Can someone who doesn’t speak learn to read and write? Yes, at any age, with teaching that replaces reading aloud with other ways of responding. It is probably the most important goal in AAC: with letters, you can say anything.

Why literacy changes everything in AAC

Without print, a person only has access to the words someone has put on their tool: for most AAC users who can’t read, fewer than 1,000 concepts, and often fewer than 100 (Beukelman and Light, 2020). A child who speaks knows more than 2,000 words by the age of 5. With 26 letters, you can write any word, name or idea: it is the only truly open vocabulary.

What is at stake goes beyond communication: among employed adults who use AAC, better reading skills went hand in hand with higher pay, promotions and greater job satisfaction (Light, Stoltz and McNaughton, 1996).

Why do so many adults not read?

Up to 90% of people with complex communication needs reach adulthood without functional reading and writing skills (Foley and Wolter, 2010). The causes identified are mostly outside the person:

• Little writing material from early childhood, and parents whose time is taken up by care.
• 30 to 35 minutes of reading a day in class, compared with at least 90 minutes recommended.
• Expectations that are too low.
• Reading activities led by the adult, with no AAC tool within reach.
• Books read aloud without pauses, with questions about the mechanics (‘turn the page’) rather than the meaning.

There is no reason to wait for prerequisites. Children aged 3 to 5 with autism, cerebral palsy or Down syndrome have learnt to read and write. A 13-year-old girl who had been told she would never read was decoding words after eight weeks of adapted teaching (Beukelman and Light, 2020). As with AAC in general, don’t test, teach (see Myths about AAC).

What should you teach?

The same components as for any beginning reader:

• phonological awareness (blending and segmenting the sounds in a word);
• letter-sound correspondences;
• decoding;
• recognising familiar words;
• comprehension, in shared then independent reading;
• spelling and writing.

A common trap: teaching only ‘whole’ words, recognised by sight. The person then can’t read a new word. Beginners need both: familiar words and decoding (Browder et al., 2006; Mandak et al., 2018).

How do you teach someone who doesn’t speak?

Without reading aloud, you need other ways to practise and check (Beukelman and Light, 2020):

• Respond by choosing from about four options: see a written word and choose the picture, see a picture and choose the word, hear a word and choose its written form.
• Choose revealing distractors. For ‘cat’, offer ‘cot’, ‘rat’ and ‘car’: the mistake shows which part of the word is causing difficulty.
• Build an inner voice. Say the sounds out loud, then invite the person to ‘say them in their head’.
• Teach letter sounds, not letter names. For reading, ‘m’ is said ‘mmm’, not ‘em’.
• Follow four stages: demonstration, guided practice, independent practice, feedback.

In what order should you teach the letters?

The American ALL programme (Accessible Literacy Learning) starts with lower-case letters and frequent letters, separates letters that look alike, then adds new letters one at a time. Its order was designed for English, so you can follow it as it is. With other materials, apply the same principles: start with frequent letters that have regular sounds.

Why give a keyboard from the start?

A child who speaks scribbles and ‘writes’ long before they can write. Someone who can’t hold a pencil needs an electronic pencil: a keyboard. Never hide it while waiting for them to ‘know how to read’ (Beukelman and Light, 2020).

• Accept invented spelling, and show the correct spelling without harsh correction.
• Keep speech feedback on for letters, words and sentences: it improves spelling (Blischak and Schlosser, 2003).
• Word prediction and spellcheckers help, but they shift the difficulty more than they remove it.

In Pictalk Buddy, the keyboard is one touch away on the Essential 24 home page and built into Horizon 80. The ‘Phonetic keyboard’ setting, on by default, says the sound of each letter or syllable as you type, then the whole word when you press Space.

Can the AAC tool help with learning to read?

As a complement. With the T2L approach (Transition to Literacy), the written word is animated and shown in large print for about three seconds when the person touches a symbol. It improved single-word reading in people aged 3 to 46 (Light et al., 2014). Pictalk Buddy does not offer this animation, which does not replace teaching.

Many grammatical endings are easy to miss when you only hear them: the written sentence is often the only place where you meet them. Buddy’s grammar engine conjugates automatically (‘she want’ becomes ‘she wants’) and displays the correct form.

How do you read a book together?

Shared reading is one of the richest activities for vocabulary, at any age (based on Beukelman and Light, 2020):

1. Let the person choose the book, and reread their favourites.
2. Introduce the topic and the new words before reading.
3. Follow the text with your finger.
4. Pause for 5 to 10 seconds.
5. Ask real questions about the story.
6. Model on their AAC tool (see Model, wait, respond).
7. Respond to what they say and build on it.
8. Invite them to retell the story in turn.

A book board (characters, actions, feelings, a repeated line) makes it much easier to take part: see Making a communication board. The free Tar Heel Reader website offers accessible books and lets you create your own.

And at school?

Spelling is the only real access to the vocabulary of the curriculum. Include reading and writing goals in the pupil’s support plan, and keep the AAC tool during reading lessons. See AAC at school.

Frequently asked questions

At what age should you start?

As early as possible: shared reading and a keyboard from early childhood. But it is never too late: teenagers and adults who start late succeed too.

Is writing the word under each symbol enough?

No. This fixed label mainly helps partners (Erickson et al., 2010). It is still useful for exposing the person to print, but it does not replace explicit teaching of sounds, letters and decoding.

Pictalk Buddy brings together AAC boards, a visual schedule, guided sequences and notebooks, with the same symbols, on Android, iOS, the web and the watch. A pay-what-you-want app, developed by a non-profit association. Discover Buddy

Sources

• Beukelman, D. R., & Light, J. C., 2020, Augmentative & Alternative Communication (5th ed.), Paul H. Brookes, chapters 6, 11, 12 and 13.
• Studies cited from Beukelman & Light (2020): Foley & Wolter (2010); Light, Stoltz & McNaughton (1996); Browder et al. (2006); Mandak et al. (2018); Blischak & Schlosser (2003); Light, McNaughton, Jakobs & Hershberger (2014, T2L); Erickson et al. (2010).