Pat Mirenda, Ph.D., is a professor in the Department of Educational and Counseling Psychology and Special Education at the University of British Columbia. In 2008, she was named a Fellow of the International Society for Augmentative and Alternative Communication. Dr. Mirenda's current research focuses on describing the developmental trajectories of young children with autism and factors that predict the outcomes of early intervention.

Teresa Iacono, Ph.D., is a speech-language pathologist, associate professor, senior research fellow, and Director of Research for the Centre for Developmental Disability Health Victoria at Monash University. Her work has focused on developmental disabilities and complex learning needs and extended more recently to physical and mental health issues of adults with developmental disabilities. In 2007, Dr. Iacono was a recipient of the inaugural National Health and Medical Research Council (Australia) Ethics Award for her work addressing ethical concerns of including people with developmental disabilities in research.

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P.M.: Twenty-five years ago would have been 1983, when I was in graduate school at the University of Wisconsin-Madison. I was part of a National Personnel Training Project for Autism at the time, so I had a chance to travel to several different states and interact with a lot of teachers who supported kids with autism. Most of the students were in self-contained classrooms or special schools, and most of them were taught a few manual signs or provided with a few picture symbols, at best. No one was using speech-generating devices with students with autism, and most professionals didn't have much of a vision for what AAC could do for them. Now, many of the same students are in general education classrooms and should have access to professionals who understand the power of AAC and try to provide multicomponent systems to students with autism right from the beginning of their school careers. Of course, that's not always the case, but I would hope that most people acknowledge that AAC can be a very powerful and important tool to support social communication and both language and literacy development for these students.

T.I.: Twenty-five years ago, I was a relatively new clinician who had just embarked on post-graduate study motivated by a realisation that AAC had much to offer children with autism, as well as those with other forms of developmental disabilities. I had started working in a 'special education' school and decided to trial signs with children who were going nowhere in direct speech interventions, or in play activities that seemed to lack direction, focus or interaction. The latter approach was favoured for the children with ASD. Access to signs allowed the children to demonstrate that they could communicate, and could learn. The principal was delighted with the progress and word spread throughout the special education community within metropolitan Sydney of the value of AAC.

Q: What uses of AAC match particularly well with some of the distinctive characteristics of autism?

P.M.: Many individuals with autism have relative strength in the area of visual processing and visual learning, and AAC symbols are a good match for that strength. Graphic symbols and, to some extent, manual signs represent words and concepts in visual form, which makes them easier than speech alone for many people with autism to understand.

T.I.: Much has been written about how AAC matches the visual processing strengths of people with autism. I think there is an additional basis for matching, in that AAC, particularly aided AAC, enables a person with autism to maintain control of an interaction and its pace, and reduces the need for auditory bombardment that can sometimes occur through repetition of spoken models.

Q: Can individuals with ASD who have relatively intact speech and language skills still benefit from AAC?

P.M.: Yes, of course. The American Speech-Language-Hearing Association's definition of AAC includes a focus on "severe disorders of speech-language ... comprehension" as well as production. So, individuals with autism who are able to speak, such as those with Asperger's syndrome, may require and benefit from augmented input techniques such as visual schedules and contingency maps that can help them predict upcoming events and understand the social rules that often elude them.

T.I.: There is a danger that people see AAC as only an expressive modality, or as a means of supporting receptive language. People with autism with relatively good speech and language skills, however, often struggle with the nuances of the pragmatics or social uses of language. AAC provides a means of making the nuanced concrete, such as through the use of AAC supported social stories.

Q: How can the use of AAC enhance learning of the general academic curriculum by students with ASD?

P.M.: Really, there are too many ways to list! When you think about it, how can a student who cannot speak even begin to participate in a general education classroom without AAC? Students with autism need to be able to ask and answer teachers' questions, interact with classmates both socially and academically, give reports, contribute to discussions, and participate in all of the other communicative opportunities that are available in classrooms. Without access to a wide range of AAC techniques, they may be "breathing the same air" as their classmates but they certainly won't be truly included in the curriculum as real members of the class.

Q: How did your own interest in children's social and emotional learning develop?

P.M.: During my graduate program, I was very lucky to be able to work with both Dr. David Yoder at the University of Wisconsin and with Dr. Adriana Schuler through the National Personnel Training Project for Autism. They both inspired me to understand the power of AAC for individuals with autism and to learn more about how to harness that power to support school and community inclusion.

T.I.: My interest developed in my early clinical work with young children with various forms of developmental disabilities. I was hugely frustrated with traditional speech interventions that failed to provide functional outcomes for the children I was working with. In my first year as a clinician, I attended a Speech Pathology Conference in Australia and heard Anne Cooney speak about using Makaton [a vocabulary program that incorporates symbols, speech, and signs from the sign language of a person's home country] with people with intellectual disabilities, including those with ASD. Anne had introduced Makaton to Australia. I was so inspired that I had to learn more and use it with a range of children I was working with. It wasn't till a year or so later, when I worked in a preschool for children with autism, that I was able to explore its uses more fully with this group.

Q: What would you like to see as the next great area of focus of research into the use of AAC and individuals with ASD?

P.M.: I look at the work of Janice Light and her colleagues when I think about this issue. They are using AAC in creative and innovative ways with very young children to support language and literacy development, and they are having fantastic results! While their work is not solely with children with autism, I think they are on the right track and I would love to see more autism-specific research employing techniques such as visual screen displays that they have developed.

T.I.: I would really like to see a focus on the provision of AAC to adults with ASD, particularly those who also have intellectual disability. This group is largely forgotten, but their needs are huge.

Q: Given the findings of recent years, if you could make one sweeping change to the general practice of people who use AAC in supporting individuals with ASD, what would it be?

P.M.: If I had a magic wand, I would want everyone to presume that people with autism can be competent communicators in every way. I don't think that most people think this way right now. Most professionals view individuals with autism as people who might be able to communicate about their wants and needs at best, so that's all they ever teach them to do! I think we unintentionally limit the potential of many individuals with autism with our narrow vision of what they can learn and what they can achieve. A bigger, bolder vision would require a total transformation of the types of AAC supports we provide.

T.I.: I would really like to see clinicians and educators become more creative and adventurous in their use of AAC. Limitations in time, and to some extent expertise, can create a situation in which people stay with the systems they were taught in their professional training or early in their careers. AAC has so much to offer, but too often, it is used narrowly. Of course, such creativity requires time to really understand how to support the communication of a person with ASD across his/her environments and with a variety of communication partners. I would love to see people adopt a more dynamic assessment approach, that enables clinicians and educators to trial and evaluate AAC as forms of communication supports, and then use the information gained to inform further intervention.