Daily conversations are highly interactive. They move very quickly over a range of topics. Conversations are so fast-paced that the only way we manage is to start planning our message while the other person is still talking. We predict what they will likely say, so we can prepare our response. We use their non-verbal cues such as pauses, tone, eye gaze, intonation, and even breath to predict our timing.

For people who use AAC, starting and maintaining a regular conversation can be a challenge. Not only because of speed and timing, but also because of (the limitations of) vocabulary and technology.

Conversational barriers for AAC users

AAC users have to balance all these demands of conversation while retrieving words manually on a device. Every single nonverbal cue can be disrupted by AAC. AAC users have to break eye contact to start generating their message. They have to direct their physical movements to their AAC, not to their communication partner. When a speaking person begins planning their message, it is invisible to the person who is still talking. But if an AAC user starts generating their message at that same point, it could appear impolite. Typing words or selecting symbols are slower than retrieving speech, but AAC users have less time to form their message. They usually form their message first, then use their technology to voice it.

Seven ways to support AAC users in conversations

All seven tips below come down to these important lessons: ask AAC users how they want to be supported. Work with them to find the best ways to encourage and support their contribution to conversations.

1. Be patient

Expect to take more time when having a conversation with an AAC user. Be patient: pause, wait and allow time for the AAC user to compose a message. Slowing the pace reduces some of the demands. It also improves understanding. Stop predicting what the other person is likely saying and listen to what they actually say. Wait for the completed message so you don't miss important words.

2. Conversation looks different

Expect that an AAC user cannot simultaneously provide the typical nonverbal cues while also using their device. The electronic voice will not provide the same cues.

3. Presume competence

Research suggests that conversation partners might underestimate AAC users due to the limitations of AAC systems. Speaking people interpret a slow pace, long pauses, broken eye contact, a blunt response, and missing nonverbal cues as poor communication skills. We need to understand these as the result of imperfect technology, not of a lack of skills or intelligence.

4. Invite the AAC user to set the topic

AAC users often respond to conversations, but research shows they rarely set the topic. Pause and be patient so they can start the conversation. Consider asking the AAC user if they have photos of what they are talking about. While you explore the visuals, the AAC user can compose their message.

5. Advocate for the AAC user

Ask others in the conversation to wait while the AAC user composes their message. Ask the AAC user how they can be best supported to contribute to the conversation, or if they want to continue a conversation online (e.g., via social media or email).  Virtual conversation usually has fewer barriers because both people are using technology rather than speech.

6. Plan ahead

AAC users need time to compose their responses but also have some quick messages pre-stored ready to use when appropriate. Most AAC systems allow the user to plan phrases for different situations and conversations, then pre-store them and quickly retrieve them. Research suggests that many AAC users do not use all of these features. Experienced AAC users and mentors can share strategies.

7. Visual supports

Some AAC users, such as those with aphasia, struggle to retrieve words. Others access words very slowly in their AAC. It is often more efficient for them to use visual supports to set topics, such as photos, line drawings, images from the internet, or reference materials like maps. Research on communication disorders like autism and dementia shows that visuals enhance turn-taking and participation. Open and share articles or memes on social media. Write and tell stories in apps like Pictello. Point to images in a magazine.

Links and References