Augmentative and Alternative Communication, or AAC for short, means all the ways that someone might communicate that isn’t talking.
Today, there are many types of AAC, from the ‘low-tech’ strategies and systems first used in the 1960s that included writing, drawing, and communication boards, to today’s selection of high-tech electronic devices and sophisticated software.
Aided VS unaided AAC
AAC generally falls into two categories: aided and unaided. Facial expressions, hand gestures, and signing are all unaided AAC as there is no aid or device used to communicate, just the person’s body. In Australia, signing options include Auslan, or Australian sign language, and Key Word Sign (KWS), which adds signs from Auslan to spoken words.
Aided AAC is when a person uses an object or device to support their communication, such as a communication board or electronic device which can display images, symbols, letters, words or short phrases.
How aided AAC devices ‘work’ and their benefits
Communication boards and books
Communication boards and books feature icons, such as symbols, letters, words, line drawings and pictures – usually in a grid format – that the user points at to create messages.
Communication boards and books can be ready-made or handmade ‘hard copies’ in cardboard or another hardwearing material, or generated by an electronic device’s software, with the icons displayed on its screen.
Communication boards and books can be customised to make them relevant and engaging to the user. Examples of customisation include icons being organised by category, or by the most frequently used words or object icons placed on the first page. And as communication boards and books are portable, compact, and comprised of just one part, they are convenient and easy to use while out and about and can be popped into a durable protective cover or water-proofed for the beach, pool and wet weather.
Communication software applications or devices
Communication apps are AAC programs used on a variety of electronic devices such as tablets, phones, or computers, or on a dedicated communication device. As with communication boards and books, users touch or click on the displayed images, letters and/or words to create messages. AAC apps can be customised for each user and can store many symbols, images, letters and words. To help speed up the creation of messages, some apps have prediction ability, that makes an ‘educated guess’ of the word or phrase being written by the user. A speech pathologist can help you choose whether an app on a tablet or phone or a dedicated communication device is a better choice for you.
Alternative access methods for electronic AAC
Alternative access methods help people use their electronic AAC devices when direct touch might not be the best option. These can include mechanical switches, joysticks, eye-tracking cameras, or even switches that sense small muscle activations.
AAC devices operated by eye movements have eye-tracking technology, which enables users to create messages using their eyes. Eye-tracking technology, also called gaze interaction, provides an AAC solution for people who have difficulty using their hands. In addition to operating AAC devices, this technology is used in other assistive technology, such as electric wheelchairs.
Eye-tracking technology is generally used with a text-to-speech software and speech-generating devices to enable users to create messages delivered by a computer-generated voice.
Some people who have progressive conditions that may mean they are eventually unable to speak, such as those with motor neurone disease (MND), can record and store their voice, in a practice called voice banking. This digital recording of their voice replaces their device’s computer-generated one, enabling their family and friends to hear them again.
One of the world’s most well-known users of speech generating AAC was physicist Professor Stephen Hawking, who was diagnosed with amyotrophic lateral sclerosis (ALS), a form of motor neurone disease.
With AAC, support from an speech pathologist is vital
As communication enhances quality of life in countless ways, from helping us maintain relationships and participate in activities to enjoying improved health and wellbeing, choosing the right AAC and maximising its benefits is vital.
Speech pathologists determine the type or types of AAC that are best suited for each person during the assessment and prescription process.
These allied health clinicians are also qualified to teach people how to use their AAC device and get the most out of it. This is vital as one of the main barriers to using and fully benefitting from AAC is a lack of support. In fact, research has revealed that people require high-quality ongoing support to adopt new AAC devices and fully benefit from their technology.
Depending on the participant and their goals, getting an AAC device may only be the first step. Speech pathologists will then use the device as a tool to help them building their language skills.
What clinicians consider when recommending AAC
When choosing AAC, consider a person’s
- needs and personal preferences;
- gross and fine motor skills;
- visual and cognitive abilities;
- understanding of language;
- goals, which might be to communicate more effectively, learn to read and write, attend school, or get a job;
- support from family, carers and support workers;
- and lifestyle, including the places where they will use their AAC.
Speech pathologists will also take into account the ability to customise a device, its design (Is it ergonomic? Is it portable?), operational requirements, and quality for reliability and longevity.
And their role doesn’t end there: they will also teach the user’s family and support network how to help them use their AAC.
The future of AAC
Since the early 2000s, high-tech AAC devices have increased in their capabilities while becoming more compact, lightweight and user-friendly.
Today, researchers are investigating ways to make electronic AAC ‘smarter’ and more user-friendly by expanding their capabilities, including the use of movement recognition technologies that interpret body motions, electrodes that measure brain activity, and speech recognition systems that utilise past conversations and other data to generate messages more quickly.
Better Rehab’s speech pathologists are qualified to recommend AAC and provide support and training. They also have up-to-date knowledge of all types of AAC, from communication boards to high-tech devices and software, to further advise on the right AAC solution for you or a loved one.
If you would like to find out more about how our clinicians can support you, simply fill out our enquiry form so one of our team can get in touch with you.
AAC fast facts
- AAC is used to replace or supplement speech.
- AAC can be used by people of all ages and types of disability.
- There is a wide variety of AAC devices, systems and strategies, many of which can be customised to further suit your needs, situation, preferences, and lifestyle.
- It’s not uncommon for people who have difficulty with speech and/or language to use two or more types of AAC to communicate, such as facial expressions and hand gestures and a communication board.
- AAC usage can be permanent or temporary.
- AAC use will not stop or slow users from learning to speak, slow down language development, or hinder speech recovery. This is supported by Speech Pathology Australia, which states that AAC use will not stop a child from developing spoken language, stop an adult from using the speech they have and can help both children and adults develop spoken language.
- In addition to communicating, AAC can enhance comprehension and expression.
