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Why I Don't Use "Hand Over Paw" Cueing

“Hand over paw” cueing refers to teaching Stella to use her AAC device by holding her paw and pushing buttons for her. In human terms, this is the equivalent to using “hand over hand” cueing to make an ASL sign with a child’s hands or push a button on his communication device with his finger. Many people assume hand over paw cueing is how I got Stella to push buttons. But, I have never once placed Stella’s paw on a button. Here’s why:


It is impossible to physically force another human being to say something with verbal speech. We can encourage, teach, direct, give cues, but we can never pull words out of someone’s mouth. AAC may seem different to the untrained eye because if I wanted to, I could physically manipulate Stella’s paw to push a button. But just because I can does not mean that I should. No matter how long it takes or how many other types of cues are needed, AAC users deserve to be in full control of their words just like humans using verbal speech are in control of their own words.


Instead of using hand over paw cueing, I watched Stella learn to imitate me pushing buttons and eventually learn to initiate communication on her own. I watch toddlers develop these same skills every day in speech therapy. It was amazing watching nearly the same process occur in a dog. When I programmed Stella’s first button and modeled use of it by pushing it with my foot at the appropriate times, it appeared like Stella wasn’t doing anything for the first couple of weeks. But I was so wrong! She was listening and watching me. Around week 3 of my modeling, Stella started intently watching me push the button. She would look up at my face, down to the button, and then up at my face again. That’s when I knew we were headed in the right direction. It was so similar to the moment when a child really watches me model words on his AAC device for the first time, or when a toddler makes eye contact with me and looks at the object we’re playing with. Throughout that week, Stella started approaching the button, nudging it, standing by it, then eventually pushed it all on her own.


That moment was SO gratifying for me because it did not just show that Stella could physically push a button; it showed her communicative intent. Observing the stages that happened before Stella said a word were just as important as observing her pushing the button for the first time. We didn’t skip the whole process of language learning to “make” Stella start saying words immediately. We gave her time to develop understanding and go through pre-linguistic stages of development just like all humans do.


My goal for Stella is for her to be able to independently communicate her thoughts, wants, and needs, even if they’re different than I would expect. I will never be able to read Stella’s mind, and would never want to risk forcing her to say something she wasn’t thinking or didn’t want to say. Stella deserves to be in control of her own voice just like we all do. By not using hand over paw cueing, we laid a foundation for Stella to become the effective communicator that she is today.


Thanks for following along!


Christina Hunger, M.A., CCC-SLP

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© 2020 by Christina Hunger, M.A., CCC-SLP