What is Augmentative and Alternative Communication or AAC?

Augmentative and alternative communication (AAC) refers to devices, systems, strategies, and tools that either substitute or assist verbal language. They are designed to aid individuals facing challenges in communicating through speech.

The initial “A” in AAC signifies Augmentative Communication. Augmenting means enhancing or supplementing. Augmentative communication involves enhancing your speech by adding elements like sign language, images, or a letter board. This addition can enhance the clarity of your message for the listener.

The second ‘A’ in AAC represents Alternative Communication. It comes into play when you cannot speak or when your speech is not understood by others. In such cases, you require an alternative means of communication.

AAC encompasses a variety of tools, systems, devices, and strategies. These resources are designed to assist individuals in their communication when relying solely on speech is not possible. This can apply to scenarios such as when a child has not yet developed speech, when someone has lost the ability to speak, when speech is intermittent, or when speaking is more challenging compared to alternative communication methods. In all these cases, AAC can provide valuable assistance.

Who can use AAC?

Numerous factors can hinder a person’s ability to communicate through speech. These factors may include developmental disabilities that impact speech development or acquired disorders that affect speech capabilities. AAC proves valuable for many individuals facing various communication challenges, including speech impediments and disorders.

Communicating without speech

Communicating without speech presents challenges, particularly in a world that predominantly relies on spoken language. The inability to convey messages effectively can lead to confusion and frustration, impacting both the non-speaking individual and their communication partner.

Non-speaking individuals often possess a wealth of thoughts they wish to express, but the question arises: how can these thoughts be articulated?

When a person cannot speak, there is a tendency for others to make judgments regarding their competence, potential, and cognitive abilities. Non-speaking individuals quickly discern that some things are straightforward to communicate, such as reaching for the TV remote to indicate a desire to change the channel. Simultaneously, they realize that conveying more complex thoughts, like relating a TV show to a deceased family member, can be challenging.

What types of AAC are often used?

AAC encompasses a wide array of tools and strategies that individuals can utilize when they are unable to rely on spoken language for communication. These tools are often categorized into two main groups: Unaided and Aided AAC.

  1. Unaided AAC – These do not require a tool or a physical aid.
  2. Gestures
  3. Facial expressions
  4. Body language
  5. Sign language
  • Aided AAC – These use tools or materials.
  • Choice cards
  • Symbol boards
  • Communication books
  • Pragmatic Organization Dynamic Display (PODD) Books
  • Alphabet charts and Keyboards
  • AAC apps on mobile devices
  • Communication or speech-generating devices

Text-based AAC and symbol-based AAC are two different approaches to augmentative and alternative communication (AAC), which help individuals with communication difficulties express themselves:

Text-based AAC

An AAC system can take the form of a text-based system with a keyboard, which is typically designed for individuals who are capable of typing the words they wish to express. These individuals often have good reading and spelling skills.

Symbol-based AAC

Many individuals, particularly those who are unable to read or spell, require the use of symbols or pictures to facilitate their communication. Visual symbols can represent words or even entire phrases.

Another approach is the use of Gayle Porter’s PODD (Pragmatic Organization Dynamic Display) system, which allows for the creation of communication books with a variety of symbols and language options. AssistiveWare offers a digital and print version of the PODD system known as simPODD. These solutions help individuals with diverse communication needs effectively express themselves using visual symbols and aids.

Multimodal communicators

Many individuals who rely on AAC for communication are considered multimodal communicators. This means they have various ways to convey their messages. In addition to AAC, they might use vocalizations, word approximations, and even incorporate gestures and sign language. Some individuals also use photos from their camera roll to supplement their communication. It’s important to recognize and respect the value of these diverse communication methods because they all convey meaningful information.

Even individuals who have some spoken communication abilities may find AAC beneficial. When their speech is limited, AAC can expand their vocabulary and language. As a result, they can often express themselves more effectively using AAC than with speech alone.

Benefits of AAC

Many individuals who cannot rely on speech can experience significant benefits from using AAC. The absence of AAC can pose challenges for these individuals. People who use AAC have described various advantages, which include:

  • Building stronger friendships and deeper relationships.
  • Engaging in richer and more frequent social interactions.
  • Assuming deeper social roles, whether as a family member, friend, professional, or student.
  • Gaining increased autonomy and decision-making power over their own lives.
  • Achieving greater independence.
  • Receiving more respect from others.
  • Participating more actively in their family lives and communities.
  • Enhancing information sharing with healthcare professionals.
  • Ensuring improved personal safety in various care settings, such as hospitals or long-term facilities.
  • Accessing more employment and volunteer opportunities.
  • Experiencing improvements in both physical and mental health.

Challenges for individuals without AAC

For individuals who cannot communicate reliably through speech and lack access to AAC, several challenges are frequently encountered. People who use AAC have reported that before having a communication system, they experienced:

  • Increased social isolation and feelings of loneliness.
  • Heightened frustration and behavioral difficulties, especially with loved ones.
  • Greater vulnerability, particularly when alone in a care setting.
  • A sense of being excluded from important decisions regarding their own life.
  • The inability to demonstrate their knowledge or capacity to learn.