AAC in Schools: The Commitment of “Tutti giù per terra”
Augmentative and Alternative Communication (AAC) is not only a support for disability, but a powerful tool for inclusion that enhances the expressive possibilities of every student, improving learning and the relational climate of the entire classroom. In Rome, the cooperative “Tutti giù per terra” represents an important point of reference in this field: with dedication and expertise, the cooperative trains, coordinates, and supervises services in numerous schools, promoting a network-based collaboration between families, teachers, and specialists. Through visual tools and experiential workshops, the cooperative’s assistants transform communication into a right accessible to everyone, breaking down barriers and helping build a truly welcoming school environment.
THE IMPORTANCE OF COMMUNICATION
“The impossibility of not communicating makes all situations involving more than one person communicative.”
This is what Paul Watzlawick stated in his first axiom of communication. In practice, he reveals that it is impossible not to communicate: even when we do not want to or are not intentionally communicating, our behavior is actually conveying a great deal about us, often without our awareness.
It is estimated that verbal communication represents only 7% of what we communicate, while paraverbal elements such as tone of voice, rhythm, speed, and volume account for 38%. However, non-verbal communication conveys the largest portion of meaning—55%: we believe we express everything through words, but in reality, visual aspects such as smiles, gazes, silences, hand gestures, and body posture often reveal more than we think.
Non-verbal communication is therefore fundamental in everyday life, but it becomes crucial when interacting with individuals who have Complex Communication Needs (CCN). For people with CCN, verbal language may be difficult or even impossible to use.
Think of children and adolescents on the autism spectrum, with genetic syndromes or cognitive delays, who are unable to communicate, express needs and sensations, emotions, or physical necessities.
It is in this context—where frustration and suffering can arise—that Augmentative and Alternative Communication (AAC) comes into play.
AAC is a set of tools, techniques, and strategies designed to support, enhance, or replace verbal communication skills in people with CCN, using and strengthening all of the person’s communicative abilities: existing vocalizations or spoken language, gestures, signs, communication aids, and advanced technology.
It involves building a flexible and highly personalized system to be used in all areas of the child’s life: home, school, therapy settings, and daily activities. The ability to communicate and express oneself freely cannot be limited to just one or a few aspects of a person’s life, but must be generalized across all environments and everyday situations.
THE EXPERIENCE OF AN AAC ASSISTANT
I had the opportunity to continuously support a student in a primary school in Rome, in the Casalotti area. M. has a severe autism spectrum profile, is non-verbal, with deficits in social interaction, restricted interests, repetitive behaviors, sensitivity to noise, and frequent challenging behaviors that lead to crisis moments with self-injurious and hetero-aggressive conduct, which are difficult to manage.
As an AAC specialist assistant, I developed a personalized intervention based on his specific communication needs, with the aim of providing appropriate tools aligned with his abilities and reducing frustration levels and the consequent challenging behaviors that often emerged.
In close collaboration with the teachers, I prepared tools tailored to the student’s abilities and vulnerabilities: task analyses to consolidate basic self-care skills such as washing hands and using the bathroom; a visual schedule with the phases of the school day to be attached and removed once completed, to provide predictability and regulate routines; visual cards with school locations such as the cafeteria, gym, library, and garden; a photo on his coat hook to promote independence during the delicate moments of arrival and departure; a communication notebook (following the PECS—Picture Exchange Communication System) and strips for making requests.
For communication and exchange, we use photographed and laminated images of school environments, proposed activities (drawing, letters and numbers, fine motor games, puzzles, matching and logical association tasks), and the child’s objects (toys, tangible and edible reinforcers, books).
The interventions were generalized across different contexts, in parallel with the child’s home and therapeutic work.
AAC-related strategies and tools were prepared, introduced, and tested together with the teachers and, where possible, integrated within the peer group: the class is relatively small, and the girls tend to interact with M. affectionately, which he seems to tolerate well. Since some children were curious about the materials used with M., on several occasions I encouraged them to use the communicator and draw pictograms themselves for M.: “hello,” “I love you,” “let’s play,” “hug.”
CONCLUSIONS
The personalized intervention, including AAC tools and strategies tailored to the student, improved communication potential: through the communication device, visual supports, and gestures (pointing, yes, no, can I, I want), feelings of frustration and anger and the resulting emotional crises decreased. Supported by routines and the ability to express himself, the child appeared calmer compared to the beginning of the school year. Basic self-care skills improved, as did his ability to formulate requests.
Dott.ssa Michela Bastianelli
Dott.ssa Fabiana Sonnino