Multi-modal communication

Also called Multimodal communication, Mixed-mode communication, Multi-modal AAC

One sentence may need a device, a sign and a raised eyebrow. That's not a failure of the device. That's how everyone talks.

What it is

Multi-modal communication is what a person does when they use more than one way to get a message across: a symbol for the noun, a sign for the verb, a facial expression for the feeling, a vocalisation for emphasis. Speaking people do it constantly; nobody thinks a shrug is a failure of English. For a person who uses AAC, the modes just happen to include a machine.

It matters as an idea because services sometimes treat the device as the person's only real voice, and everything else as a fallback or a bad habit. The person's communication is all of it, and it's the partner's job to read all of it.

Who it can help

Every AAC user, at every stage. It's particularly worth naming for people whose partners have been told to "make them use the device": autistic people who sign a little and speak a little, people with cerebral palsy whose speech is understood by family but not strangers, people with motor neurone disease moving between speech, writing and a device as the day goes on.

It's a description of what people already do, so it isn't "for" anyone in the sense of being prescribed. What can be prescribed is that partners learn to read it, and that the communication passport lists every mode.

How it works

Each mode has a cost and a reach. Speech is fast but may be unclear. A sign is fast and expressive but only works with a partner who signs. A device is slow but reaches strangers and carries precise vocabulary. Gesture and face are instant and carry feeling. A fluent multi-modal communicator picks, moment by moment, the cheapest mode that will work with this partner, in this place, for this message. With mum at home, a look and a grunt. At the GP, the device.

Partners help by noticing the switch and going with it, not by insisting on one mode. "Use your words" or "Use your device" when the person has already said it clearly by another means teaches that the other means don't count.

Where it goes wrong is when the modes are read by only one person. A parent who understands every sound and sign is a translator, and translators leave the room. That's the case for the device: it's the mode that works without the translator.

Getting started

List every mode the person uses and what each one is good for. Put it in the communication dictionary or passport.

Respond to the first mode that works. If they signed it, you got it; don't wait for the device version.

Practise switching modes yourself. Say it, sign it, touch it on the Talk board, all in one sentence. You're showing that mixing is normal.

Where to get help

Communication Matters is the UK organisation for AAC users, families and professionals and treats multi-modal communication as the norm. 1Voice connects families and adult AAC users who can tell you what it looks like from the inside. A speech and language therapist can help the person's partners agree how each mode is read.