Finding the right words at AAC Camp



Graduate student speech-language pathologist Natalie Mahalla (left) works with campers in AAC camp, which teaches kids with speech and communication disorders how to use augmentative and alternative communication. (Photos by Ethan Simmons)

Midway through his third session of Augmentative and Alternative Communication Camp at the University of Illinois, one elementary schooler wanted to say “yes” with a little more oomph.

So he grabbed his AAC device—a tablet with an array of common words and phrases that speak when clicked—and typed in a new word of his own: “Duh,” with a rolling-eyes emoji for effect.

“This was an example of how AAC can help a child communicate like any other kid who wants to be silly or tease his friends,” said Stella Shiffrin, a U. of I. graduate student studying to become a speech-language pathologist, who was this camper’s one-on-one clinician. “It was very funny, yet socially relevant and useful.”

For the second year, faculty and graduate students at the Department of Speech and Hearing Science at Illinois hosted a summer camp for local children to practice their skills with AAC devices, and meet other kids with similar communication needs.

Augmentative and alternative communication, or AAC, is an umbrella term for the methods that nonspeaking or minimally speaking people use to communicate.

In practice, AAC can mean techless options, such as sign language and gesturing, or text-to-speech devices, like the kids in camp used this summer.

The camp is designed and run by Speech and Hearing Science Assistant Professor Savanna Brittlebank and Clinical Assistant Professor Andrea Burie, who support AAC implementation among children from academic and clinical perspectives.

A child at the AAC Camp at the University of Illinois Urbana-Champaign clicks a word on their device to speak.

Common users of AAC include individuals with autism, cerebral palsy, and other intellectual and/or physical disabilities who experience difficulty using speech for functional communication. Roughly one-third of children on the autism spectrum are nonspeaking, according to recent estimates. While a spoken conversation can employ anywhere from 150 to 250 words per minute, AAC users might convey eight to 10 words per minute.

“If you’re a child who grows up using AAC, you might be the only one in your class or in your grade or even in your school who uses AAC to communicate,” Brittlebank said.

“Being able to be in a room with other children who use AAC helps normalize it, it helps their social skills just having an example from peers, which helps them build friendships, too. It helps them realize they’re not the only one who communicates in that way.”

A hands-on experience

What was new in the second go-around was a short AAC “boot camp” for the graduate student clinicians, which clearly boosted their confidence working with the campers and the AAC tech that each of them used.

Also, they served more kids this year. Seven campers between the ages of 5 and 10, including a couple of returners, joined the Thursday sessions for six weeks this summer; five campers joined last year. The days were split into two sessions, with one designed for more medically complex children.

At AAC Camp, facilitators hosted interactive, crafty games each day with the campers, with fun asides and simple conversations to help the kids make meaningful steps toward improving their vocabulary and literacy while adopting the technology. In addition, each kid got one-on-one time with a student clinician, supervised by faculty.

This experience is critical for Speech and Hearing Science students who are training to be speech-language pathologists. Each of them must spend at least 375 hours working directly with patients in a supervised setting before obtaining their degree and licensure.

“They’re able to have a lot of hands-on, in-depth experience with this [AAC] population that is typically underserved in our field,” Burie said. “This is trying to target that gap in speech-language pathology training.”

On one humid day, the campers went outside with their clinician partners and went on a nature scavenger hunt, picking up branches, plants and flowers to show at the session, then described what they found using their devices. One camp favorite theme was “Summerween,” where the kids walked around the rooms of the Audiology and Speech-Language-Pathology Clinic for trick-or-treating.

Graduate student speech-language pathologist Stella Shiffrin works with a camper in AAC camp. This summer saw two sessions each week, with one designed for more medically complex children.

“Something that is really fun about the camp setting is that it naturally facilitates social communication between peers,” said Natalie Mahalla, who’s heading into her second year of the speech-language pathology master’s program. “We can model and prompt on the device all we want, but to see the kids use their devices to be able to connect with their peers socially was really fulfilling.”

Camp facilitator Andrea Burie joined the faculty of the Department of Speech and Hearing Science in August 2024, after nine years as a speech-language pathologist in Champaign Unit 4 Schools. Her connection to the district helped her find families that could participate in the AAC camp during its first run in summer 2025.

For Burie, her familiarity with AAC started in the home. Her oldest sister, Alison, was born with a severe physical and cognitive disability, which required the use of AAC support to communicate beyond a few vocalizations. 

Alison used voice-output switches and speech-generating devices throughout her school years, but their family received “very limited” training on how to support AAC use at home, so Alison’s use of the tech tapered off after she left the school system, Burie said. 

“I understand the challenges families can face when trying to incorporate it into everyday life,” Burie said. “Now, as an SLP, it’s been a passion of mine to help families find simple, meaningful ways to support AAC device use in the home.”

Activities also go home with the campers. Families were given an “AAC Bingo,” filled with prompts to help their kids use the AAC devices outside of the camp. One square asks them to go outside and identify three things they see with their device; another asks the user to describe what they liked most about their meal.

“The goal isn’t to add more work to a family’s day but rather to highlight communication opportunities that already exist within everyday routines and moments,” Burie said.

Evidence-based approach

Andrea Burie (center), assistant clinical professor at the Department of Speech and Hearing Science, holds up a snack during AAC Camp.

Through all the fun games and crafts, the summer AAC camp is designed with the latest educational approaches in mind, specifically how kids develop language—and social skills—if they aren’t communicating with speech.

At AAC Camp, the facilitators are keen on getting the kids to ask questions with the help of their devices.

“In typical language development, requesting and social communication actually develop in tandem,” said Brittlebank, who joined the College of Applied Health Sciences in 2024. “But when we provide intervention, sometimes the social piece is overlooked. How do we build that? Taking turns is that underlying piece. And a lot of that is how we ask and answer questions.”

Among augmentative and alternative communication users, literacy needs are critical. An estimated 90 percent of individuals who use AAC graduate high school without functional literacy skills.

Part of this has to do with traditional literacy curricula, which draw heavily from phonics—the sounding out of words—to teach reading. Nonspeaking children have to rely on different approaches.

“There are evidence-based curricula that exist that have non-speech responses, but they’re not very well known or widely implemented, and so we’re drawing on those curricula that exist to support literacy instruction,” Brittlebank said. “Unfortunately, it’s a barrier in practice and the field in general. There is a huge push right now to improve literacy outcomes for individuals who use AAC.”

At AAC Camp, facilitators used visual aids, such as a kid’s photograph from their family’s trip to a baseball game, to spur on the conversation each day.

‘Does it make you happy?’

With many of the campers still learning the ins and outs of their AAC devices, patience was key for the student clinicians working with each child as they formulated their thoughts in new ways.

The AAC camp is a learning experience for the clinicians, too: faculty facilitators model how to intervene with the campers, then slowly go more hands-off as the camp progresses. 

The student clinicians learned to adapt the activities to the child’s unique interests, Shiffrin said: “This makes therapy more meaningful and fun for them.”

Learning AAC can be a tedious process, but parent feedback from the camp has been promising. One parent shared that this was the first summer camp their child had ever attended; others talked about how their child made new friends; or were fascinated to see other kids’ AAC devices for the first time, according to a survey collected by facilitators.

At one session, student clinician Chesney Hassett asked, “Who likes our time together, talking to each other?” The campers raised their hands in agreement.

“Does it make you happy?” she asked. One camper nodded, then clicked the word on his tablet: “Duh.”

Editor’s note:

To reach Savanna Brittlebank, email savannab@illinois.edu
To reach Andrea Burie, email aburie@illinois.edu

(To reach Ethan Simmons, email ecsimmon@illinois.edu)

 

Share on social

Related news

SHS Clinic gives students, faculty the opportunity to provide clinical services for the community



The Audiology and Speech-Language Pathology Clinic is located at 201 S. Oak Street in Champaign
(Photo provided)

Nestled in the University of Illinois’ Research Park is a place where the Department of Speech and Hearing Science improves communication and quality of life using evidence-based practices on a daily basis. This mission goes back to the founding of the department.

The Audiology and Speech-Language Pathology Clinic, operated by SHS, provides a full range of diagnostic and therapeutic services to 200 children and adults annually. The clinic serves individuals in the local community and across Illinois via in-person and telepractice means, providing services to clients across the lifespan. 

May is Better Hearing and Speech Month, and 2023 marks the 50th anniversary of the celebration of that occasion, as well as the 50th anniversary of SHS being established at the University of Illinois. The month’s theme of Building a Strong Foundation and its emphasis on “life-altering treatment” fit nicely with the department’s history of service, instruction and research.

During the month free pediatric and adult hearing and speech-language screenings will be offered to community members. Graduate students will perform the screenings with supervision from certified audiologists and speech-language pathologists. The event will be held at the clinic at 2001 S. Oak St. Suite B in Champaign on the morning of Wednesday, May 24, and the afternoon of Thursday, May 25. All are welcome and can call the clinic at 217-333-2205 if interested in scheduling a free screening.

Other community activities have included:

  • Presentations from second-year masters students at the OSF Heart of Mary Medical Center stroke support group’s monthly meeting.
  • Presentations at the Parkinson’s Disease Support Group of Champaign County about the role of speech-language pathology and its benefits for quality of life in Parkinson’s disease.
  • Convenient, no-charge audiology and hearing care services provide to residents of Clark Lindsey Nursing Home. Doctor of Audiology students informed residents about listening and repair strategies, cleaned and maintained hearing aids, and cleaned earwax out of residents’ ears.
  • Free hearing and speech-language screenings at the Child Development Laboratory on campus and at Chesterbrook Academy Preschool.
  • Sharing information about communication disorders and the services available at the clinic with the community as part of the College of Applied Health Sciences booth at the Urbana Market on the Square.

Graduate students in audiology and speech-language pathology develop knowledge and skills to provide clinical care to the community through their academic coursework and clinical practica experiences.

“As a clinic, we’re working very closely with the department,” said Clarion Mendes, a speech-language pathologist at the clinic and a clinical assistant professor in SHS. As Mendes explains, exposure to the needs of the community in the clinic informs teaching.

“Part of our mission is to intertwine the two and not see them as distinct entities,” she said. “The department has gone through a curriculum revision for the master’s program in recent years that highlights cultural and linguistic diversity, and if we look at that with a broader lens, that also includes looking at speech differences rather than considering them as disabilities. Speaking for myself, my clinical population nearly exclusively consists of marginalized populations. I work nearly exclusively with gender-diverse individuals. Working within that landscape requires a lot of reflection and cultural humility, constantly revising how I approach clinical practice and teach it to my students.”

The clinic gives students the unique opportunity to provide cutting-edge care informed by research and clinical expertise in an immersive environment under the supervision of licensed and nationally certified audiologists and speech-language pathologists. While clients are receiving care, they are contributing to new discoveries in the assessment and treatment of communication disorders and training the next generation of speech, language, and hearing clinicians and researchers.

Working with external partners and increasing the diversity of the student body bring fresh viewpoints and experiences to the clinic and department. In fact, the international composition in the clinical programs body is at a 10-year high, with seven international students in the clinical programs in audiology and speech-language pathology. “Efforts are also underway to expand the accepted insurances to get a broader patient base,” Clinical Assistant Professor Sadie Braun said.

Clinical work powers education and research and has motivated SHS since its humble beginnings. Jennifer Dahman, a speech-language pathologist and clinical assistant professor at SHS, credits her work as a clinical educator for making her a “better speech-language pathologist.”

“Yes, we teach the how, but more importantly, we teach the why,” she said. “And if we don’t know the why then we find out. Being able to explain that active kind of learning perspective to students translates into their service delivery.”

Learn more about the Audiology and Speech-Language Pathology Clinic by visiting the website.

Return to the SHS at 50 page

Related news

SHS audiologist ‘hopeful’ about hearing aid ruling



After a recent FDA decision, hearing aids are now available over the counter.

A decision by the Food and Drug Administration that permits hearing aids to be sold without consulting a medical professional could be a positive development, Speech and Hearing Science audiologist Sadie Braun said.

But, as she’s fond of saying, consumers might have to “play it by ear”.

The FDA ruling, which was finalized in August and took effect on Oct. 17, allows adults with mild or moderate hearing loss to purchase a hearing aid without prescription. The ruling will create more competition and lead to quick technology advancements and lower device costs, but without FDA approval a company cannot classify its product as a “hearing aid.” Per the FDA, the devices covered are air-conduction hearing aids, which fit either in the ear canal or sit behind the ear. Other types of hearing  devices include cochlear implants or bone-anchored systems.

While there are plenty of positives to the new rule, it is important to stress that hearing aids are not a one-size-fits-all proposition, Braun said.

“I am a little nervous about the idea that some people who are self-diagnosing may not actually have a mild-to-moderate hearing loss,” she said. “They might be getting hearing aids that are not ideal for them. More importantly, I’m worried that by removing audiologists and ear, nose, and throat doctors from that process altogether, that patients might not get the care that they need for some of those more significant auditory and medical conditions that can be related to the ears and can be very serious if left untreated, such as acoustic neuromas, and Meniere’s disease, to name a couple.”

Given those concerns, Braun recommends that anyone who is considering trying an over-the-counter device make an appointment with an audiologist for an initial hearing test.

That said, Braun believes the ruling will end up being a good thing for “our patients, for audiology, and for the hearing aid industry on the whole.”

“I think that this legislation definitely opens the door for some of our traditionally underserved and underrepresented populations and communities so that they can obtain devices that can help them hear better that they might not have otherwise been able to obtain,” she said, citing the cost of hearing aids. 

The average price for a pair of prescription hearing aids is $4,600, but OTC hearing aids are expected to cost far less. The federal government estimates Americans could save up to $3,000 on hearing aids by choosing OTC brands rather than prescription devices. If that’s the case, the average cost for a pair of OTC hearing aids would be around $1,600. One wrinkle is that there are now several different devices that can be used to amplify sound for a multitude of purposes: hearing aids and Personal Sound Amplification Products, better known as PSAPs, and it can be difficult for consumers to differentiate them.

“The big difference with PSAPs is that they are not meant to treat hearing loss,” Braun said. “They are actually for normal-hearing individuals only. And they’re therefore not classified as medical devices. Instead, they’re considered electronic products. Because of this, they are not regulated at all by the FDA. One example of something the FDA determines with medical devices is age limitations and requirements, and they have stated that OTC aids are ‘not intended for use by individuals who are younger than 18’.  However, while they say that in the rules and regulations, they do not require age verification before over-the-counter hearing aid purchase. But on PSAPs, for example, there’s no recommended requirement.”

Another benefit of the FDA OTC rules, Braun believes, is they will go a long way toward ensuring safety standards for OTC devices.

“The rules and regulations that took years to develop and fine-tune are critical pieces in this OTC legislation,” she said. “We really have to have those built-in safety mechanisms to protect the consumer, to make sure the consumer does not get injured. Also, we have to make sure that these devices meet a set of standards, a set of criteria, to be sure that they do what they claim they will do, or what they are intended to do. Without those regulations in place, I would be much more wary of recommending OTC hearing aids as an option for some of my patients who have mild-to-moderate hearing loss.”

Still, Braun cautions that in the early stages of the aftermath of the rules, much is yet to be determined, and she stresses the need for professional guidance.

“Each person has a different and unique set of needs,” she said. “Some individuals can navigate that process, on their own and potentially be successful with over-the-counter devices. I think that other individuals really need that guidance of a professional to help them through the entire process from start to finish and to be there for support and assistance the entire way. Over-the-counter hearing aids cut out the service component, and that professional service component is what a lot of patients really rely heavily on.”

One way to access that professional service is through SHS’s Audiology & Speech-Language Pathology Clinic. You can reach clinicians by calling 217-333-2205 or emailing shsclinic@illinois.edu.
 

Editor’s note:

To reach Sadie Braun, email svojak@illinois.edu.
 

Share on social

Related news

College of Applied Health Sciences
110 Huff Hall
1206 South 4th Street
Champaign, IL 61820
(217) 333-2131