What is Augmentative and Alternative Communication (AAC)

Key takeaways
What is Augmentative and Alternative Communication (AAC)

What types of AAC can supplement speech

What is Augmentative and Alternative Communication

Augmentative and Alternative Communication (AAC) encompasses a range of tools, strategies, and technologies that help people with speech or language difficulties express themselves effectively. From simple picture boards to sophisticated speech-generating devices, AAC systems provide vital communication support for individuals with conditions like autism, cerebral palsy, ALS, or speech apraxia. These communication solutions can be unaided (using body language, gestures, or sign language) or aided (utilising external tools like communication boards, tablets, or specialised devices). For millions of people worldwide, AAC serves as a bridge to meaningful interaction, enabling them to share thoughts, needs, and feelings with family, friends, and caregivers. Whether temporary or long-term, AAC interventions play a crucial role in enhancing independence, social participation, and quality of life for people with complex communication needs.

Categorising types of AAC

We often categorise AAC systems into two groups

No-tech communication systems do not need any tools, and include:

  • Gestures and facial expressions
  • Writing
  • Drawing
  • Spelling words by pointing to letters
  • Pointing to photos, pictures, or written words

Low-tech communication systems need some form of external support and the user’s body, and include:

  • Using an app on an iPad or tablet to communicate
  • Using a computer with a “voice," sometimes called a speech-generating device
  • Using an eye gaze device to communicate
Augmentative and Alternative Communication (AAC) can be categorised into two systems: No-tech communication and Low-tech communication

A person may use different types of AAC because there are many ways that we all communicate. An AAC system refers to all the tools of this type that a person uses, offering transformative communication for those who use AAC. These devices are designed specifically for individuals who cannot rely on natural speech.

How do they function?

  1. Input Methods: Users can input language in various ways, whether through touchscreens, keyboards, or even eye-tracking technology. This adaptability ensures that each individual's unique needs are met.
  2. Speech Conversion: Once the language is inputted, the device converts it into speech. This process allows users to express themselves verbally, facilitating interaction with others and enhancing their ability to participate in everyday conversations.

By integrating these powerful tools, individuals can bridge communication gaps, empowering them to connect more effectively with the world around them.

Who would benefit from AAC?

Imagine how difficult life would be if you are unable to communicate? Communication is a basic human right and the inability to communicate can significantly impact the quality of life of a person. The purpose of AAC is to provide the person with a form of communication. AAC is used by people who, some or all of the time, cannot rely on their speech. AAC incorporates the individual's full communication abilities and may include any existing speech or vocalisations, gestures, manual signs, and aided communication.

A Speech Pathologist may recommend AAC for the following reasons:

  • Spoken language does not develop (non-verbal)
  • Spoken language is slow to develop
  • Spoken language is limited or difficult to understand
  • Spoken language is lost long term or short term 
There are several reasons why a speech therapist might recommend Augmentative and Alternative Communication (AAC) devices

AAC provides people with the ability to express their needs and wants, participate in making their own life choices and expressing their opinions, making and maintaining relationships, and making connections with people at school, work, and in the community.

Speech pathologists play a vital role in guiding individuals through the AAC journey. They work closely with individuals to:

  • Explore and Choose the Right AAC System: Speech pathologists assess various AAC systems to ensure the selected system aligns with the individual's unique needs and lifestyle.
  • Optimise Current AAC Use: They help individuals maximise the effectiveness of their current AAC system, ensuring they are getting the most out of their tools.
  • Implement Alternative Access Methods: For those who need it, speech pathologists introduce and train on alternative access methods, such as eye-gaze technology or switch devices, to enhance communication capabilities.
  • Teach New Visual Languages: Learning a new visual language can be challenging, and speech pathologists provide the necessary support and training to make this transition smoother.
  • Track Informal Communication: By monitoring informal communication methods, speech pathologists help refine and improve overall communication skills, especially with unfamiliar people.
  • Involve Family and Friends: They also educate family and friends on how to support the individual's communication needs effectively, fostering a supportive environment for AAC use.

Through these comprehensive strategies, speech pathologists empower individuals to communicate confidently and participate fully in all areas of life.

Meet Matthew and Rachel. Just some of Ascend Health's experienced and qualified speech therapists and therapy assistants.

Benefits of using AAC

AAC provides people with the ability to express their needs and wants, participate in making their own life choices and expressing their opinions, making and maintaining relationships, and making connections with people at school, work, and in the community.

For individuals with autism, intellectual disabilities, or motor difficulties like cerebral palsy or muscular dystrophy, AAC can be a game-changer. It empowers them to communicate effectively without hindering the development of spoken language. In fact, integrating AAC can enhance their spoken language skills.

By facilitating clearer communication, AAC not only supports personal expression but also fosters a sense of independence and connection in various social settings. Whether in educational environments, workplaces, or community interactions, AAC helps bridge communication gaps, enabling individuals to fully participate and thrive.

How Does Personalisation of AAC Systems Work?

Personalising an Augmentative and Alternative Communication (AAC) system is essential because communication needs are unique to each individual. Here's how the process unfolds:

Understanding Individual Needs

  1. Assessment: A comprehensive evaluation is the first step. Professionals assess an individual's communication abilities, preferences, and goals.
  2. Customisation: Based on this assessment, the AAC system is tailored to fit these unique needs, factoring in things like vocabulary, symbol size, and layout.

Multimodal Communication

Many users benefit from employing more than one form of communication. This approach, known as multimodal communication, ensures flexibility and adaptability in various situations:

  • Tech-Based Solutions: Devices like tablets or dedicated speech-generating devices can be integrated.
  • Low-Tech Options: Includes pictorial cards or letter boards for simpler or backup communication.

Continuous Adaptation

  1. Feedback Loop: Users and caregivers provide ongoing feedback to refine the system.
  2. Regular Updates: The system can be adjusted as communication needs evolve over time, whether due to changes in skill level or goals.

Personalised Features

  • Voice Options: Users select a voice that feels natural, which can boost confidence and clarity.
  • Language Settings: Systems can be configured with multiple languages for multilingual individuals.

By tailoring AAC systems meticulously, users not only communicate more effectively but also feel empowered in expressing their thoughts and emotions. This bespoke approach ensures that the communication tool grows alongside its user, adapting to their ever-changing needs.

How AAC in the Environment Facilitates Task Participation

Augmentative and Alternative Communication (AAC) tools designed for environmental use play a crucial role in helping individuals engage in day-to-day tasks. These tools leverage visual systems that are both intuitive and accessible.

Visual Guidance Tools

  • Timetables and Schedules: Visual timetables offer a structured way to convey daily routines, making it easier for individuals to anticipate and prepare for upcoming activities.
  • Sequencing Boards: First/then boards help clarify task sequences by breaking them down into manageable steps, reducing anxiety about what comes next.

Enhanced Understanding and Engagement

These AAC tools work by providing clear, visual cues that are especially helpful for individuals who benefit from non-verbal instructions. They promote independence by enabling users to follow instructions at their pace, fostering a sense of accomplishment as they complete each step.

Supporting Independence

By incorporating these visual supports in their environment, individuals can become more autonomous. This setup not only aids in understanding tasks but also boosts confidence, making participating in various activities a smoother process.

In summary, AAC in the environment paves the way for active involvement by offering structured, visual guidance that simplifies complex tasks and encourages independent participation.

Understanding Paper-Based AAC Systems

What Are Paper-Based AAC Systems?

Paper-based AAC (Augmentative and Alternative Communication) systems are tools that utilise physical materials, such as books or boards, to facilitate communication. They often feature an array of symbols, pictures, or words organised in a way that helps individuals express themselves without relying on speech.

How Do They Aid Communication?

  1. Visual Supports: These systems provide visual cues that can be understood by users with limited or no verbal ability, making interactions more accessible.
  2. Ease of Use: Because they don’t require electronic devices, paper-based systems are simple and can be used across various environments without needing a power source.
  3. Customisability: Users and caregivers can tailor the choice of symbols and words to fit specific needs or contexts, allowing for personal expression.
  4. Affordability: Compared to high-tech solutions, these systems are typically low cost, making them widely accessible.
  5. Portability: Lightweight and easy to carry, these systems enable users to communicate on-the-go, ensuring constant access to a communication tool.

Through a combination of intuitive design and functional application, paper-based AAC systems remove communication barriers, fostering more inclusive and effective interactions.

AAC Myths and Questions

How do signing systems work in AAC?

AAC (Augmentative and Alternative Communication), signing systems such as Auslan and Key Word Sign play a critical role in facilitating communication. These systems are particularly beneficial for individuals who may not be able to rely solely on verbal communication.

  • Auslan (Australian Sign Language): This is a fully developed sign language used predominantly in the Australian Deaf community. It incorporates gestures, hand shapes, facial expressions, and body movements to convey meaning. In AAC, Auslan offers users a robust and nuanced way to express complex ideas when speech is limited or absent.
  • Key Word Sign: Unlike full sign languages, Key Word Sign involves using signs alongside spoken words to emphasise key information. It simplifies communication by highlighting the most important words, providing visual cues to aid understanding. This is particularly useful for individuals with limited language comprehension or expressive abilities.

Benefits of using signing systems

  1. Enhances Communication: By utilising gestures and signs, individuals can convey ideas beyond their verbal abilities, broadening their communication toolkit.
  2. Supports Language Development: Visual reinforcement of language can aid in both comprehension and learning, making it easier to acquire new vocabulary and language structures.
  3. Increases Engagement: For non-verbal individuals or those with speech impairments, signing systems provide an active way to participate in conversations, boosting confidence and social interaction.

By incorporating these systems into AAC strategies, users are empowered with alternative methods to express themselves effectively and engage with others, tailored to their communication needs.

My child has to be a certain age before using AAC

Research shows that AAC helps people of all ages (even those younger than 3 years old). The earlier you get onto AAC, the more competent the AAC user becomes. There are no prerequisites for AAC!

Using an AAC device will stop my child from talking

This is not true! Research has found that AAC in fact does the opposite and promotes speaking. AAC can be seen as a form of learning. Some people are visual learners, some learn by hearing and some learn by touch. AAC incorporates all these forms of learning and provides people with more input and opportunities to learn. 

AAC is not suitable due to limited movements e.g. unable to move hands

There are many ways to use an AAC system without touching it. Your Speech Pathologist can work with Occupational Therapists and Physiotherapists to determine other access methods. Some examples include eye gaze devices, switches and neuronodes. 

AAC is for long-term use only

This is not true. AAC can also be used temporarily in specific situations. For instance, individuals may benefit from AAC after surgery when their ability to speak is temporarily impaired. This short-term application ensures they can continue to communicate effectively during their recovery period.

By integrating both permanent and temporary solutions, AAC provides a versatile approach to addressing various communication challenges. Whether for a brief period or an extended duration, AAC can be tailored to meet the unique needs of each individual.

How does an AAC device get funded?

In Australia, AAC devices are funded for people with disabilities under the National Disability Insurance Scheme (NDIS). If you have an NDIS plan, speak to your Speech Pathologist about how to get the device funded through NDIS. 

What AAC equipment is used for AAC?

  • Liberator Rugged
  • iPads
  • Liberator Accent Devices

What AAC software is used for AAC?

Each software system has different functions and needs to be matched to an individual based on their strengths:

  • LAMP words for life: LAMP Words for Life® is a therapeutic approach based on neurological and motor learning principles that uses a speech generating device to provide opportunities to learn language in engaging activities by using a consistent motor plan to say words and getting a natural response to that communication.
  • Touchchat: TouchChat HD is a full-featured communication solution for individuals who have difficulty using their natural voice. It is category based and easy to navigate.
  • Proloquo2go: Proloquo2Go is an easy to use communication app for people who cannot speak or need help being understood. Featuring natural sounding voices, including real children’s voices,Proloquo2Go is a simple yet powerful AAC (augmentative and alternative communication) tool.
  • Unity Language System: The Unity language system is flexible and helps communicators of all skill levels learn quickly and build language skills for maximum independence. Individuals start with early first words and grow to sophisticated adult communication.
  • TD Snap: TD Snap is a flexible communication app supporting individuals with speech and language disabilities such as autism, cerebral palsy, Down syndrome, Rett syndrome, and aphasia. It meets users where they are while fostering the development and growth of communication, language, and literacy skills.

What Role Does Informal AAC Play in Communication?

Informal Augmentative and Alternative Communication (AAC) is a crucial element in the communication toolkit, enriching interactions beyond spoken words. It includes natural, non-verbal signals like gestures, head nods, eye movements, or facial expressions.

Enhancing Understandability

These informal methods bridge gaps when words fall short, improving mutual understanding even in noisy or complex environments. They offer a universal language that can transcend linguistic barriers.

Supporting Formal AAC Systems

Informal AAC complements more structured communication aids such as symbol boards or electronic devices from brands like Dynavox or Prentke Romich. By integrating body language and simple signs, users can enhance the effectiveness and speed of their formal AAC tools.

Increasing Engagement

Through informal AAC, individuals can engage more dynamically with others. This spontaneous form of communication invites authentic interaction, fostering stronger relationships and social connections.

In essence, informal AAC enriches communication by making it more flexible, inclusive, and accessible, empowering individuals to express themselves clearly and naturally in everyday settings.

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