I have been supporting people with complex communication needs (CCN) for more than 16 years.  I have learned (sometimes the hard way) that the successfulness of a communicative interaction with someone with CCN is often dependent on the skills (or lack thereof) of the communication partner.  We, as service providers, can sometimes get wrapped up in developing communication programs, creating communication boards, programming devices, and learning the technical aspects of the device, that we forget to take a breath and take some time to look at our own communication skills.  We spend little or no time improving the way in which we interact with individuals with CCN and learning the best ways to support communication language learning for them.  I think back to a little boy with whom I had the pleasure of meeting several years ago.  I was called in to consult with his school team to help them better implement the AAC device into the classroom.  This little guy had cerebral palsy and desperately wanted to communicate!  You could see it in his eyes.  He often spent most of the school day sitting in his wheelchair next to his one-on-one aide, away from the other students with little or no classroom participation opportunities.  As we began our initial meeting to discuss strategies to increase his communication and learning opportunities, the team kept asking me when we would start working on the device.  I helped the team understand that we needed to first work on communication partner skills so that communication and learning interactions would be more successful. 

As we strive to become the best communication partners to our students and clients with CCN, try to remember PACT: 

Provide a positive communication environment. 
Our attitude, the comments that we make and the way in which we respond to the communication attempts of people with significant communication disabilities can have either a positive or negative influence on the successfulness of the interaction.  Negative attitudes can be contagious.  If we dwell on the challenges instead of trying to find solutions, everyone around (including the AAC user himself) will take on these same attitudes.  Keep in mind that positive attitudes can be contagious too! 

Avoid over prompting. 
Many individuals with CCN can quickly become prompt dependent.  By using the Chain of Cues, you can encourage independent communication through a planned cueing strategy. The end goal would be that the individual would respond with the least amount of cueing possible.  The chain of cues consists of a five level “least to most” cuing process which includes: Natural Cues, Indirect Cues, Direct Verbal Cues, Direct Pointer/Light cues or Direct Gestural Cue, Physical Assistance. 

Learn more about the Chain of Cues at the DynaVox website: http://www.dynavoxtech.com/training/toolkit/details.aspx?id=280

 Create opportunities to communicate. 
The key to successful AAC implementation is to make a plan of intervention.  This will help you identify potential opportunities where the individual with CCN can practice new communication skills.  To increase opportunities for communication, you must know when, where, why and how the communication system will be used throughout the day.  

Time to learn, process and respond. 
Jane Korsten stated that, “The average 18 month old child has been exposed to 4,380 hours of oral language at a rate of 8 hours/day from birth.  A child who has a communication system and receives speech/language therapy two times per week for 20-30 minutes sessions will reach this same amount of language exposure in 84 years.”  Learning how to communication for individuals with CCN, who may have very limited opportunities to practice and learn new skills, takes time.  Don’t expect that they will know what to do with a communication system.  It is our responsibility to be good communication partners and to invest the time to teach communication skills.  In addition, we must be extremely knowledgeable regarding the content in our students’ communication system in order to model appropriate use.  If you don’t know how the system works, then you can’t teach them how to use it. 

Reference:
http://atto.buffalo.edu/registered/ATBasics/Populations/aac/consider.php)