What is Augmentative and Alternative Communication (AAC)

Augmentative and Alternative Communication (AAC) refers to the methods used to help individuals with speech or language impairments communicate effectively. AAC encompasses a broad range of tools and techniques, from simple gestures and picture boards to sophisticated electronic devices. The goal of AAC is to enhance communication for individuals who cannot rely solely on verbal speech to express themselves. This blog post explores who typically uses AAC, the different types of AAC, their benefits, and how they can be effectively implemented to support communication needs.

This is the sign for “help” in both British Sign Language and Makaton. To find out more about Makaton, go to our blog post here.

AAC is used by a diverse range of individuals who have speech or language impairments. Here are some groups of people who commonly use AAC:

1. Children with Developmental Delays:

   AAC supports children who have delays in speech and language development, including those with autism, Down syndrome, and cerebral palsy.

2. Adults with Communication Needs:

   Adults with learning disabilities, stroke survivors, or those with conditions such as dementia. These conditions can affect a persons speech, cognition and motor skills, making AAC a crucial tool for effective communication.

3. People with Acquired Conditions:

   • Those who acquire speech and language impairments due to conditions such as stroke, traumatic brain injury (TBI), amyotrophic lateral sclerosis (ALS), Parkinson's disease, and multiple sclerosis (MS) may use AAC. These conditions can impair the ability to speak or articulate words clearly, necessitating the use of AAC for communication.

4. Individuals with Temporary Communication Needs:

   • People who experience temporary speech impairments, such as after surgery (e.g., tracheostomy) or due to acute medical conditions (e.g., intubation), might use AAC until they recover their speech abilities.

5. Children with Speech Delays:

   • Some children experience delays in speech development due to various reasons, including hearing impairments or other speech and language disorders. AAC can support these children in communicating while they develop verbal skills.

6. Elderly Individuals:

   • Older adults who develop conditions like dementia or Alzheimer's disease, which can impair speech and language abilities, may benefit from AAC to maintain communication as the disease progresses.

7. Individuals with Learning Disabilities:

   • People with learning disabilities often use AAC to enhance their ability to communicate, participate in social interactions, and perform daily activities independently.

The Picture Exchange Communication System (PECS) is a low-tech AAC. To find out more about PECS, go to our blog post here.

Types of AAC

AAC systems are typically categorized into two main types: unaided and aided communication.

1. Unaided AAC:

   • Gestures and Body Language: Simple, natural gestures and body movements can convey messages. This includes facial expressions, pointing, and other body language cues.

   • Sign Language: A more structured form of unaided AAC, sign language is a complete language system that uses hand gestures, facial expressions, and body movements to convey meaning.

2. Aided AAC:

   • Low-Tech AAC: These are non-electronic tools such as picture boards, communication books, and symbol cards. They do not require batteries or electronic devices and are often used as a starting point for AAC.

   • High-Tech AAC: These involve electronic devices, ranging from simple voice output communication aids (VOCAs) to complex speech-generating devices (SGDs). These devices can be programmed with a wide array of vocabulary and are often used with touch screens or switches.

This is a high-tech AAC call Proloquo2Go which you can use on phones and tablets. To find out more about high-tech AAC and speech generating devices, go to our blog post here.

Benefits of AAC

1. Enhanced Communication:

   • AAC provides individuals with a means to express their needs, thoughts, and feelings. This can significantly reduce frustration and improve overall quality of life for both the individual and their caregivers.

2. Improved Social Interaction:

   • By facilitating communication, AAC helps individuals participate more fully in social interactions. This can lead to stronger relationships with family, friends, and peers.

3. Increased Independence:

   • With the ability to communicate more effectively, individuals can make choices, express preferences, and advocate for themselves. This fosters greater independence and self-determination.

4. Support for Developmental and Educational Goals:

   • AAC can play a crucial role in the educational development of children with communication impairments. It can support language development, literacy skills, and academic learning.

Implementing AAC

1. Assessment and Selection:

   • Choosing the right AAC system often involves a thorough assessment by a team of professionals, which can include speech and language therapists, behaviour analysts, occupational therapists, and educators. The assessment should consider the individual's communication needs, abilities, and preferences.

2. Training and Support:

   • Successful implementation of AAC requires training for both the user and their communication partners (e.g. the people they are communicating with). This includes learning how to use the device or system, understanding its features, and incorporating it into daily routines.

3. Integration into Daily Life:

   • For AAC to be effective, it must be integrated into all aspects of the individual’s life. This means using the AAC system at home, in school, and in the community. Consistent use helps reinforce communication skills and ensures that the individual can communicate across different settings.

4. Ongoing Evaluation and Adaptation:

   • AAC needs can change over time, so it’s important to regularly evaluate the effectiveness of the system and make adjustments as needed. This might involve updating vocabulary, exploring new technologies, or modifying the AAC strategy to better meet the individual’s evolving needs.

Challenges and Considerations

1. Accessibility and Cost:

   • High-tech AAC devices can be expensive, and not all individuals or families have access to the necessary resources. Seeking funding from the NHS or specific charities can help alleviate some of these financial barriers.

2. Stigma and Misconceptions:

   • There can be stigma associated with using AAC, both from the public and sometimes within the individual’s immediate social circles. Education and advocacy are crucial in overcoming these misconceptions and promoting acceptance and understanding of AAC.

3. Technical Issues:

   • High-tech devices can sometimes malfunction or require technical support. Ensuring there is a plan in place for troubleshooting and maintaining these devices is important to avoid disruptions in communication.

4. Cultural and Linguistic Considerations:

   • AAC systems need to be culturally and linguistically appropriate. For bilingual individuals or those from diverse cultural backgrounds, AAC tools must be tailored to reflect their language preferences and cultural norms.

Where to Find Support

If you think that your child may benefit from using AAC but are struggling to know where to find support or advice, there are lots of options for this. Get in touch with your child’s GP and discuss a referral to the Child and Adolescent Mental Health Services (CAMHS) team in your area. You can also speak to a private Speech and Language Therapist or Behaviour Analyst. EBL Consultancy have expertise in AAC, including assessing children for AAC and providing training and support to children and their caregivers to use AAC. If you want to talk about this to an EBL Practitioner, you can arrange a free initial meeting here.