AAC stands for Augmentative and Alternative Communication. AAC includes all the ways we communicate that do not include talking. Everyone can use AAC, and we often do without realizing it! 

Augmentative means adding to or supplementing spoken language. This can include sign language, gestures, use of pictures, or a letter board to enhance your message.

Alternative means using a different way to communicate, other than spoken language.

Click here for more AAC specific term definitions

Gesturing at something for emphasis, frowning to express displeasure, or writing someone a note – these are all ways to communicate without talking. Children and adults with severe speech or language problems may need to use alternative means of communication. AAC may be used all the time, or just to increase their intelligibility. Speech and Language Pathologists can help determine the most appropriate means of supplementing or replacing spoken language with AAC.

AAC systems are considered aided or unaided.

Unaided Systems:

Unaided systems do not require a tool or physical aid but do need a certain level of motor control. They are types of communication that only requires the use of your body. Options like gestures, body language, facial expressions, and sign language. Unaided systems are no-tech options.

Aided Systems:

Aided systems vary in complexity and include low-tech/basic systems and high-tech options.

Low-tech aided systems may include pen and paper, picture visuals, choice boards, and picture cards. Free downloadable low-tech AAC systems available for children and adults can be found here.

High and low-tech aided AAC system examples.

High-tech options are often what we imagine when we hear the term AAC. This can include static and dynamic displays, speech-generating systems, and AAC apps on mobile devices.

Static displays do not change but can include a speech-generating component – a prerecorded word or message. Dynamic displays are interactive and change based on user input from options such as:

  • Touch
  • Eye gaze
  • Switch access
  • Head stick
  • Beam of light

How to access AAC:

Unaided systems are always available to individuals. An SLP can help you learn how to effectively use these no-tech options, based on your needs. This may include learning/relearning how to appropriately use gestures, facial expressions and body language or learning to use sign language. Many individuals with communication impairments require explicit instruction to use unaided systems.

Aided systems may need more time to access and learn.

Low-tech/basic aided systems can be faster to access. These may not require additional funding, especially if you are already working with an SLP who can help create the materials you need.  

Low-tech aided options may include:

  • Communication boards – A display of photos, icons, symbols, or pictures. The display can be simple (ex. Yes/No) or include a large variety of items, depending on the person’s needs
  • Communication books – A book that includes pages of photos, icons, symbols, or pictures, usually grouped into categories. 
  • Written language – Use of writing to supplement spoken language
  • Visual schedules – Pictures, photos, symbols, or written icons placed in order, as a schedule of events
  • Choice boards – Pictures, photos, symbols, or written icons presented as choices

High-tech aided options will take more time to access. They can be costly and access often requires approval from a funding source (school districts or insurance providers). A trained SLP will conduct an evaluation of speech and language development. This will help determine the most appropriate high tech AAC system, based on your/your child’s needs. Your SLP can also help identify options for funding, such as your insurance company or the school district. 

  • Speech generating devices – These are devices that generate speech.
  • Dedicated devices – These are devices used exclusively for communication. This does not include iPads with AAC apps.
  • Static display – A single display that does not change when you interact with it. Can include speech generating options such as prerecorded messages.
  • Dynamic display – A display that changes when you interact with it through touch, eye gaze, switch access, etc.

Team Decision

AAC devices assist in communication. That does not mean, though, that only SLPs are involved in selecting AAC devices. Decisions regarding the use of these devices are often made with a team of individuals as other factors will impact AAC access. Factors such as fine motor skills, visual impairments, or positioning needs will also impact AAC options. This team can include the following:

  • Parents or caregivers
  • Speech and language pathologists
  • Occupational therapists (positioning, access, fine motor needs)
  • Physical therapists (positioning)
  • Vision specialists
  • Learning specialists
  • Doctors
  • Assistive technology specialists

Logistics

When exploring and considering AAC options, there are a few factors to consider.
First, understand that SLPs vary in their training when it comes to the evaluation and implementation of AAC devices. It is important to ask your SLP the right questions to get the care you need.

Things to ask your SLP include: 

  • What experience do they have in evaluating AAC needs? 
  • What experience do they have in implementing AAC? 
  • Do they know the process for receiving an evaluation based on the funding source or service location? 
  • Will they assist you in seeking out funding, if needed? 
  • If they are not able to conduct the evaluation, will they help you with the appropriate referral? 

Second, the funding source or location of the evaluation may influence your decisions. For example, school districts often have an individual or team assigned to AAC evaluations, and insurance companies often work with specific AAC vendors. So don’t forget to take all factors into consideration, and ask your SLP for guidance.

If you are looking for an SLP who has experience in the use of AAC devices in the San Diego area, search our directory!

Cocoa Berry
Author: Cocoa Berry