Donaldson Amy L, Corbin Endever, Zisk Alyssa Hillary, Eddy Brandon
Department of Speech & Hearing Sciences, Portland State University, OR.
#AutChat.
Lang Speech Hear Serv Sch. 2023 Jan 17;54(1):140-155. doi: 10.1044/2022_LSHSS-22-00031. Epub 2022 Nov 4.
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.
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.
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.
家庭和专业人士常常将辅助和替代沟通方式（AAC）视为应对沟通有障碍者的“最后手段”；然而，会说话的自闭症成年患者表示，他们要是小时候就能接触到AAC，会从中受益。本教程探讨了这种“最后手段”做法的历史及其在残疾医学模式中的延续。该教程重点关注自闭症学生的沟通机会、选择和自主性。
我们简要概述了AAC群体及其偏好的术语，回顾了AAC与自闭症研究的传统方法的历史，然后审视了残疾模式与能力主义之间的关系，以及将口语视为干预重点的观点。关于这一主题的研究很少，抵制能力主义需要承认并尊重残疾人的经历和专业知识。因此，我们在循证实践的框架内推广自闭症患者的专业知识，并讨论自闭症患者与口语的经历。最后，我们考虑言语语言病理学家（SLP）在评估中的作用，并提供基于自闭症的沟通支持策略和建议。
由于将口语置于优先地位且对AAC的益处缺乏认识，那些能从AAC中受益的会说话的自闭症学生可能无法获得AAC。我们建议言语语言病理学家和学校专业人员通过实施多模态沟通策略来支持和促进自闭症学生获得沟通机会、进行沟通选择并实现自主性，这些策略包括让自闭症学生使用AAC，无论其口语状况如何。促进所有类型的沟通并确保跨多种模式的沟通机会对于儿童的自主性和自决权至关重要，AAC的常态化也是如此。
