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Alternative and Augmentative Communication

AAC Systems are methods of communication used to supplement or replace spoken or written language. A speech generating device (an AAC system with voice output), will have vocabulary organized to help the individual communicate. The vocabulary system might include words, phrases, sentences, keyboards or a combination of all of these.

The words that make up AAC have special meaning. Augmentative means to supplement or add to existing abilities. Alternative means to use something in a different way. So, Augmentative and Alternative Communication (AAC) offers individuals a communication system that can add to or replace speech. This might be a book of pictures, a specialized app, or dedicated communication technologies. Think of AAC as a set of tools and strategies that are used to solve everyday communication challenges.

People with severe speech or language difficulties rely on AAC to learn language, supplement existing speech, or replace speech that is not functional. For example, some children are born with difficulty controlling their tongue, lips, and vocal cords. Others may have difficulties learning speech because of Autism, Down Syndrome or other developmental disabilities. Some individuals may lose the ability to speak due to an injury or disease. AAC can help all of these individuals say what they want, and help them learn language along the way.

There are many different kinds of AAC systems. An AAC evaluation team (usually led by a speech-language pathologist) typically determines an individual communicator’s strengths and needs then tries different systems or devices to determine the best fit for that person. When the AAC system uses voice output, it is often referred to as a speech generating device or SGD.

AAC is a voice for people who can’t speak.

Explore AAC

We also have the right to communicate and tell people about the choices we make. We have the right to communicate in whatever way works best for us. Everybody communicates – whether using language, behavior, gestures, facial expressions, sounds, or other means. We have the right to use augmented and alternative communication (AAC) methods, like sign language, communication boards, and iPads. Effective communication is a key part of self-determination!

Self-Determination – Autistic Self Advocacy Network

One common argument against a particular type of communication service for toddlers and preschool-age children is that such children are “too young” to introduce the use of an augmentative/alternative communication (AAC) mode. Specifically, some parents and professionals believe that the introduction of an AAC mode at an early age will preclude the child from ever developing speech as his/her primary mode of communication. In fact, however, numerous studies have demonstrated that the use of AAC does not interfere with speech development (Romski, Sevcik, & Hyatt, in press) and actually has been shown to support such development (see Millar, Light, & Schlosser, 1999 for a review of research demonstrating this effect; Romski & Sevcik, 1996Romski, Sevcik, & Pate, 1988). Nor do communication needs disappear when school services end; they remain or expand as children transition into adulthood and as young adults grow older. Communication permeates every aspect and cycle of life, influencing one’s self-determination and life quality. Likewise, a number of studies have shown that individuals with severe disabilities continue to develop communication and language skills well into their adult years (McLean, Brady, & McLean, 1996); and that adolescents and adults with a variety of severe disabilities make measurable gains when provided with appropriate communication services (Iacono, Carter, & Hook, 1998McLean & McLean, 1993Romski, Sevcik, & Pate, 1988Sack, McLean, McLean, & Spradlin, 1992). Communication is essential across the lifespan, thus it is inappropriate to restrict access to communication services and supports on the basis of chronological age.

Eligibility determinations based on a priori criteria violate recommended practice principles by precluding consideration of individual needs. These a priori criteria include, but are not limited to: (a) discrepancies between cognitive and communication functioning; (b) chronological age; (c) diagnosis;

Access to Communication Services and Supports: Concerns Regarding the Application of Restrictive “Eligibility” Policies

A systematic review of research on the effects of interventions that include communication partner modeling of aided augmentative and alternative communication (AAC) on the language acquisition of individuals with complex communication needs was conducted. Included studies incorporated AAC modeling as a primary component of the intervention, defined as the communication partners (a) modeling aided AAC as they speak and (b) participating in the context of a naturalistic communication interaction. This review used a best-evidence approach, including nine single-case studies, with 31 participants, and 70 replications, and one quasi-experimental randomized group design study, including 63 participants. The results of the review indicated that AAC modeling intervention packages led to meaningful linguistic gains across four areas including (a) pragmatics, marked by increases in communication turns; (b) semantics, marked by receptive and expressive vocabulary increases; (c) syntax, marked by multi-symbol turn increases; and (d) morphology, marked by increases in target morphology structures.

AAC Modeling Intervention Research Review – Samuel C. Sennott, Janice C. Light, David McNaughton, 2016

Aided modeling interventions share several components: (a) they are implemented during opportunities that arise out of natural contexts, (b) they augment the spoken input the child receives, and (c) they employ modeling to expand vocabulary. This article discusses the research evidence suggesting that aided modeling interventions may be effective for children with autism spectrum disorders (ASD).

Aided Modeling Interventions for Children With Autism Spectrum Disorders Who Require AAC | Perspectives on Augmentative and Alternative Communication

1) What are the types of AAC?

There are lots of different ways to categorize AAC. The two I will mention are symbol-based vs text-based. Symbol based has a grid of buttons with words and symbols. Text based involves typing or using buttons with saved phrases.

2) Would AAC be helpful for me?

If you are wondering, try it out and see how it works. Lots of people can benefit, whether it’s because you lose speech when you’re overwhelmed, find speech tiring, have a hard time being understood, express yourself better in writing, etc.

3) What AAC system should I try?

Depends on what device(s) you have and if you prefer symbol-based or text-based. I will list some options for apps here, but you can also try a lower-tech option like writing out notes, using picture cards, or using a letterboard.

Cole (he/him) on Twitter

Speech, vocalisations, words, sentences, phrases, AAC, body language, facial expressions, pointing, signing, symbols, alphabet charts, pen / paper, communication books, objects, ​electronic devices, sending pictures, memes, gifs, Makaton, BSL, braille, laughing, crying, emojis, email, texting, messaging, voice notes, body movements, music, behaviour, pointing, gesture, echolalia, stimming, text-to-speech / speech-to-text


Communication Features | AutisticSLT

All people with a disability of any extent or severity have a basic right to affect, through communication, the conditions of their existence. Beyond this general right, a number of specific communication rights should be ensured in all daily interactions and interventions involving persons who have severe disabilities. To participate fully in communication interactions, each person has these fundamental communication rights:

  1. The right to interact socially, maintain social closeness, and build relationships
  2. The right to request desired objects, actions, events, and people
  3. The right to refuse or reject undesired objects, actions, events, or choices
  4. The right to express personal preferences and feelings
  5. The right to make choices from meaningful alternatives
  6. The right to make comments and share opinions
  7. The right to ask for and give information, including information about changes in routine and environment
  8. The right to be informed about people and events in one’s life
  9. The right to access interventions and supports that improve communication
  10. The right to have communication acts acknowledged and responded to even when the desired outcome cannot be realized
  11. The right to have access to functioning AAC (augmentative and alternative communication) and other AT (assistive technology) services and devices at all times
  12. The right to access environmental contexts, interactions, and opportunities that promote participation as full communication partners with other people, including peers
  13. The right to be treated with dignity and addressed with respect and courtesy
  14. The right to be addressed directly and not be spoken for or talked about in the third person while present
  15. The right to have clear, meaningful, and culturally and linguistically appropriate communications
Communication Bill of Rights

Further reading,