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Alyssa Hillary Zisk: Adults With Autism Who Use AAC Part-Time

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This week on TWT, Rachel interviews Alyssa Hillary Zisk! Alyssa is a graduate student in neuroscience who shares their experiences as an autistic adult who uses AAC part of the time to communicate. 


Key ideas this episode:


🔑Some autistic adults experience intermittent or insufficient speech.

🔑Some of these adults use AAC part of the time.

🔑It is important to give AAC users the same chance to participate in discussions and to allow them to communicate in whatever modality they choose.


Before the Interview:

  • Rachel – hiking to Havasupai in the Grand Canyon
  • Chris presenting in Connnecticut – 3 hour workshop on fundamentals of AAC
    • How environment can change a presentation – auditorium vs conference room presentation
  • Keeping in mind the environment of a room for clients – keeping it free of clutter, etc
  • If a child is not doing what you are asking in therapy and is distracted, pay attention to distractors (e.g. look at the environment) instead of just blaming the student
  • Dana Nieder responded to Cathy Binger on her blog – Cathy Binger wrote a reply comment in the blog that was respectful, well-worded, and open to the perspective of others.


During the Interview:

  • Alyssa is a graduate student and autistic adult who uses AAC part time.
  • Alyssa wrote an article about AAC for speaking autistic adults – can experience intermittent or insufficient speech. This can include selective mutism, but it isn’t always selective mutism.
  •  If Alyssa is sick, tired, done a lot of talking that day, felt sensory overload, etc, then their speech can become unreliable (e.g., using scripts that don’t mean what you want to say)
  • Lots of free and low-cost tools can make it less obvious you are using AAC, but most aren’t designed for AAC specifically
  • People who speak can still use AAC, there is nothing wrong with using multiple ways to communicate
  • There is a gap in research about adults with autism who are part-time AAC users
  • Alyssa: Groups & sites where I learned about AAC
  • Alyssa – Using scripts takes less effort than coming up with new words and speaking at the same time. 
  • Most reliable communication methods for Alyssa
    • 1st – using a keyboard 
    • 2nd – relaying factual info Alyssa has a script for
    • 3rd – using other scripts in conversation
    • 4th – improvised, original speech
  • AAC Used by Alyssa
    • Proloquo for Text on iPad, 
    • Writing in Open Office on their computer
    • Flipwriter on the iPad (flips what you write to the other person & does text to speech)
    • eSpeak on their laptop (free text-to-speech)
    • Writing on paper, whiteboards, and index cards
  • Alyssa will use different systems and tools depending on the context
  • Rachel: How to you explain to others that you use AAC part time?
    • Sometimes Alyssa uses AAC when speech is inconsistent without telling others about it first
    • Alyssa discusses communication needs with professors before the class begins
  • Rachel: Generally, any negative experiences? 
    • Alyssa may not get included in discussions in class as much. 
    • Allowing more time for AAC users is important, but there is an inclination to ask less of people who use AAC. May be deeper – people may not expect AAC users to participate as much.
    • Not including AAC users may come from not wanting to put pressure on people who use AAC, but there are ways to let the AAC user decide how much they want to participate.
  • Biggest challenge for Alyssa – people may see their using AAC for different reasons. people may assume that Alyssa’s AAC use means they are not happy or have had sensory overload, but Alyssa uses AAC for lots of reasons and its not a signal of their mental or emotional state.
  • if you had a billboard every SLP read, what would you want it to say? AAC FOR EVERYONE
    • AAC covers all the ways people communicate in addition to speech. 
    • When we look at implantation, we think of it as an intervention and therapy tool and not a life tool that everyone can use
    • Even clients whose speech sounds good can benefit from AAC

We want to know what you think! You can connect with us at our Facebook group Talking with Tech, on Twitter, and Instagram (@talkingwithtech)! Also, please subscribe and post a review for us on iTunes – it helps others to find us!


Dana Nieder’s response to Cathy Binger on her blog

Facebook communities mentioned


  • Flipwriter on the iPad (flips what you write to the other person & does text to speech)
  • eSpeak on the laptop (free text-to-speech)

Find out more about Alyssa:

Interested in earning CEU’s by listening to “Talking With Tech”? Check out our course at bit.ly/twtcorepd.


Hosts: Rachael Madel and Chris Bugaj

Producer: Luke Padgett

Audio Engineer: Michaela Ball

Music: “Ebb and Flow” by Fabian Measures

May 29, 2019

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