31 Jul AAC Basics

What Is Augmentative/Alternative Communication and How Do You Chose a Device?

By: Sarah Wyse – M.A. CCC-SLP

Augmentative/Alternative Communication (AAC) is any form of communication that is not the spoken word to help someone express their thoughts, wants, and needs. There are simple forms of AAC, such as: writing with pen and paper, sign language, gestures, drawing, pointing to a pictures in a communication binder, an eye gaze chart, or even the Picture Exchange Communication System (PECS). There are also more complex forms of AAC made from electronic devices that serve for communication. Some examples of complex devices include: an iPad, a Dynavox, and a Springboard Lite. An AAC device is considered dynamic if it is a device that can be used for speech along with other things (i.e. games, email, the internet); however, it is considered a static device if it only used for communication.

AAC should not be used in place of speech, which is why we consider it both alternative and augmentative. An AAC device should be used to augment speech in those clients who already have some spoken words. Those words should be used with the device to help generate total communication (i.e. using spoken word, and both complex and simple forms of AAC) as the goal is always to have speakers message understood. In clients with no speech, the communication device is used as an alternative to speech. Research actually shows that using AAC with a child with little to no speech will usually increase their spoken vocabulary, meaning that it usually increases a child’s ability to communicate through spoken language.

How then do you chose which device or form of AAC to use? Typically a child should be trialed on several devices to determine which is more appropriate for him/her. It is best to seek out the help of a certified Speech and Language Pathologist; together you should consider several factors to help determine which 2 or 3 devices you feel would be appropriate to trial. They go as follows:

1. Physical Limitations– How is the child’s fine and gross motor skills? Their vision? Hearing? Are they mobile or in a wheelchair? Do they have sensory issues? These questions are important to consider because you want to think of how a child will selecttheir message on a device (either through touch, vision, or auditory). If a child has limited motor skills, you might have to consider selecting through their sight or hearing. Also, you need to consider the placement of the device. If a child only can see through their right side, then the device should be placed to the right.
2. Cognition– How is the child’s attention & memory? These questions are important to consider for several reasons. If the child has low cognition, it is important to go with a device that is not overwhelming for the child. Perhaps a simple form of AAC, like PECS, or a complex device that is static. If a child has a higher cognition, they might be able to use a more complex device, with more buttons, and more pages they can navigate through. *It is important not to make assumptions regarding ones cognition based on their verbal status.  A child who is nonverbal may in fact be of normal or even advanced cognitive abilities.
3. Daily Routine– Does this child travel often? In what environments will he need this device and for what daily routines? This is important when considering the size and weight of a device.
4. Childs Strengths– It is also important to play on the child’s strengths. For example, if a child is a good speller, then perhaps a keyboard can be used in place of a pictured device.

If you or someone you know may be a good candidate for AAC – Therapy Works LLC can help!  Contact us today and you and/or your loved one may be one-step closer to improved communication.

* Picture 1 – Tyler using an ECO communication device

*  Picture 2 – Carson using an iPad communication app