Emma Emmerich OT

08/07/2025

22/02/2025

Revisiting the Prompt Hierarchy for AAC (Part 2 of 4)

Today I want to share with you an updated version of the prompt hierarchy for AAC. In this version, I’ve tried to make abundantly clear what was implied in the original version in 2015.

The 2015 version was a recreation of a resource from the Rocky Bay Positive AACtion resource out of Australia. This resource was chosen by myself and a group of SLPs with whom I collaborated. We felt like it described the heavy-handed prompting we saw in many classrooms; often by well-intentioned staff who were given very little training on how to support students using AAC.

The only change we made was to the color gradation. The Rocky Bay resource had the least restrictive prompts colored RED and the most restrictive prompts colored GREEN. This, we feared, would lead staff to thinking they should use a most-to-least prompting method.

Since that time, several of my teacher and SLP colleagues have introduced other visuals that better describe respectful practices for teaching AAC. I’ll share some of those with you at the end of today’s post.

For now, focus on the importance of using the first four strategies during AAC instruction and intervention. Foundationally, we need to explicitly say, “We cannot prompt skills that we have not yet taught.” Just because we have a linguistic target in mind - does not mean that our learners can predict that target. First and foremost, let’s advocate for meaningful and engaging instruction BEFORE we expect learners to demonstrate new skills.

I’m going to repeat that to emphasize how simple yet foundational this is. We cannot prompt skills that we have not yet taught. As educators, we need to have a discussion about what type of explicit instruction we are providing AAC learners. Yes, modeling/demonstration. Yes, verbal referencing. But also -- teaching. Specific vocabulary, functional strategies for use, pragmatic skills, the connection to literacy. All of it. Even the healthy prompting strategies will be challenging if we are trying to magically elicit skills that do not yet exist.

So today, please read over this updated graphic. Consider which of these strategies are used the most in your program/classroom/clinic. And think about where you can start guiding teams to agree that physical prompting and forced imitation are not good practice. Tomorrow, I’ll share more about the risks associated with heavy prompting. In the meantime, consider also using these resources on supporting AAC learners in a healthy and respectful way.

Jane Farrall (2023): https://www.janefarrall.com/the-problems-with-hand-over-hand-v2-0/

The AAC Coach (2020): https://m.facebook.com/theaaccoach/posts/194495858704259/

Kate Ahern (2016):
https://teachinglearnerswithmultipleneeds.blogspot.com/2016/03/rethinking-aac-prompting-hierarchy-in.html?fbclid=IwAR0_mhRUx3_9jBWvcCTSCNvQoOXcNiH0xotNn7-otcfJaW6ESVFbXw-YISM

10/02/2024

This!

15/12/2023

03/12/2023

09/11/2023

Yes!!

Love this 💗

https://x.com/helenatslt/status/1722331769779724314?s=46

Image Description: Content of Helen Robinson’s post on X (formerly Twitter): “A fab day delivering our Autism & AAC course today. We asked the group "what is the role of an SLT or SLTA when supporting autistic AAC users? I love this response from Sharon Carpenter, shared with her permission - what a fantastic message!”

A post it note with handwriting that says “my role is to find the interest, find the fun. Break all the rules. Be there with the child, in the moment, see what happens.”

09/10/2023

Know better, do better!

03/10/2023

Something to consider..

06/08/2023

A brilliantly simple way of explaining a concept.

People often use the word “regulated” as if it is the “intellectual-sounding” synonym for the word “calm”. People also often use the word “dysregulated” as if it is the intellectual-sounding synonym for the word “angry” or “crying” or “tantruming” or whatever else word they might want to use.

Regulated means your energy levels match the task.
Dysregulated means your energy levels do not match the task.

A child laughing hysterically and kicking and squealing and playfighting is not regulated to go to sleep.
A child laughing hysterically and running enthusiastically through an open field outside is perfectly regulated to play outside in a big open field.

Sometimes helping a child regulate means putting them into an environment where their level of energy matches the environment. Sometimes helping a child regulate means helping their body get its needs met so that their energy can match the task that’s up next.

[Image description:
A cartoon drawing of a child running through a field with a yellow kite. Handwritten text next to them reads: REGULATED means your energy levels match the task. It does not mean ‘calm’.
The image is by Neurowild. End description.]

02/08/2023

Another one!

To kick off the back-to-school season, I have created this handout/classroom poster to remind you that “Supporting AAC is a piece of cake!”

Just follow the acronym “CAKE” and you’re sure to start the year off on the right foot!

I was planning to create a visual reminder for my special education classrooms to help them remember some of the most important tips for successful AAC-use, and then I thought it might be helpful for some of you, too!

I included my top tips and mindset shifts when I work with all of my AAC-learners and users within the acronym CAKE!

When families or staff ask me advice for supporting their AAC-users, I always find myself coming back to the same important ideas:

C-Connect!
A- Acknowledge!
K- Keep modeling!
E- Encourage & Entice (don’t demand or require!)

If you think this handout would be beneficial in your classrooms or as a handout for communication partners, head on over to my TPT store to download this version (as well as a couple other color schemes) for free!

Don’t forget to save and share this post if you think others might find it helpful! 🥰

We’ve got this! 🙌🏻

Grab the free printable PDF here! https://www.teacherspayteachers.com/Product/Supporting-AAC-Classroom-Posters-and-Handouts-FREEBIE-AAC-is-a-piece-of-CAKE-9932904

02/08/2023

Love this!

Love this analogy for AAC modeling!

To get all the great details & video clips, please read both posts on the Speak for Yourself blog:

http://www.speakforyourself.org/2015/12/07/aac-modeling-part-1-a-piece-of-cake-and-a-bite-of-broccoli/

http://www.speakforyourself.org/2015/12/08/aac-modeling-part-2-layers-of-modeling-engagement/

(8/1/23: The links have been updated: https://speakforyourself.org/aac-modeling-part-1-a-piece-of-cake-and-a-bite-of-broccoli/ & https://speakforyourself.org/aac-modeling-part-2-layers-of-modeling-engagement/)