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Using hand-over-hand assistance with someone using an AAC (augmentative and alternative communication) device can be beneficial in certain contexts, but there are several potential drawbacks to consider:

1. Reduces autonomy and authentic communication:

Hand-over-hand prompting can unintentionally lead to guiding the individual’s communication rather than allowing them to express what they truly want to say. This could result in the individual communicating what the facilitator expects, rather than their own thoughts or needs.

2. Prompt Dependency:

The person using the AAC device might become overly reliant on the facilitator, which can affect their ability to use the device independently or effectively in situations where assistance is not available.

3. Inhibits learning and exploration:

When someone else is guiding their hand, it reduces opportunities for the individual to explore the AAC device independently, which is crucial for learning how to navigate it, select appropriate symbols or words, and express their thoughts in their own way.

4.Discomfort or frustration:

Physical prompting can be intrusive or uncomfortable for the person, particularly if they are sensitive to touch or have different sensory processing needs. It may also lead to frustration if they feel they are not in control of the communication process.

There are several alternatives to hand-over-hand assistance that can support effective communication using an AAC device while promoting independence and user control. Here are some strategies and techniques to consider:

Modeling:

Demonstrate how to use the AAC device by using it yourself. This helps the user learn the system and its functions through observation and practice.

Gradually increase wait time after modeling to allow the user opportunities to imitate or try using the device on their own.

Verbal Prompts:

Offer verbal guidance and cues to help the user navigate the device. This can include instructions on which buttons to press or reminders about the available vocabulary.

Visual Supports:

Use visual aids such as instructional charts, icons, or step-by- step guides to help the user understand how to use the AAC device. These supports can be placed near the device for easy reference.

Customized Vocabulary and Layout:

Ensure the AAC device has a user-friendly layout and vocabulary tailored to the individual’s needs. A well-organized and personalized device can reduce the need for physical assistance.

Repetition:

Provide frequent opportunities to help the user become more proficient with the device. Practice sessions can build confidence and skills in using the device independently.

Switches and Alternative Input Methods:

For users who may struggle with touch- based input, consider alternative input methods such as switches, eye-tracking, or head pointers. These methods can be customized to the user’s abilities and preferences.

By employing these alternatives, you can help ensure that the user maintains a sense of autonomy and develops their skills while still receiving the support they need to communicate effectively.

See our handout for Prompting Strategies to learn more!