Let's Talk About Sex Baby, Let's Talk About it on AAC

Abstract

AAC users are at a higher risk for sexual assault and abuse. Disabled adults also face greater odds of victimization than minors, suggesting that unlike the general population, disabled people remain at elevated or increased risk throughout their lives (Mailhot Amborski et al., 2022). Collier et al. (2006) found that across 26 AAC user survey participants, the majority (73–88%) had no means to communicate about sexuality or safeguarding. The lack of relevant vocabulary on AAC devices left individuals unable to report abuse, seek help, or recognize abusive situations. Most participants received no sexuality education from family, school, or healthcare providers. SLPs are in a unique position to make a difference in AAC user’s safety, as we are the primary professionals programming vocabulary on devices.

Author Donnie Denome, an AAC user, highlights in his blog, How do you symbolize intimacy? For many AAC programs, not particularly well (2020), that when vocabulary is absent from a device by default, the responsibility for adding it falls to whoever manages and programs the device, and for many AAC users, that is an SLP or another professional, not the user. The author makes clear this creates a serious problem: Many AAC users do not have the literacy or technical skills to edit their own devices. This means the SLP or another adult communication partner effectively controls the entire vocabulary corpus, everything the user can say. This places an enormous ethical responsibility on SLPs. An SLP who does not proactively program vocabulary around abuse, body parts, sexuality, puberty, consent, and reporting must reckon with the fact that their inaction can leave a client unable to disclose abuse or communicate about their own body and health. The author is explicit: a communication partner who does not want an AAC user to communicate about these topics, whether out of discomfort, assumption, or intent, can effectively silence them on these issues entirely.

A survey study of 83 North American SLPs covering their practice patterns, beliefs, perceived barriers, and sense of professional role in addressing sex education for their clients with communication disorders found that SLPs on average actually addressed the topic of consent with 37.4% of clients, addressed body autonomy with 27.6% of clients, and addressed sex ed topics with only 10.1% of clients (Wolford and Jansen, 2024). Looking at the reported perceived barriers may give us some answers and directions to address this gap. The second highest reported barriers for SLPs in the 2024 survey were a lack of knowledge or training in the topic and a lack of available resources.

This poster will help close the research to implementation gap, teaching clinicians about the importance of sexual health literacy and present research that addresses two questions: (1) Are the top 100 CSD graduate programs, as designated by the U.S. News and World Report, covering this topic in their AAC courses and if not, why not? (2) How much education and what types of resources would SLPs believe to be enough to change their own practice patterns?

References:

Collier, B., McGhie-Richmond, D., Odette, F., & Pyne, J. (2006). Reducing the risk of sexual abuse for people who use augmentative and alternative communication. Augmentative and Alternative Communication, 22(1), 62–75. https://doi.org/10.1080/07434610500387490

Denome, D. T. (2020, June 15). How do you symbolize intimacy? For many AAC programs, not particularly well. Mumblings from an Autistic Fairy. https://donnie.lgbt/2020/06/14/how-do-you-symbolize-intimacy-for-many-aac-programs-not-particularly-well/

Mailhot Amborski, A., Bussières, E.-L., Vaillancourt-Morel, M.-P., & Joyal, C. C. (2022). Sexual violence against persons with disabilities: A meta-analysis. Trauma, Violence, & Abuse, 23(4), 1330–1343. https://doi.org/10.1177/1524838021995975

Wolford, L. L., & Jansen, K. L. (2024). Who helps children with communication disorders access sex education? Practice patterns of speech-language pathologists and psychologists. American Journal of Speech-Language Pathology, 33(2), 848–865. https://doi.org/10.1044/2023_AJSLP-23-00326