Multi Modal Communication is simply a term for describing all the different ways we employ in communicating with each other, every day. This may be via spoken language, texting, tweeting, emailing, handwriting, body language, & gesturing, or by using a communication device.
When individuals who have difficulty communicating verbally use alternative modes, it is generally called Augmentative and Alternative Communication (AAC), which embraces all the above modalities, plus a few others. All of us rely upon a multi-modal approach to getting our message across, & it is exactly the same for AAC-users.
For people who depend upon AAC as part of their communication strategy, a multi-modal methodology holds even greater importance since without its benefits their functional ability to communicate will be compromised.
The communicative ability of many AAC-users is often hindered by a number of factors that make basic communication difficult & complicated, including:
- Fine and gross motor skills
- Cognitive impairment
- Social stigma
- Language & literacy level
We take for granted how easy it is for us to switch between different modalities. In fact, during this article you may have been reading, answering a phone call, glancing at a text or waving somebody away, all without realising you were switching modalities.
For someone with a disability, this cognitive ability to switch modalities and use even 2 or 3 modalities can be quite difficult, depending on their cognitive state. It is necessary to be aware of this and work with the individual and their family to find the most effective and functional modalities that fit within their cognitive and functional ability.
The need to have multiple modes of communication available becomes all the more important if a primary mode becomes unavailable. This could be caused by a voice-output device failing or being physically damaged. The user might be forced to swap to an iPad or a low-tech option. Or again, it could result from a device user starting their day accessing a device via eyegaze, becoming fatigued & having to change over to switch access in order to keep communicating.
Even though modern voice-output devices are generally more rugged, dustproof & to some extent waterproof, certain environments & situations call for other modes. You would be brave to take a device into a swimming pool when a slate tablet or a picture board might turn out to be more than adequate. Bath-time could mean a watery grave for many speech-generating devices. Most dynamic display devices are difficult to read or navigate when in strong direct sunlight. A simpler back-up method is often required.
If someone who is non-verbal has developed successful strategies to get their message across, then these should be maintained & preserved. They may be unorthodox or individual, but it they work, they work. Introducing a sophisticated electronic AAC device may well mean, over time, that the user tends to favour it over other more restrictive techniques, yet that should not signal the abandonment of other modes of communication that have proven to be tried & tested.
Here are a few tips and recommendations when you are communicating with someone who uses AAC & has a heavy reliance on multimodal communication methods:
- Be respectful of their mode of communication, not rushing or finishing their sentences.
- If they are learning how to use a different modality, it can be okay to model its use with them e.g. use sign language in conversation with them or use their device to model what you are saying.
- Use language that reflects their current use and understanding, at times modelling one step beyond what they are already capable of generating.
- Don’t forget the importance of gestures, vocalisations and manual signs!
- Body-language may tend to be far more individual & even distorted by physical movements that are difficult to control.