November 5, 2002 Feature

AAC, Literacy and Bilingualism

Children who use augmentative and alternative communication (AAC) have historically been challenged in their attainment of literacy skills. These challenges are even greater for AAC users who are bilingual.

AAC users in the United States comprise large numbers of individuals from culturally and linguistically diverse backgrounds. Current demographic trends indicate that linguistic diversity will continue to intensify. During the 12 years between 1986 and 1998, the number of U. S. children who were identified as limited English proficient increased from 1.6 million to 9.9 million (see Tucker 1999). It is estimated that, by the year 2050, 40% of school-aged children in the United States will come from homes where English is not the first language. Individuals who use AAC systems surely will be represented in this group.

The fact that many children in the United States, including those who use AAC systems, live amidst a sea of languages has captured national attention and has influenced our educational system. The new thrust to achieve educational equality represents a historic change. Many bilingual or monolingual schools that taught in languages other than English existed before World War II. For example, many German-only schools could be found in the northern Midwest. Afterward, a pattern of English-only instruction dominated our education system.

As recognition of the cultural and linguistic diversity of the United States grew, a need to provide effective and appropriate education for bilingual children arose. Educators, parents, and researchers have challenged the notion of an English-only education for children from linguistically diverse backgrounds.

Research supports the notion of education for limited-English-proficient children, including those relying on AAC systems, to be introduced in their first language, providing a transition to stronger second-language usage. This is logical given the fact that literacy attainment depends on language.

Language learning, including reading and writing, is always culturally based. Reading and writing involve particular ways of using and thinking about written language that go beyond finding meaning in text and include the construction of sociocultural viewpoints or ways of understanding the world around us. It is important to realize the sociocultural and communicative nature of literacy, because of the possible therapeutic impact when working with bilingual AAC users.

Writing, similarly, is a contextualized social event. It is a transactional, circular process created from a person's linguistic resources and interaction with past experiences. Viewing literacy learning as it is socially constructed through language provides a nice perspective of the need to educate linguistically and culturally diverse children from their first-language knowledge base.

Research Challenges

The challenges of literacy attainment for both monolingual and bilingual children who use AAC have become an area of focus for special educators, speech-language pathologists, parents, and researchers. Although research in reading and writing development of AAC users has increased steadily over the past 10 years, only recently have researchers turned their attention to reading and writing development of bilingual AAC users.

Many of these children are unsuccessful in developing literacy, yet there is increasing recognition that this group is capable of developing sophisticated reading and writing skills. Bilingual AAC users who are highly successful in developing these skills make tremendous gains in overall language development and in use of their AAC systems. Acquisition of more vocabulary and the ability to compose text are just two advantages that literacy attainment brings to their receptive and expressive language development.

Major focus has been brought to the topic of literacy attainment for bilingual AAC users because of its particular importance for this population. Attainment of literacy allows bilingual and monolingual AAC users, like all students, to be able to prepare messages to be used at a later time, produce exact messages, and learn vocabulary with which they can spontaneously spell out messages. But Light and McNaughton (l993) give three reasons why literacy development holds additional importance for AAC communicators. First, their face-to-face communication skills are often severely limited. Communication can be quite slow. Often the able-bodied message receiver doesn't have time to participate in communication interaction with an AAC communicator.

Research shows that, in interactions between a person who is using an AAC system and a speaking person, the speaking person often dominates the interaction, and the person using the AAC system may not have opportunities to initiate topics or converse fully. Literacy gives an AAC communicator the opportunity to overcome many of the restrictions of face-to-face interaction, especially those imposed by slow AAC systems. Through writing it is possible for individuals to communicate more fully, to express themselves in more detail, and to circumvent some of the time limitations that they would normally experience in face-to-face interactions.

The second aspect of school literacy importance for individuals who use AAC systems is that those who are preliterate are often limited to an ideographic literacy system. Some of these graphic systems force AAC communicators to use a closed vocabulary set and do not allow them to generate words to communicate new ideas. For example, an AAC communicator may operate a system composed of just 50 pictures or 100–200 ideographic symbols. They do not have access to the many thousands of concepts and ideas that they need in order to communicate fully and effectively.

The use of orthographic literacy skills can be one way to open up access to a full range of concepts and vocabulary to students who use AAC. The literate AAC communicator, using traditional orthography, may spell words that are not printed on their communication boards or indicate first letters of words to which they don't have access on their communication system. In this way, they can use literacy skills to communicate in face-to-face interactions.

The literacy development of augmentative communicators also may provide them with a means to participate in society by using written communication (as others also use written communication) to express opinions and give information. Using literacy as others do may help the bilingual AAC communicator advocate for bilingual education and acquire a sense of belonging to society as well as a stronger sense of value.

The third way that literacy development carries added importance for bilingual AAC users involves vocational opportunities. In North America, there are very few individuals who use AAC systems who are competitively employed. The number holding white-collar jobs is few. The range of job opportunities available to individuals who have physical disabilities in general is restricted. AAC communicators are not usually employed in jobs requiring manual labor. Thus, they may need highly developed literacy skills for jobs involving, for example, data entry or word processing. Given limited vocational opportunities, the role of literacy in job preparation for bilingual AAC communicators is critical.

Yvonne's Story

AAC users must rely on innovative and sometimes creative strategies to learn to read, write, and monitor their understanding of what they are reading. Literacy-learning strategies for bilingual AAC users have not received as much attention as those of monolingual users. Some of the unique struggles and successes of literacy attainment can be seen in the story of Yvonne, a young Puerto Rican AAC user. Yvonne provides a wonderful example of the importance of first-language support and the use of specific literacy-learning strategies for bilingual AAC users.

Yvonne is a 10-year-old girl with cerebral palsy of the spastic quadriplegic variety. She is nonambulatory and limited-speaking secondary to cerebral palsy. Her hearing and vision are within normal limits. During my initial contact with Yvonne, her intellectual functioning had not been formally determined.

Yvonne's family immigrated to the United States one year before my initial contact with them. She is an only child. The primary language of the home is Spanish. Her father had limited English proficiency and her mother spoke no English at the time of my initial contact, although over the course of the school year they gained more proficiency. Another important characteristic of this family was the fact that the parents decided not to have any other children in order to devote total attention to Yvonne's education and health needs. Although no extended family lived in the area, they resided in a supportive neighborhood with other Puerto Ricans.

Yvonne communicated primarily through use of an eye-gaze communication board. She used Mayer-Johnson Symbols and usually had a maximum of six symbols on her board. Other methods of communication included a smile/frown, yes/no response. A smile meant yes and a frown meant no. Yvonne also communicated by directing her eyes toward people or items that she wanted.

Yvonne was not reading or writing very much in English when we first met. She may have recognized some English words that she encountered daily such as the names of her school, teacher, and classmates, and she had limited environmental vocabulary. I was not sure of her exact reading proficiency in Spanish; however, she did not demonstrate the ability to independently read upper-elementary-graded text w ritten in Spanish and answer basic content questions. Her listening comprehension for stories read to her in Spanish was good. We were not able to assess written language use because the classroom lacked the technology for text composition. Yvonne had a strong desire to learn to read more proficiently.

Yvonne was a student in a general elementary school located in western Massachusetts. Her classroom was nongraded, but the students, all classified as special needs, were of comparable ages to those of fourth grade. The room was self-contained and designated by the school system as a special education classroom. The special need categories included physically and cognitively impaired. Half of the class comprised other Puerto Rican children.

My role was that of AAC literacy consultant, but I also brought my expertise in the area of multiculturalism in speech-language pathology. My initial meeting with Yvonne occurred early in the school year, in her classroom with the classroom teacher and instructional aide. Yvonne immediately greeted me with a welcoming smile because she appeared to know that I was there especially to help her learn. During my initial meeting I was able to informally assess that Yvonne had good cognitive skills. She used her voice to initiate communication to bring attention to matters of need or interest. She laughed appropriately at jokes, her eyes followed speakers in a conversation, and she spontaneously used her eyes to appropriately answer yes/no questions. All of the conversations around her and directed to her by her teacher were in English. Yvonne obviously acquired some English proficiency, although she may not have understood everything.

I had formal training in Spanish and worked some years earlier in a predominately Mexican-American school district in Southern California where I used the language daily. Although I lacked confidence in my use of Spanish, I greeted Yvonne and introduced myself in Spanish. Approaching her using Spanish set a tone for Yvonne that I was supportive of her background and language usage. She recognized that I needed help using the dialect of Spanish that she was familiar with as a primary way of communicating with her. We learned quickly to work together around the use of a language system. Honoring her first language was important to our working together. Another important factor was Yvonne's desire and willingness to learn English, which contributed significantly to her rapid acquisition of stronger English proficiency.

On my second day of visiting the classroom, I was extremely pleased to meet the school SLP assigned to Yvonne. This wonderfully competent, energetic clinician just happened to be bilingual in English and Spanish. With a bilingual SLP and my knowledge of literacy-learning techniques for AAC users, Yvonne blossomed over the course of that academic year in her English proficiency and particularly in her ability to read and spell.

A Successful Technique

I first introduced a spelling/word-level reading technique to Yvonne that proved to be highly successful and allowed her to gain 10–12 new words in reading recognition and spelling each week. Upper-elementary-aged bilingual AAC users with profiles similar to Yvonne should start with whole-word-level reading aimed at teaching recognition of entire words such as swim, pool, the, or cap. Instruction of whole words leads to success in reading phrases and simple sentences quickly. Phonetic instruction should occur as well.

The Words on the Wall technique, which can be used with monolingual as well as bilingual AAC users, begins by the teacher selecting approximately 3–5 new words that the student needs to learn. These should be words relevant to familiar situations and not spelling words from a spelling book. For example, Yvonne went swimming each week in school and thus, during her first week, she learned the words swimming, towel, pool, water, and splash. These words were initially introduced in Spanish only.

The next step in this technique is to make the word accessible by writing it in large print on a sentence strip and attaching it to the wall. The word may initially be paired with a symbol, with the symbol being phased out over time leaving just the written word. The student and the teacher define the word and talk about events involving the target word. After all of the target words are discussed and displayed on the wall, the teacher asks the student to identify each word one at a time as in a spelling test. Yvonne used eye gaze to identify her target words.

During the next day or week, depending on how well the student masters each set of words, introduce more words (1–3 a day). Leave all words on the wall for the school year, increasing the number of words each week. Review old and new words. After enough words are mastered, have the student begin to read simple sentences. Introduce words such as a and the to allow formation of sentences.

The school SLP delivered all of the training to Yvonne in Spanish first and followed it with English only after she knew that Yvonne understood the word in Spanish. Because this literacy-learning technique is based primarily at the word level, it is easier to transition from the Spanish to the English word. The school SLP also kept in close contact with Yvonne's parents, phoning them and sending home each week the word that Yvonne was working on.

Yvonne's communication reflected her increased vocabulary. A board in Spanish was sent home and used with her parents and an English board was used at school initially. As Yvonne's parents gained more English proficiency, they requested to have the English communication board as well. During the school year we piloted different types of high-tech AAC devices and switches with Yvonne. We also explored technology for writing purposes during this year.


Words on the Wall lends itself to a Maze Reading Assessment technique once a student has acquired reading of simple sentences. This technique involves the deletion of target words in a sentence leaving a blank space. The student should be provided with three alternative words in random order at each blank (correct choice, incorrect choice of the same part of speech, incorrect choice of a different part of speech). For example: The boy ate a ______ (truck, this, banana).

This technique can be used easily with many AAC users. Yvonne's eye gazed to her chosen word using this technique. The scale of reading proficiency most often used for informal reading assessments such as this is 90% accuracy indicating that the student is reading at an independent level, 60%–80% accuracy relating to a level where more instruction is needed, and below 60% is equivalent to a frustration level. For Yvonne, the Maze technique was delivered in English because she already had mastered the words on the wall and read simple sentences in English.

The Words on the Wall technique and a Maze Reading Assessment Technique are two techniques that can be culturally and linguistically sensitive and used well with AAC users. Voice output is not required for these techniques, and the words are derived from the students' existing linguistic bases or contextual experiences.

Other techniques also can be used to facilitate literacy development with bilingual AAC users. Techniques that contextualize instruction in the experiences of the home and first language are desirable. For young bilingual literacy-language learners, it is important to use interactive learning techniques that involve the teacher, peers, and the AAC user. Techniques that allow students to demonstrate competence in using language and literacy throughout the school day in all instructional activities are greatly beneficial. Techniques that use narratives such as storytelling, listening to stories, or writing are good for content development. These narratives should be delivered in the language that will allow the child to gain academic skill while learning English.

My first year with Yvonne was a successful one. She gained approximately 10 new words a week over the course of the school year. For AAC users similar to Yvonne in age and cognitive ability, this is an expected rate of growth. There is no typical rate of growth for all AAC users because this population is so diverse in skill and ability.

The Next Year

I returned to visit Yvonne the next year when she had been promoted to a new class and school. The successful learning environment that she had previously experienced had come to an abrupt end. There was a lack of continuity with her education from the previous year. Yvonne was in a new school with all new staff. There was no Spanish language support. The literacy-learning methods had been abandoned. Communication with Yvonne was a problem. There was limited communication between the school and home.

I spent the first few days in Yvonne's classroom as a participant observer and quickly assessed the social and literacy-learning needs of everyone involved in Yvonne's schooling. The goals of my intervention with Yvonne during this second school year included elimination of the communication problem between the school and the family and establishment of better trust and communication, reestablishment of appropriate instructional methods, eliminating AAC barriers, and supporting cultural identity through literacy lessons/interactions and development of a more efficient communication system. The lack of Spanish support and having to demonstrate and convince the new teachers of Yvonne's literacy-learning capabilities resulted in lost time in her development.

Strong first-language support and knowledge of specific literacy-learning techniques for bilingual AAC users led to a successful outcome for Yvonne. She enjoys reading and had a strong desire to continue reading and learning English. This was compatible to the wishes of her parents.

Like Yvonne, not all bilingual AAC users have significant difficulties learning to read and write; however, many of them do. Therefore, it becomes important to communication disorders specialists to identify variables of language that are predictive of later reading difficulties. Researchers and other professionals from different fields of study are combining their interests to close the knowledge/information gap that exists between what is already known about bilingual AAC users' acquisition and development and the information needed to help develop intervention strategies for successful written language.

Strategies for Monolingual Clinicians: A Postscript

Although I did have formal training in Spanish in high school and college and had worked in a predominately Spanish-speaking community in Southern California, I still lacked confidence to converse with Yvonne in Spanish when I first met her. I knew that there were many dialects of Spanish, and I initially did not know enough about the Spanish that she and her family used. Clinicians who are monolingual or who lack information about a second-language-speaking student must do the research to find linguistic information particular to that student. Such knowledge is also helpful in understanding the contexualized uses of literacy in the home that will complement those used in the classroom.

General professional development in the area of bilingual literacy learning is highly recommended, as is professional development in AAC. Understanding policies in educating bilingual students that are implemented in your school district is important. Clinicians should understand how policy affects access to instruction for bilingual students. Social, cultural, and economic issues that affect student learning and instruction also should be well understood. It is helpful to gain information from parents, other teachers, and community members about ways that they find helpful in instructing bilingual AAC users.

Ovetta Harrison-Harris is chair of the department of communication sciences and disorders at Howard University. She is project director for a U.S. Department of Education Office of Special Education and Rehabilitative Services-funded graduate training program in AAC with an emphasis in multiculturalism and literacy development.

Ovetta L. Harrison-Harris, is chair of the department of communication sciences and disorders at Howard University. She is project director for a U.S. Department of Education Office of Special Education and Rehabilitative Services-funded graduate training program in AAC with an emphasis in multiculturalism and literacy development.

cite as: Harrison-Harris, O. L. (2002, November 05). AAC, Literacy and Bilingualism. The ASHA Leader.

For More Information

Light, J., Binger, C., & Smith, A.K. (1994). Story reading interactions between pre-schoolers who use AAC and their mothers. Augmentative and Alternative Communication, 10, 225–268.

Light, J., & McNaughton, D. (1993). Literacy and Augmentative and Alternative Communication (AAC): Expectations and Priorities of Parent and Teachers. Topics and Language Disorders, 13(2), 33–46.

Light, J., & Smith, A.K. (1993). Home literacy experience of pre-schoolers who use augmentative communication systems and their non disabled peers. Augmentative and Alternative Communication, 9 , 10–25.

Pearson, B.Z., Fernandez, S., & Oller, D.K. (1993a). Lexical developmental in simultaneous bilingual infants: Comparison to monolinguals. Language Learning, 43, 93–120.

Pearson, B.Z., Fernandez, S.C., & Oller, D.K. (1993b). Lexical development in bilingual infants and toddlers: Comparison to monolingual norms. Language Learning, 43(1), 93-120.

Pearson, B.Z., Fernandez, S., & Oller, D.K. (1995). Cross-language synonyms in the lexicons of bilingual infants: One language or two? Journal of Child Language, 22, 345–68.

Pearson, B.Z., Oller, D.K., Umbel, V.M., & Fernandez, M.C. (1996, October). The Relationship of Lexical Knowledge to Measures of Literacy and Narrative Discourse in Monolingual and Bilingual Children. Paper presented at the Second Language Research Forum, Tucson, AZ.

Tucker, G.R. (1999). A global perspective on bilingualism and bilingual education [online]. Available at


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