Want to know more about Augmentative and Alternative Communication? Read on!
Q: AAC…what does that mean?
A: AAC is an acronym for Alternative Augmentative Communication. The 2 A’s in AAC are important to understand. The first A stands for Alternative. Meaning simply, an alternative method to communicate. If a child is unable to verbalize, then in order to have communicative exchanges, there needs to be some alternative. The second A is more overlooked and less understood: Augmentative. What do we mean by “augmentative”? Basically, it is used in a supplementary role. This means the child may have limited verbalizations but AAC is there to support the child in expanding their ability to communicate with a variety of people across many different settings.
Q: My therapist has started suggesting that we use AAC? What exactly does that entail?
A: AAC basically covers any type of communication that does not use verbalizations to communicate. This can take many forms, including (but not limited to): Sign language, objects, pictures, and speech generating devices.
Q: Has my therapist given up trying to have my child communicate verbally?
A: The very simple answer is: No. In fact, a recent study has shown that introducing speech generating devices may increase verbalizations in children with Autism (Schlosser and Wendt (2008)). But the fact is that a tremendous amount of growth in children’s communication skills happen from birth to 3. And for older children, being unable to fully communicate can lead to high levels of frustration, which in turn can lead to behavioral issues. If a child is struggling to communicate verbally, only working on verbal communication while not supporting the child with another pathway to communicate locks them out of a multitude of communication experiences.
Q: Will using AAC stop my child from communicating verbally?
A: No. When people communicate, we use the fastest, most efficient communication that we possess. If a child is able to get their message across verbally, that is what they will do. Using AAC requires more planning and more steps. For example, if a child needs to go to the bathroom, the easiest thing to do will be to say “potty”. The more complex task is to sign bathroom, find a picture, or use an icon on a device that says “potty”. But, if for whatever reason a child cannot verbalize the need to go to the bathroom, then ideally he or she will have another way of letting you know. From my own personal experience as a therapist, I have had children master high tech AAC, but use their limited verbalizations as well. And if the child can get their listener to understand their verbal message; that is ALWAYS what they use first.
Q: What is the best AAC to use?
A: There is no one size fits all, best AAC to use. Every child is unique in their abilities and their areas of need. What works fantastically for one child might be completely wrong for another child. All methods of AAC have pros and cons. You and your therapist should work together to select what is right for your child.
Q: What different types of AAC are there?
A: AAC is often organized into 3 broad categories: No tech, Low tech, and High tech.
- No Tech: Sign language, gestures
- Pros: No cost. Available to the user at all times. No additional equipment needed.
- Cons: Limited to the people who understand the signs and gestures. For example, the general population does not understand the sign for “more”.
- Low Tech: Object/Picture Exchange
- Pros: Low cost. Can use actual object representation or print out actual pictures of specific objects or use abstract symbols. Understood by a wide variety of people.
- Cons: Difficult to transport. Difficult to have every symbol printed out and available at all times for every situation. Can be time consuming to use. No voice output.
- High Tech: Speech Generating device
- Pros: Voice output. Messages are easily understood. Can call out to people to gain attention/communicate with people who are not directly looking at the individual. Individuals get auditory feedback of their message. Can generally communicate a wide variety of messages (dependent on the device)
- Cons: Wide range of cost. Devices can start at a couple of hundred dollars (generally these devices are limited in the amount of messages that they are able to communicate, such as devices found at: https://www.ablenetinc.com/technology/speech-generating-devices) to thousands of dollars. More expensive devices can be explored through companies such as TobiiDynavox (tobiidynavox.com) and Prentke Romich (https://www.prentrom.com/). Some insurances will cover high tech devices. They can also be broken, not charged, or otherwise not available, then the individual will not be able to communicate.
Q: Does my child have master no tech/low tech AAC before getting a high tech device?
A: No. These classifications should not be seen as a hierarchy to move through. In my experience as a therapist, I have had many children-especially those with Autism- struggle with sign and picture exchange, but become highly skilled at using high tech AAC. Again, the system that you use is dependent on the child’s needs and should be chosen in collaboration with a Speech Language Pathologist.
-Amanda Cox, M.S. CCC-SLP
If you have more questions regarding speech/language impairment and AAC devices, please contact contact Curlee Communication Consultants at (865) 693-5622. We have a team of experienced speech-language pathologists that would love to meet with you and discuss options for your family.