Purpose Autistic adults use a variety of communication methods, including both speech and augmentative and alternative communication (AAC); however, there has been limited, if any, academic research in this area. The purpose of this study was to examine the experiences of speaking autistic adults who use AAC. Method Using a participatory research method, we completed an online survey that included five demographic questions and 29 open-ended questions related to communication choice, communication access, attitudes, and recommendations. Six autistic adults who use AAC participated. The data were analyzed with thematic analysis using an inductive approach at the semantic level. Results Participants reported identifying AAC as a communication choice as adults, after using speech during childhood. They described how forced communication choices have greatly impacted their lives, both historically and today, and reported on the successes they experience when communication autonomy is promoted within a supportive environment. Participants further described what impacts their in-the-moment decision making related to use of different communication methods. Finally, they discussed the importance of normalizing AAC use and disability in general and provided recommendations for other AAC users, families, and professionals. Conclusions Historically, AAC intervention was considered a “last resort” for children who did not develop functional speech. Speaking autistic adults encourage families, professionals, and society to promote and accept all communication as equal—ensuring opportunities for all children to develop full and rich communication without delay and without stigma.
Purpose: Families and professionals often consider augmentative and alternative communication (AAC) a “last resort” for persons with communication challenges; however, speaking autistic adults have reported that they would have benefited from access to AAC as children. This tutorial discusses the history of this “last resort” practice and its perpetuation within the medical model of disability. The tutorial focuses on communication access, choice, and agency for autistic students. Method: We provide a brief overview of the AAC community and their preferred terminology, review the history of traditional approaches to research on AAC and autism, and then examine the relationship between disability models and ableism to views of spoken language as a priority of intervention. Studies on this topic are rare, and resisting ableism requires acknowledging and honoring disabled people's experiences and expertise. Therefore, we promote autistic expertise within the framework of evidence-based practice and discuss the experiences of autistic people and spoken language. Finally, we consider the role of the speech-language pathologist (SLP) in assessment and offer autistic-based strategies and recommendations for communication support. Conclusions: Speaking autistic students who could benefit from AAC may not have access to AAC due to the prioritization of spoken language and lack of awareness of the benefit of AAC. We recommend that SLPs and school-based professionals support and facilitate access, communicative choice, and agency by implementing multimodal communication strategies to include AAC use for autistic students regardless of their spoken language status. Promoting all types of communication and ensuring opportunities for communication across multiple modalities are paramount to a child's agency and self-determination, as is normalization of AAC.
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