Paeds Cases · growth-development-and-behaviour
AAC counselling — communication OSCE
OSCE on early AAC counselling, myth-busting, feature-match planning and partner training for a child with complex communication needs.
osce communication and developmental counselling
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Target exams
MRCPCH ClinicalRACP DCE
Prompt
Parents of a 4-year-old minimally verbal autistic child request advice after preschool meltdowns; a relative said a speech device will stop talking.
Objectives
- Explain multi-modal AAC without shutting down hope for speech. [2] [3]
- Give honest PECS/SGD evidence boundaries. [1] [2]
- Co-design a participation-focused assessment and trial plan with partner training. [13] [14]
- Address preschool behaviour as possible communicative frustration. [13]
Candidate brief
12-minute station. Parents present. Child not in room. No emergency features. [13]
Expected actions
- Ask goals: what must the child request/refuse/share at home and preschool. [14]
- Bust the “AAC stops speech” myth; keep speech therapy alongside AAC. [2] [3]
- Summarise evidence: PECS helps requesting; speech gains variable; SGD naturalistic approaches supported. [1] [2]
- Plan team assessment (SLP ± OT), feature-match, trial, low-tech backup, preschool training. [13] [14]
- Safety-net and follow-up date; written plan. [13]
Marking
Pass: early AAC offer; multi-modal framing; honest evidence; trial + training plan; behaviour linked to communication access. [1] [2] [13]
Fail: advise waiting years for speech only; promise fluent speech from PECS; device shopping without goals/training; dismiss preschool distress. [1] [13]
References
- [1]Flippin M Effectiveness of the Picture Exchange Communication System (PECS) on communication and speech for children with autism spectrum disorders: a meta-analysis. American journal of speech-language pathology, 2010.PMID 20181849
- [2]Gevarter C Naturalistic Speech-Generating Device Interventions for Children With Complex Communication Needs: A Systematic Review of Single-Subject Studies. American journal of speech-language pathology, 2018.PMID 29971336
- [3]Therrien MCS A Systematic review of AAC interventions using speech generating devices for autistic preschoolers. Augmentative and alternative communication (Baltimore, Md. : 1985), 2025.PMID 40164143
- [13]Resina P Identifying and Describing Best Clinical Practices for Children and Adolescents With Complex Communication Needs: A Scoping Review of Healthcare-Based Interventions. Journal of intellectual disability research : JIDR, 2025.PMID 40745993
- [14]Coan-Brill J Exploring augmentative & alternative communication assessment practices for children with limited functional speech & motor skills: a scoping review utilizing the Participation Model of AAC. Disability and rehabilitation. Assistive technology, 2025.PMID 39891921