Chapter 3 – Assistive Technology for Communication

Judi Cumley

Julie Maro

Mandy Stanek

Getting Started with AAC

Augmentative/Alternative Communication (AAC) refers to the methods used to maximize the communication abilities of individuals whose natural speech is either temporarily or permanently impaired. These methods involve the use of aided and/or unaided symbols. Aided symbols require some type of tangible representation. Examples include: real objects, Picture Communication Symbols, letters and/or words. These can be presented on a non-electronic communication board or displayed on an electronic communication device. Unaided symbols are those that are produced using the individual’s body and may include gesture, sign and/or fingerspelling (ASHA, 2002).

Regardless of the symbol set selected or the display used, it is critical to keep in mind that augmentative/alternative communication systems are not meant to replace speech. Many families fear that the introduction of an augmentative/alternative communication system means that professionals are “giving up on speech”. Nothing could be farther from the truth. Millar, Light and Schlosser conducted a meta-analysis of research published between 1975 and 2003 on the impact of speech before, during and after using AAC. Of those studies that met the criteria for evidence-based analysis, none of the individuals lost speech production as a result of using AAC. Some of the subjects did not increase their production, but most (89%) had at least modest increases in speech production (Millar, Light & Schlosser, 2006). Linda Burkhart made this statement in her book Total Augmentative Communication in the Early Childhood Classroom (Burkhart, L, 1993, p.37)

By providing a child with a variety of means to communicate, including speech, the pressure to produce speech is diminished. In the past, clinicians and parents worried that giving a child another means to communicate would hinder speech development. Children who are given augmentative skills develop speech as quickly as the control group and often surpass them.

Several reasons are cited for this phenomenon. The pressure to produce intelligible speech may be reduced knowing that the child has an alternative way to say something. The use of augmentative communication systems allows the child’s language skills to continue to grow and develop. Using speech is the easiest way to communicate. If the child is able to use it, they will choose speech over an alternative form of communication. There is research that supports introducing AAC at an early age before a student experiences communication failure because of a lack of speech production or intelligibility (Romski & Sevcik, 2005).

For those who cannot use speech effectively, there exists a wide range of augmentative communication system options. These range from simple communication boards or displays presented on paper to high tech electronic systems with voice output. No one system can meet all of an individual’s needs. For example, a student may be able to use head nods to clearly and efficiently communicate yes and no to caregivers. However, when discussing course choices for the coming academic year with family and teachers, an electronic system with the option of spelling and accessing pre-stored messages may be more appropriate and efficient.