Augmentative and Alternative Communication (AAC)
AAC offers a versatile solution to the communication challenges faced by individuals who struggle with verbal speech, opening up new avenues for self-expression and interaction. The goal of AAC is to bridge the communication gap, ensuring everyone has an equal opportunity to voice their thoughts and feelings.
Augmentative and Alternative Communication (AAC)
Every individual on this planet has a unique voice that they use to express their thoughts, emotions, dreams, and fears. For certain individuals, oral speech can be a barrier in them expressing these thoughts. Whether the individual would benefit from alternative methods of communication at all times, or only to have available during moments of overwhelm or when they are unable to access verbal speech, Augmentative and Alternative Communication, or AAC, can be an essential tool.
AAC encompasses all forms of communication, apart from oral speech, that are utilized to convey thoughts, needs, wants, and ideas. This method of communication is primarily designed to assist (“augment”) or replace verbal speech for individuals dealing with difficulties in speech or language skills [5]. However, AAC is not just limited to these individuals; it can be employed by anyone, of any age, including toddlers, youth and adults with Complex Communication Needs (CCN), or people who have experienced language loss as a result of stroke or brain injury [6].
AAC offers a versatile solution to the communication challenges faced by these individuals, opening up new avenues for self-expression and interaction. The goal of AAC is to bridge the communication gap, ensuring everyone has an equal opportunity to voice their thoughts and feelings.
Enhancing Communication with External Tools
There is a wide variety of AAC tools and systems available. They can be as simple as a picture board or an alphabet chart, falling under the low-tech category, or as advanced as a speech-generating device or eye-gaze system, classified as high-tech. There are also mid-tech devices such as voice output communicators that strike a balance between complexity and simplicity.
The primary objective of these tools is to convert an individual's thoughts into understandable communication. Picture boards, for example, use images to represent words or phrases. These can be extremely useful for individuals who find verbal communication challenging but can understand and associate meaning with images.
On the other hand, speech-generating devices take this a step further by using synthesized or digitized speech to 'speak' for the individual. With advancements in technology, these devices have become increasingly sophisticated, offering personalized voice options and adaptable vocabularies to better suit the user's needs.
These tools not only facilitate communication but also empower individuals with speech or language difficulties to express themselves independently, thereby improving their quality of life[9].
Implementing AAC for Children with Complex Communication Needs (CCN)
For children with CCN, effective communication can pose a significant challenge, impacting their overall development, including functional communication skills, speech and language development, cognitive growth, literacy skills, social participation, educational access, and overall life quality [6]. They may also have motor challenges that make it difficult for them to access “mainstream” systems, such as an iPad or keyboard.
For these children, implementing appropriate AAC support is one crucial aspect of early intervention. When done correctly, AAC can empower children with CCN, giving them the tools they need to communicate effectively and improving their quality of life significantly.
AAC systems are not “one size fits all”. It is important for the speech-language pathologist to properly assess a child’s linguistic skills, access needs, and understanding of symbols in order to identify a method or system that will be best suited for that child.
Some Examples of AAC Systems
Core boards: Core boards are often a great starting point for supporting emerging language users who benefit from augmented input (i.e., visuals to represent words that are being spoken to them) and alternative output options (i.e., the choice to point to the picture board rather than being required to speak verbally).
BigMack: To build understanding of the power of language, or the “cause and effect” that our words can have, a BigMack (or similar) may be a tool used for early communicators.
TouchChat: TouchChat is one example of a high-tech, app-based AAC system. It is a robust system, meaning that there are virtually no limits to what can be expressed with their built-in and customizable vocabulary sets. Even within a single system, such as TouchChat, there are many things to consider for each individual, including button size, arrangement of icons, or helpful accessories such as a mounting plate or keyguard.
These are just three examples to highlight the wide variety of tools available in the world of AAC, each with its own unique advantages and applications. However, it's crucial to remember that the most effective AAC device will always be the one that best suits the individual's needs and preferences. Speech therapists are trained to assess and identify which system will be best suited for your child.
Strategies for Successful AAC Implementation
While the availability of AAC devices is undoubtedly crucial, equally important is the implementation of these tools. Introducing AAC to a child can be a significant change for everyone involved, and it's essential to ensure that this transition is as smooth and effective as possible. Here are some helpful tips to keep in mind when introducing an AAC system:
Model, model, model! Just as children listen to others speak for a whole year before they may begin to talk themselves, children need to see others using AAC before they can be expected to use it. Your speech therapist can support you in identifying when and where are the best and most effective situations for using AAC at home. We want it to become a part of your daily routine, not be an “extra” task that needs to fit into your busy schedule.
Mix Up the Activities: In the teaching phase, it's important to maintain the child's interest and engagement throughout the AAC learning process. Alternating between different types of activities can help achieve this [8]. Mix in activities that involve movement with those that require sitting down.
Encourage the Child's Efforts: Positive reinforcement can be a powerful motivator. Encourage the child's attempts to use the AAC device, even if they don't get it right the first time [3]. This can boost their confidence and motivate them to keep trying.
Share Resources and Collaborate: A child's success with AAC is not just a personal journey but a collaborative effort involving families, the child’s school team, and other service providers[8]. Sharing resources and working together can provide a more consistent and supportive environment for the child.
The Future of AAC: Research and Development
The world of AAC is constantly evolving, driven by the need to improve and enhance communication for those who need it most. The field is witnessing increasing research and development, aimed at pushing the boundaries of AAC technologies and interventions.
Future research in AAC aims to develop more effective tools and strategies for children with CCN, enabling them to maximize their communication, language, and literacy skills. The ultimate goal is to empower these children to reach their full potential and lead a fulfilling life[1].
Innovations in AAC technology are making devices more intuitive, customizable, and user-friendly. From devices that predict what the user wants to say next, to systems that adapt to the user's communication style over time, AAC technology is getting smarter and more sophisticated.
Augmentative and Alternative Communication is one significant way that we can support individuals to communicate their thoughts, needs and interests. AAC allows everyone to participate meaningfully in their life, despite challenges with spoken language. Speech-Language Pathologists are here to help you and your child identify approaches or systems that will best suit their current strengths and help them progress in their communication journey.
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https://pubmed.ncbi.nlm.nih.gov/17701740/
https://www.aacandautism.com/success
[3] https://www.speechandlanguagekids.com/teach-your-child-to-use-an-aac-device/
[4] https://www.speechpathologygraduateprograms.org/2017/11/top-10-aac-augmentative-and-alternative-communication-devices/
[5] https://www.asha.org/public/speech/disorders/aac/
[6] https://pubmed.ncbi.nlm.nih.gov/21791864/
[7] https://www.assistiveware.com/blog/the-greatest-gift-niveyahs-story
[8] https://praacticalaac.org/praactical/10-tips-for-starting-aac-therapy-with-little-ones/
[9] https://enablingdevices.com/product-category/communication-devices/
[10] https://www.assistiveware.com/learn-aac/what-is-aac
[11] https://www.ohsu.edu/sites/default/files/2019-05/New%20and%20emerging%20AAC%20technology%20supports%20for%20children%20with%20complex%20communication%20needs%20and%20their%20communication%20partners%20State%20of%20the%20science%20and_0.pdf
[12] https://us.tobiidynavox.com/pages/success-stories
[13] http://www.augcominc.com/newsletters/index.cfm/newsletter_25.pdf
[14] https://lingraphica.com/aac-devices/what-is-an-aac-device/
[15] https://ebip.vkcsites.org/augmentative-and-alternative-communication/
[16] https://ahs.uic.edu/inside-ahs/events/teaching-movements-for-communication-accessing-aac-for-children-who-have-complex-communication-needs/
[17] https://praacticalaac.org/video/video-of-the-week-aac-implementation/
FAQs
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The exact cause of stuttering is still unknown. There are at least four main factors that can contribute to an onset of stuttering: (1) Genetics - stuttering is often something that runs in the family. (2) Language or developmental delays - stuttering is more common for children with co-ocurring language or developmental delays. (3) Neurodevelopment - differences in brain functioning such as dopamine levels, the functioning of the basal ganglia, and internal timing cues (among others) are thought to contribute to disfluent speech. (4) Family dynamics - busy, fast-paced and high-pressure environments are thought to contribute, in some cases, to stuttering.
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Yes, speech therapists at Ruby Speech Therapy are trained to support individuals with fluency disorders, including stuttering. Treatment approaches depend on the age of the child and several other factors, including self-awareness and personal and families goals related to fluency.
Click here to submit a contact form. We’ll give you a call to discuss any questions you may have regarding stuttering assessments and treatment.
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Yes, there are 3 different types of stuttering.
1.Developmental Stuttering is the most prevalent form of fluency disorder occurring in young children, typically between the ages of 2 to 5. It can occur when the child's speech and language development is not sufficiently advanced to accommodate their communicative needs or intentions. The vast majority of toddlers who stutter will recover within 12 months.
2. Neurogenic stuttering can occur in the aftermath of neurological events like a stroke or brain injury. It's the result of signal disruptions between the brain and the nerves and muscles that are instrumental in producing speech.
3. Psychogenic stuttering is a relatively rare type of stuttering that might occur in the wake of emotional trauma, or it may co-occur with cognitive or reasoning challenges.
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There is no “cure” for stuttering, and many will agree that disfluent speech is not something that needs to be cured! It is true though that, without proper support and knowledge, people who stutter can experience significant barriers to communication, relationships, and participation in all aspects of their daily life. Speech therapy can help educate individuals and their support network about stuttering, teach strategies for smooth speech, and help individuals to speech with confidence and control - whether stuttering or fluently.
Links & Resources for AAC
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PrAACtical AAC - blog and resource
PrAACtical AAC is a blog with endless ideas for implementing AAC instruction at home, in the classroom, and in the therapy room. They provide information for parents, educators and SLPs to better support their students with complex communication needs. Check them out at https://praacticalaac.org/.
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I CAN Centre for Assistive Technology
For Edmonton, AB, and surrounding areas, the I CAN Centre for Assistive Technology at the Glenrose Rehabilitation Hospital offers assessments for children and adults with complex communication needs. Read more about their clinic and referral process here. An SLP at Ruby Speech Therapy can help support your family with this referral process and community-based support for implementation of an AAC system.
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Power AAC - Online training for SLPs and Educators
Power AAC is a series of online modules by Gail Van Tatenhove, CCC-SLP. This is an amazing, FREE video series with handouts and resources that will greatly enhance the capacity of any SLP or educator who wants to better understand AAC and support their students with complex communication needs. View the online modules here.
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