Motivation

Preferred activities are ideal contexts for teaching individuals to request. An alternative strategy is to identify activities that an individual really doesn’t like. These activities can be appropriate contexts for teaching communication responses that indicate “I don’t want to do that.” – NJC – ASHA – https://www.asha.org/NJC/Definition-of-Communication-and-Appropriate-Targets/

When working with adults who need AAC, it is sometimes necessary to teach the power of communication. Some emergent learners may not understand the connection between an intentional symbolic act and the positive result of getting what they want. The use of an AAC device may not be motivating at the start of the learning process.

How can we teach someone that symbolic communication has value? How can we pair that communicative act with a positive, tangible result? We often look to what that person finds intrinsically motivating. Learning a new language is hard work. We are more likely to respond when we like the result!

What does the person like?

In assessing someone’s preferences, we need to look beyond the limited world of using foods as reinforcers. Yes, food preferences are important, but we should also consider other things that are of value to our consumer.

Many people have specific sensory likes and dislikes. They may prefer a low sensory-input environment. Do they like dim lights or soft music? Is access to such an environment important when they become stressed or upset? Sensory preferences are individual. Some people crave high input activities, such as rough textures, or a bumpy car ride. Being able to communicate about sensory preferences can be highly motivating. We all use preferred sensory input to help regulate our moods.

We also need to look at whether that person has any control over their daily routines. Do they get to choose when to bathe, what to wear, and where to go? Some adults with complex communication needs have learned passivity as a response to an environment they can’t control. In my experience, this is especially true for those who have experienced long-term institutional care. They may have gone decades with little or no say about what happens to them.

How can we teach someone to make a choice when choosing itself is a foreign concept? We may need to start by pairing a preferred activity with a choice that is neutral, or even disliked. This is not about punishment. We want them to understand that expressing a preference is a powerful communicative act.

We should then look at all the ways in which they might initially express their preferences. Do they reach for an item? Do they use their eyes? Do they push away something they dislike? All of this behavior is communicative. We can pair the observed behavior with the use of a symbol system. They will learn, with repetition and opportunity, that they can use AAC to choose what they like (or to reject and say no).

I have often been asked if it is okay to take words off a communication device. The person may have chosen something they cannot have. For instance, soda would be ill advised for an individual with diabetes. Please don’t take words away. Instead, respond by offering a choice of two things or activities the person is able to have. I am allergic to avocado, but I still need to be able to talk about it!

Yes, we will sometimes have to listen to words we don’t want to hear. Yes, people will ask for things they can’t have that very moment. Yes, some folks will perseverate on topics. Instead of limiting access to communication, look at this through a different lens. How would you address this behavior if the person were verbal?

Make a list. Describe the activities, places, people, objects, and foods that someone finds reinforcing. Use these as a catalyst for growing communication. Be prepared to reassess what motivates someone over time. People’s preferences may change.

When communication is about what matters to someone, they will engage. When motivated, we all do better.