What is Augmentative and Alternative Communication?

Technology’s changing our lives and has given us the means to do what was thought to be impossible - to give voice to others. 

In this video, Stephen Hawking, discusses his new communication system with a BBC journalist.

Stephen Hawking is an AAC user. 

So,  what is AAC?

ASHA’s definition: "Augmentative and Alternative Communication is  Augmentative and alternative communication (AAC) includes all forms of communication (other than oral speech) that are used to express thoughts, needs, wants, and ideas. We all use AAC when we make facial expressions or gestures, use symbols or pictures, or write."

Smiling when talking to a friend, inserting an emoticon when sending a message, raising shoulders to express uncertainty are all examples of AAC. 

Who benefits from AAC

AAC systems are designed for individuals who are not able to use functional speech temporarily or permanently. For example, a child might use a low tech system while his/her speech and language is developing. When an AAC system is put in place permanently, it is seen as the individual’s primary method of communication throughout his/ her life. 

Additionally, AAC systems are sometimes appropriate to supplement individuals whose speech is difficult to understand. In these cases, verbal speech remains the main method of communication, and AAC system is only used as a means to clarify communicative breakdowns.  

Most often, Augmentative and Alternative Communication is prescribed for children with acquired communication disorders such as Autism Spectrum Disorders, Cerebral Palsy, Down Syndrome, Developmental delay, Apraxia of Speech, which result in significantly compromised communication skills. 

Some individuals with acquired conditions, like stroke for example, result in loss of communication skills later in life, and may also be candidates for AAC. 

Individuals suffering from progressive disorders (e.g., Amyotrophic Lateral Sclerosis, Huntington’s Disease) may also benefit from AAC.  

Selection

The process of selection of communication system is the combined effort of a team of professionals: a speech-language pathologist, an occupational therapist, a physiotherapist, a physician, an engineer, a vision specialist, a learning specialist as well as the AAC user and her/ his family.  

AAC systems

Unaided Communication Systems - rely only on the individual’s body to convey the message. Gestures, sign language, and nonverbal communication are all examples of unaided systems.  

Aided Communication Systems - rely on additional materials and/ or equipment to convey the message and involves visuals, communication books, and speech-generating devices. 

The biggest advantage aided communication systems have over the unaided ones is in the transparency of their messages. Everyone knows that a red stop sign means we have to stop, whereas only a limited number of people know sign language and understand the meaning each sign represents. 

The benefits of using AAC systems

Social Interaction

Studies show 30-50% of all children with ASD don’t develop functional speech. Many children with developmental delay also rely on AAC to communicate. AAC provides a way for individuals to participate in routines, games, and learning. 

Behaviour

The relationship between behaviour and communication has been well documented in the research literature. Therefore, it should not be surprising that the implementation of AAC systems often leads a decrease in maladaptive behaviours (e.g., screaming, hitting, pinching, etc).  

Communication

AAC systems support the development of expressive, receptive language, and speech production skills. 

Universal

AAC systems can be adapted to match each child’s cognitive and language level. There is no expectation that children would need a certain set of skills in order for AAC to be introduced.

Literacy

Through AAC systems, children severe expressive language delays can be introduced to grammar and literacy at the same age their peers learn these skills. 

Recommended readings: 

Millar, D., Light, J., & Schlosser, R. (2006). The impact of augmentative and alternative communication intervention on the speech production of individuals with developmental disabilities: A research review. Journal of Speech Language Hearing Research, 49, 248-264.

Beukelman D. , Mirenda P. (2005). Augmentative and alternative communication: Supporting children and adults with complex communication needs. (3rd Ed.)

Denitsa Getsova

Denitsa graduated from the Master’s program in Speech-Language Pathology at Sofia University, Bulgaria. In her practice, she has worked with preschool and school-aged children with a wide range of communication difficulties – speech (articulation, phonology, motor speech), fluency (stuttering), language, preliteracy and literacy skills, cognitive-communication (social communication, executive functions). Denitsa has completed the It Takes Two to Talk®and More Than Words®family-focused intervention programs designed for parents of children with language delays and social communication difficulties/Autism Spectrum Disoders (ASD). Additionally, Denitsa has received training in the PROMPT system(for motor speech disorders), DIR®Floortime Model (child-centered approach for children with ASD) and PECS (augmentative/alternative communication program for nonverbal or minimally verbal children). Denitsa incorporates new technology and uses an iPad in her sessions both as a way to support her clients’ communication needs and a tool for language learning. She provides assistance to parents in the process of selection of educational iPad applications for home practice.