Speech & Communication

Emily McFadd, Ph.D. CCC-SLP

Communication that works in your actual life

I’ve spent more than fifteen years helping people find a way to communicate that holds up outside the therapy room — at home, at school, at work, and with the people who matter most. My specialty is augmentative and alternative communication (AAC), and my aim is always independent communication: a system that lets you say whatever you want to say, to whomever you want to say it — opinions, questions, and jokes as available as requests.

This page walks through our three-month AAC program — what we do together each month, and where it is meant to lead. If you are not sure whether it is the right fit, that is what a first conversation is for.

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The program

Sage NeuroCare AAC with Dr. McFadd

Month 1

Discover

Understanding the person behind the communication.

We begin by getting to know each client as an individual, understanding their strengths, interests, relationships, routines, communication style, and what matters most to them. Together with the client and the people who know them best, we’ll explore what is working now, where communication feels difficult, and what might open up new possibilities.

We may explore

  • Complete a comprehensive communication and AAC evaluation
  • Identify all the ways the client already communicates, including speech, vocalizations, gestures, signs, facial expressions, body movements, writing, pictures, and technology
  • Learn about the client’s interests, relationships, daily routines, sensory preferences, and motor and access needs
  • Identify communication strengths and barriers across home, school, work, community, and social settings
  • Explore and trial AAC systems, vocabulary organizations, and features
  • Evaluate the best access method, including direct touch, keyguards, switches, eye gaze, alternative pointing methods, or other supports when appropriate
  • Explore communication needs related to independence, self-advocacy, relationships, education, employment, and community participation
  • Establish an individualized communication baseline and meaningful goals
  • Select and begin personalizing an AAC system when appropriate
  • Begin funding and documentation for a dedicated communication device when recommended
  • Collaborate with family members, caregivers, educators, therapists, support staff, and other important communication partners
Month 2

Connect

Communicating about what matters.

This month is about putting the communication system to work in real life. Therapy focuses on helping the client communicate more of what matters to them. We go beyond wants and needs to support the expression of opinions, questions, feelings, stories, humor, boundaries, ideas, and more.

Together, we focus on

  • Individualized AAC therapy sessions 1–2 times per week, with extended 2 hour sessions and home visits available
  • Set up, personalize, and refine the client’s AAC system
  • Add meaningful vocabulary related to important people, interests, places, activities, education, work, health, and everyday life
  • Model AAC naturally without requiring imitation or a particular response
  • Develop communication for a wide range of purposes, including commenting, asking questions, refusing, advocating, sharing information, expressing emotions, and connecting socially
  • Build vocabulary, sentence formulation, conversation, and literacy skills as appropriate
  • Place special emphasis on supporting communication of choice, consent, boundaries, and self-advocacy
  • Optimize access, positioning, layout, and system settings
  • Coach family members and caregivers in becoming responsive communication partners
  • Identify opportunities for communication throughout everyday routines and activities
  • Collaborate with schools, vocational programs, day programs, workplaces, or other providers when appropriate
  • Continually troubleshoot barriers and adjust the plan based on what we learn
Month 3

Thrive

Making communication work in everyday life.

Communication belongs everywhere. During the final month, we focus on helping the client carry their communication skills and supports into the relationships, environments, and experiences that make up everyday life.

We work toward

  • Continue individualized AAC intervention
  • Expand vocabulary and the range of messages available to the client
  • Support increasingly spontaneous and self-directed communication
  • Practice communicating with different people and in different settings
  • Build skills for initiating, maintaining, and repairing conversations
  • Support participation in friendships, family relationships, education, employment, healthcare, and community life as appropriate
  • Develop strategies for communicating with unfamiliar communication partners
  • Continue personalizing the AAC system as the client’s interests, responsibilities, and communication needs evolve
  • Help caregivers and other communication partners learn when to offer support — and when to give the client time and space to communicate independently
  • Coordinate recommendations across the client’s support team
  • Review progress and identify emerging priorities
  • Complete final AAC recommendations, programming updates, and a personalized plan for continued growth
Communication for life

More Than a Device

The goal is bigger than learning how to operate an AAC device.

We want each client to have more ways to express who they are, make choices, build relationships, advocate for themselves, participate in their community, and have greater influence over their own life.

We also want the people around our clients to leave feeling more confident. Communication partners will learn how to create the time, access, opportunities, and support that allow the client to communicate for themselves.

Every client learns at their own pace

While we have intentionally designed an initial three-month period, services may be extended on a month-to-month basis when additional time, practice, or support would be beneficial. Together, we’ll consider the client’s progress, goals, and ongoing needs to determine the right next step.

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