Early cognitive skills as prerequisites to augmentative and alternative communication use: What are we waiting for?

The observation of correlations between cognitive abilities and language and communication abilities in normally developing children has led to the assumption that there are specific cognitive prerequisites to the development of symbolic communication. For many individuals with severe disabilities, this focus has led to a clinical decision to teach these prerequisite skills or to wait for them to emerge before providing communication programs either for teaching speech or for introducing augmentative and alternative communication (AAC) techniques. In this paper, literature regarding cognitive prerequisites to communication development for nondisabled children and for individuals with disabilities is reviewed. Issues related to providing communication teaching programs are discussed, and specific intervention strategies are presented.