Interview With Professor Lisa Geary of Towson University

Lisa M. Geary is a Clinical Assistant Professor at Towson University in Maryland. She has over 25 years of experience in the field, including work in the public school, outpatient clinic, and private practice settings. Her research and clinical interests include Augmentative and Alternative Communication (AAC), Language and Literacy, Autism and Related Disorders, and Clinical Supervision/Interprofessional Education.

Note: You should consult with your doctor or speech pathologist for recommendations on treatment. The views and opinions expressed in this article are those of Professor Geary and do not necessarily reflect the official policy or position of

How did you become interested in Augmentative and Alternative Communication (AAC) and low-income literacy?

I fell in love with AAC and literacy intervention while working in the public school setting. I worked primarily in Title I schools, where the majority of students came from low-income households. In addition, these schools offered special education programs for students with complex communication needs. I found helping students find a voice and become a more active participant in their learning to be so rewarding.

How does income level affect literacy?

While income level is not the only factor, it is clear that a low socioeconomic status (SES) can negatively affect a child’s literacy development and overall academic performance (Morgan, Farkas, Hillemeier, and Maczuga, 2009; Buckingham, Wheldall, and Beaman-Wheldall, 2013). Access to books and early reading experiences are critical to literacy development, but over-burdened families with limited funds, time, and resources are often unable to provide adequate exposure to books and reading. These same families may also be limited in the types of life experiences they can offer their children, which in turn can limit the meaningful connections children can make with what they are reading (Aikens and Barbarin, 2008; Bergen, Zuijen, Bishop, and Jong, 2016).

How have we become better at addressing the impact of income on literacy?

There are many programs, often provided through the public school system, that work to educate families about literacy development and provide access and exposure to books. We know that reading with a child is the single best way to positively impact a child’s academic performance (Cullinan, 1988), and schools work hard to foster reading in the home setting. We also now know the importance of helping young children develop phonological awareness skills that set the foundation for literacy (Ehri, 2004). Academic instruction and intervention are now very intentionally designed to teach children sound awareness and sound manipulation abilities, skills that often require explicit instruction for a child to master (Roth, Speece and Cooper, 2002).

What are some of the major challenges that exist today when it comes to getting low-income students the speech and language therapy that they need?

We know that early intervention is critical to a child’s communication development and future academic performance. A child’s physician is often the first to identify speech-language concerns and make the referral for an assessment and intervention. But parents from low SES households may not have adequate access to healthcare or other community resources that help a child get the early intervention they need. For school-aged children, overcrowded schools and schools with inadequate resources can negatively affect whether a child receives the therapy they need (Aikens and Barbarin, 2008).

Another area of expertise of yours is AAC, what are some of the most important developments that have shaped current AAC technology?

The advent of mobile technology has truly revolutionized the industry and the potential for communication. Mobile devices such as smartphones, iPads, and other tablets are now not only portable and functional, but they are often deemed more mainstream and socially acceptable. Such trendy devices now actually help to foster participation and inclusion for the AAC user (McNaughton and Light, 2013).

What are some of the challenges to getting those with communication issues the AAC tools that they need?

I often see clients who already have AAC devices, but they are not using them to functionally communicate. Often these clients never received the intervention necessary to develop any proficiency, but many times they never even had an AAC assessment, a crucial and necessary step in the process. Families or organizations often opt for one of the affordable mobile options that are now available, and clients are then handed iPads or tablets equipped with the latest communication app download. While those devices and apps might be appropriate for some users, they are not necessarily appropriate for every user. A proper AAC assessment is first required to identify the precise device features needed to help the client overcome specific communication barriers. After those features have been identified, then the device can be selected and matched to the client’s specific needs. Device training and speech-language therapy are also essential elements to successful communication, steps that are also, unfortunately, often missed.

What aspect of your work are you most proud of?

I am most proud of my work in higher education. The students I work with are inspired, passionate, and eager to learn. I truly love the experience of helping them develop their clinical skills and expertise, especially in the area of AAC. Students are often surprised how useful their AAC training is, particularly as they move into off-campus clinical placements. I love getting their calls and emails, and hearing about how their AAC training helped them better serve their clients. Training this next generation of speech-language pathologists (SLPs) is so rewarding, and I consider it a noble calling.

What is your advice to SLPs?

My advice to SLPs – don’t give up. Don’t give up on yourselves of course; always believe in the power of what you can offer. But also — don’t give up on your clients. In this messy time of caseload guidelines, insurance restrictions, and overstretched budgets, it might seem easier or even preferable to write off someone’s potential. But I have learned over the years that we should never give up on our most vulnerable clients. Communication is a fundamental human right, and everyone deserves a voice.

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Aikens, N. L., and Barbarin, O. (2008). Socioeconomic differences in reading trajectories: The contribution of family, neighborhood, and school contexts.  Journal of Educational Psychology, 100, 235-251.
Bergen, E., Zuijen, T., Bishop, D., and Jong, P. F. (2016). Why are home literacy environment and children’s reading skills associated? What parental skills reveal. Reading Research Quarterly, 52, 147-160. doi:10.1002/rrq.160
Buckingham, J., Wheldall, K., and Beaman-Wheldall, R. (2013). Why poor children are more likely to become poor readers: The school years. Australian Journal of Education, 57, 190-213. doi:10.1177/0004944113495500
Cullinan, B. (2000). Independent reading and school achievement. School Library Media Research, 3, 1-14.

Ehri, L.C. (2005). Learning to read words: Theory, findings, and issues. Scientific Studies of Reading,9:2, 167-188, DOI: 10.1207/s1532799xssr0902_4

McNaughton, David and Light, Janice (2013) The iPad and mobile technology revolution: Benefits and challenges for individuals who require augmentative and alternative communication. Augmentative and Alternative Communication, 29:2, 107-116, DOI: 10.3109/07434618.2013.784930.
Morgan, P. L., Farkas, G., Hillemeier, M. M., and Maczuga, S. (2009). Risk factors for learning-related behavior problems at 24 months of age: Population-based estimates. Journal of Abnormal Child Psychology, 37, 401-413. doi:10.1007/s10802-008-9279-8
Roth, F. P., Speece, D. L., and Cooper, D. H. (2002). A longitudinal analysis of the connection between oral language and early reading. The Journal of Educational Research, 95, 259-272.