Following the recent publication of the recommendations of the High Authority for Health (HAS) concerning autism spectrum disorder (ASD), the Nantes University Hospital announces the development of digital tools for Alternative and Enhanced Communication (AAC) within its child psychiatry services. Press release.
Alternative and Augmentative Communication (AAC) (see box) has been used for several years in the child psychiatry units of the Nantes University Hospital to support children with neurodevelopmental disorders, in particular autism spectrum disorder and developmental oral language disorder, who have difficulty communicating through speech.
La communication alternative et améliorée (CAA) est un ensemble de stratégies et d’outils destinés à compenser des déficiences de la communication orale et écrite. Le terme « alternative » fait référence aux solutions de communication autres que le langage oral. Ces moyens permettent aux personnes qui n’ont pas l’usage de la parole de communiquer différemment. Le terme « améliorée » fait référence aux solutions de communication qui complètent, améliorent la parole des personnes qui n’arrivent pas à se faire comprendre et de rendre leur message plus compréhensible. Selon l'ISAAC (International Society for Augmentative and Alternative Communication) : « La CAA comprend tous les moyens de communication (autres que la parole orale) utilisés pour exprimer des pensées, des besoins, des désirs et des idées. Elle inclut des gestes, le langage des signes, des symboles, des tableaux de communication et des technologies de communication assistée. »
Source : https://www.monparcourshandicap.gouv.fr/glossaire/caa
Lire également le guide de l'Anap "Communication Alternative et Améliorée (CAA) : Un droit, pas une option"
CAA, an anchored practice, now strengthened
AAC allows children to be better understood and express themselves, which limits crises and associated behavioral disorders and supports the development of communication. The new HAS recommendations for the care of autism spectrum disorders recall the importance of implementing AAC from the start of therapeutic interventions.
Around 150 children are currently affected within the PETAL unit (Evaluation and Support Pathway for Autism Spectrum Disorders, Learning and Language), the Haute-Roche day hospital and the CDJE(1). Alternative and Improved Communication allows you to:
- Promote the child’s communication with those around him in all places where he lives;
- Reduce challenging behaviors and frustration linked to expression difficulties;
- Make the environment, instructions and information accessible;
Support oral language development
The AAC tools already deployed are varied and adapted to the specific needs of each child:
- Pictograms and images (including those from the PECS – Picture Exchange Communication System method);
- Communication boards and notebooks;
- Non-verbal language (facial expressions);
- Signs;
- Photos ;
- Objects;
- Slate;
- Sequentials used in sessions and at school;
- Gestures and signs (adapted sign language);
- Electronic devices and mobile applications with speech synthesis.
These supports are personalized and integrated into multi-disciplinary therapeutic support, led by a collective of professionals with complementary expertise: speech therapists, psychomotor therapists, specialized educators, nurses, psychologists, child psychiatrists and all specialized professionals involved in the care pathway.
A shift towards innovative digital tools
In a context of rapid evolution of digital tools and care practices, the Nantes University Hospital wishes to strengthen its offer by offering innovative digital tools dedicated to AACnotably through the use of tablets equipped with specific software. Patients already have access to digital tools at home. It is therefore essential to integrate the care provided in hospitals into this societal reality, consistent with national recommendations and the expectations of families.
A project carried out by the teams and awaited by the families
This new project is led by the CHU’s speech therapists: Isolde Brisset (from CMP-HDJ(2) Douet Garnier), Lydie Fioleau (from CMP-HDJ Haute Roche) and Clara Madelaine (from the PETAL unit) and supported by all the care teams involved with the children and their families. Families express strong expectations regarding these new communication tools, which constitute an essential lever for the autonomy, inclusion and quality of life of children.
« We are strengthening the integration of AAC in our units using digital tools, in order to support its daily use and fully promote the mental developmental potential of each child. », explains the Dr. Sylvain Bisleauchild psychiatrist at Nantes University Hospital within the PETAL unit (Evaluation and Support Pathway for Autism Spectrum Disorders, Learning and Language). “ The implementation of AAC is much more than a therapeutic choice, it is an obligation, that of giving our young patients the means to express themselves, to be understood, to exchange. AAC supports daily communication, a support for thinking, for learning while the emergence of oral language is hampered », assure Isolde Brissetspeech therapist at Nantes University Hospital.
1 – Early Child Development Center.
2 – Medical-psychological center-day hospital.
