Janelle Strickler
Issue in AAC Paper
12/5/2011
Peer Attitudes Toward Children Who Use AAC in School
Approximately 0.3%-1% of school-aged children use augmentative and
alternative Communication (AAC) devices. Many of these children are being included in
regular education classrooms (Beck, Bock, Thompson, Kosuwan, 2002, p. 218). Young
individuals who use AAC can face many challenges. Interactions with peers who are not
familiar with children who use AAC can be difficult for the young child using a device.
These peers may demonstrate negative attitudes toward this individual. They may have
difficulty accepting an individual who uses an AAC device or they might be
uncomfortable around the AAC user. Inclusion in regular activities with peers may be
difficult for these reasons. Many studies have been conducted in order to determine peer
attitudes towards AAC users and techniques that can be used in order to encourage
positive interaction between peers and AAC users. It is important to educate peers about
AAC and utilize techniques that develop positive attitudes toward users of AAC devices.
This is important because it could encourage more positive interactions between children
who use AAC devices and their peers (Beck, Fritz-Verticchio, 2003, p. 51-57).
Peer Reactions Toward Children Who Use AAC
Peers who are exposed to users of AAC devices can respond in different ways.
However, many studies have shown that negative attitudes are typical of children who
encounter another child who uses an AAC device to communicate. Peers might not want
to include these children in activities. This may be because they do not believe the
individual is able to participate, or because they do not know how to interact with
someone who uses a different way of communicating. It could be intimidating for a child
to see a fellow student who uses an AAC device to communicate. Unfortunately, this can
result in isolation of the young AAC user (Beck, Thompson, Kosuwan, Prochnow, 2010,
p. 573).
In general, individuals with communication impairments report experiencing
negative social reactions when communicating with others. These people also report
being stared at or teased (Beck, et al., 2010, p. 573). When considering those who use
communication devices due to physical disabilities, research states that peers view these
individuals as less intelligent than they really are. These individuals may be ignored,
neglected, or treated in a condescending manner. This can hinder a child’s ability to
participate fully in everyday life and develop positive relationships with other children of
the same age (Dudek, et al., 2006, p. 18).
Factors Influencing Peer Attitudes Toward Children Using AAC
Studies have shown that various factors can affect a peer’s attitude toward an
AAC user. One such factor is gender. According to a research by Lilienfeld and Alant
(2002), female children generally respond in a more positive manner to individuals who
use AAC devices. Age of the children in school is also a factor that could contribute to
peer attitudes toward AAC users. Studies show that the younger a child is, the more open
they are to interacting with an individual who uses an AAC device. Studies cited by
Lilienfeld and Alant (2002) suggest that as both boys and girls grow older, their attitudes
towards AAC users become less positive (Lilienfeld, Alant, 2002, p. 92).
Some factors that could potentially affect the attitudes of individuals toward AAC
users are different for adults as opposed to children. An example of this is the type of
augmentative or alternative device used by the individual. Researchers state that the
more sophisticated the communication device, the more positive the attitudes toward
AAC users tend to be. High-tech communication devices have been shown to result in
more positive attitudes than low-tech devices. However, these results have only been
shown pertaining to adult reactions to users of AAC devices. The type of AAC device
does not appear to influence attitudes that children in grades 1-6 have towards users of
AAC (Beck, et al., 2010, p. 574). A study conducted by Dudek, Beck, and Thompson
(2006) resulted in no difference between peer attitudes toward individuals who use one
type of device over the other. This study specifically used static screens and dynamic
screens in order to determine if attitudes were more positive towards one type or the
other. However, no difference in attitudes was found in regards to static versus dynamic
screens (Dudek, Beck, Thompson, 2006, 17-23).
Although the type of AAC device used has been shown to have no effect on peer
attitudes, research shows that the specific features of an AAC device have an effect on
the attitudes of peers and their willingness to interact with these children. Peers are more
likely to react in a positive manner when the messages from an AAC device are more
intelligible; socially appropriate; and reflect appropriate intelligence, age, and gender
(Lilienfeld, et al., 2002, p. 91-92). Research has also indicated that the attitudes of peers
who are familiar with AAC users tend to be more positive than those of peers who are
unfamiliar with AAC users. This appears to be the case with attitudes toward individuals
with disabilities as a whole. In fact, research has shown that as familiarity increases,
positivity of attitudes increases (Beck et al., 2010, p. 573-574).
Scales Used to Measure Peer Attitudes Toward Children Using AAC
In order to determine the nature of peer attitudes toward users of AAC devices,
measures should be taken using an accurate rating scale. This information can be used to
determine if techniques for encouraging positive interaction with AAC users should be
utilized. One scale that was used by Lilienfeld and Alant is called the Communication
Aid/Device Attitudinal Questionnarie (CADAQ). This questionnaire was used to
determine attitudes of 11-13 year olds toward individuals who use AAC devices
(Lilienfeld, et al., 2002, p. 91).
Similar to the CADAQ, the Assessment of Attitudes Toward Augmentative and
Alternative Communication Scale (AATAAC) has also been used by researchers to
measure attitudes of peers (Beck, Fritz-Verticchio, 2003, p. 53). Beck, Thompson,
Kosuwan, and Prochnow (2010) conducted a study that developed the Assessment of
Attitudes Toward Augmentative and Alternative Communication Scale - 2 (AATAAC-2).
This is a second form of the original AATAAC designed for use with adolescents rather
than younger children. In comparing the CADAQ to the AATAAC, it is apparent that the
two forms of the AATAAC cover a wider range of ages than the CADAQ, which was
normed for only 11-13 year olds. Many scales exist for the purpose of measuring peer
attitudes toward individuals with disabilities; however, they may not be sufficient for
specifically measuring attitude toward users of AAC. The CADAQ and AATAAC scales
appear to be appropriate measurements for this purpose (Beck, et al., 2010, p. 574).
Techniques for Encouraging Positive Interaction
As discussed, peer attitudes can affect the way that peers treat and interact with
classmates who use AAC devices. Negative attitudes of peers may result in children who
use AAC devices becoming isolated from others. They may not be included in activities
in and out of school. These attitudes could be resulting from lack of education about
AAC devices. If a student utilizes an AAC device to communicate, their peers should be
educated about it in order to encourage more positive attitudes and interactions. Studies
have shown methods or techniques that can be used to encourage positive interactions
with AAC users (Beck, et al., 2003, p. 51-57).
An example of a specific technique for increasing peer interaction with
children who use AAC devices is discussed by Beck and Fritz-Verticchio (2003). This
technique is called role-playing. The purpose of role-playing is to establish an
understanding of how an individual using an AAC device may feel. Peers are able to
experience the limitations and struggles encountered by a child using a communication
device. This way, the attitudes of peers toward individuals who use AAC devices may
become more positive (Beck, et al., 2003, p. 51-57).
Beck and Fritz-Verticchio conducted a study in which children were required to
play the role of an individual who can only communicate through an AAC device. These
children carried out an activity in which they played “Go Fish” with each other. They
were required to use only the non-electronic communication boards supplied by the
examiners. These boards included only words and phrases necessary to play “Go Fish.”
This way, the children could appreciate the limitation of not being able to respond with
any comment that they wanted. They could only use the words and phrases that were
provided for them. This study utilized the Assessment of Attitudes Toward
Augmentative and Alternative Communication Scale (AATAAC). This scale was used to
measure peer attitudes before the study began and after the study ended. It was found
that peer attitudes were significantly more positive after the conclusion of the experiment.
This suggests that role-playing is a successful method of educating peers about the
treatment of and attitudes toward users of AAC devices (Beck, et al., 2003, p. 51-57).
Conclusions
Various studies have been conducted which explore the attitudes of peers toward
children who use AAC devices. Peer attitudes can influence such issues as inclusion in
regular activities and the overall treatment of children who use AAC devices. Feeling
included by classmates is important to all children. Peers may need to be encouraged to
include children who utilize AAC devices. Techniques such as role-playing may increase
the positive attitudes toward students using augmentative and alternative communication.
It is important that educators as well as parents utilize techniques such as role-playing to
encourage positive attitudes toward users of AAC devices. This way, children who use
AAC devices can feel more included among other classmates their own age (Beck, et al.,
2003, p. 51-57).
The following websites can be used to further explore the topic of peer attitudes
toward children who use AAC devices in school:

http://www.speechpathologyguru.com/what-is-augmentative-alternativecommunication-aac-and-who-uses-it-a8/
o This website contains general information regarding the use of AAC
devices. It includes examples of types of AAC devices, who may use
AAC devices, as well as other useful information. This information can
be used to better establish a baseline understanding of AAC devices and
their users.

http://tnt.asu.edu/helpdesk-communication-social?page=6
o This website contains various tips for communication and socialization of
children who use AAC devices. This website can be used by parents or
educators to assist young children who use AAC devices to interact with
peers. These strategies are geared towards preschool development;
however, many of the ideas can be used for school-aged children as well.

http://csd.illinoisstate.edu/files/coins/profile/arbeck
o This website describes a leading researcher in the field of AAC. Ann
Beck has completed much research in the area of AAC and attitudes of
peers toward users of AAC. It lists major articles that are useful resources
for this topic.

http://k-12.pisd.edu/currinst/sped/AT/UsingPeers.htm
o This website describes how peer interactions can actually be used in
intervention with individuals who use AAC devices. The website includes
tips on activities and ways to reinforce socialization for both the peer and
the child using AAC. These tips can be used to encourage positive
interactions between children who use AAC devices and their peers.

http://www.blatner.com/adam/pdntbk/rlplayedu.htm
o This website describes techniques for using role-playing as a means of
education. This website includes useful tips for educators that can be used
when utilizing role-playing as a technique for encouraging positive
interactions among children who use AAC devices and their peers.
References
Beck A. R., Fritz-Verticchio H. (2003). The influence of information an role-playing
experiences on children’s attitudes toward peers who use AAC. American Journal
of Speech-Language Pathology, 12, 51-60.
Beck A. R., Bock S., Thompson J. R., Kosuwan K. (2002). Influence of communicative
competence and augmentative communication technique on children’s attitudes
toward a peer who uses AAC. AAC Augmentative and Alternative
Communication, 18, 217-227.
Beck A. R., Thompson J. R., Kosuwan K., Prochnow J. M. (2010). The development and
utilization of a scale to measure adolescents’ attitudes toward peers who use
augmentative and alternative communication (AAC) devices. Journal of Speech,
Language, and Hearing Research, 53, 572-587.
Dudek K., Beck A. R., Thompson J. R. (2006). The influence of AAC device type,
dynamic vs. static screen, on peer attitudes. Journal of Special Education
Technology, 21(1), 17-27.
Lilienfeld M., Alant, E. (2002). Attitudes of children toward an unfamiliar peer using an
AAC device with and without voice output. AAC Augmentative and Alternative
Communication, 18, 91-101.