. After all, that is what we ultimately want to teach early AAC users – that you make a selection on the screen (a word or phrase) and it impacts on your environment (through the response of people). Using EC can also be really motivating for some users, in a way that other activities might not be.

We can go further than just turning a TV on or off, by adding in the reaction of everyone in the room. For example, turning off the TV and being met with cries of “hey I was watching that, can you turn it back on please”, then turning the TV back on so that everyone says “thanks for turning on the TV!”. Or, changing the channel when Mum is watching EastEnders and seeing what reaction that gets?

If you have an EasyWave socket, there are so many options where you can use EC as a communication activity, where the reactions of people are just as important as the EC itself. One of my favourites is using a fan, asking the user to turn the fan on and off, with a page of people so they can choose who the fan is pointed at.

Simple Servus Environment Control

The Simple EC page in Grid 3 is a great place to start, and if you need any help in programming a remote control or socket accessory, you can learn how to here:

simple EC grid set

3) Being the boss

It’s a classic that never goes out of fashion – Simon Says.

Anyone working in the field of AAC will probably have used this game, but the reason for that is because it is so powerful! The user is given complete power to choose from a list of actions and get everyone in the room with them to carry out what they ask – the power to command your mum to blow a raspberry, or tell your teaching assistant to jump up and down.

This is an activity which can often be really helpful for users who are more interested in the people around them than the screen – in this case, it’s ideal, as everyone around them becomes the most boring people possible, not moving or talking or doing anything interesting… until the user makes a selection on the screen.

If this is still difficult, then it may be helpful for one person in the room to model how to make the selection for the user, before everyone responds.

My tips for this activity are to change Simon’s name to the name of the user, reduce or increase the number of actions depending on the user’s attention or access, and to mix it up with the actions.

Extended Simon Says

Here is an extended Simon Says grid set, with four different variations on the game, with options for the user to instruct people to make animal noises, dress up in fancy dress clothes, and sing nursery rhymes, as well as some classic actions.

Simon says - animal grid

Download Simon Says Extended

Read Daisy’s previous blog

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