Augmentative/Alternative Communication (AAC)

The following information about Augmentative and Alternative communication is taken and adapted from the article “Say what? Augmentative and alternative communication” (Down Syndrome Resource Foundation, n.d.).

What is AAC?

AAC stands for Augmentative and Alternative Communication. It includes all the things that support communication when someone cannot always use their natural speech or language skills to express themselves. The goal of AAC is to enhance the communication of individuals with complex communication needs.

You may not realize it, but we use forms of AAC all the time – such as giving a thumbs up to a friend from across the room or texting on our phones.

Types of AAC

There are several forms of AAC that are used by special education students who need assistance with communication.

Unaided

Unaided forms of AAC include all the ways you can use your body to communicate. This includes using facial expressions, gestures, vocalizations, body language, and signs.

Aided

Aided forms of AAC take advantage of external tools or devices. Examples of low-tech forms of AAC are things such as picture symbols, communication boards, or writing with a pen and paper. Examples of high-tech forms of AAC utilize technology such as iPads or other speech-generating devices.

Why would someone need AAC?

Students in special education can have difficulty being understood for many different reasons. Difficulties could be related to articulation skills. AAC is often considered when speech intelligibility is a concern.  If someone is difficult to understand, we would say that their intelligibility is reduced. Intelligibility is usually moderately to severely reduced in people with disabilities such as Down syndrome.

Many factors can affect someone’s speech intelligibility, including the environment or one’s conversation partner. Typically, a more familiar conversation partner will understand the student better.  However, it is important to remember the student’s intelligibility with unfamiliar listeners as well.  The need for AAC is typically due to one of the following reasons:

• Severe phonological/articulation impairment – low intelligibility
• Poor expressive language/functional communication skills

AAC Myths and Realities

There are many myths about AAC that can impact the special education team’s willingness to pursue it for a student. Thankfully, the research shows that AAC has many positive outcomes for individuals with complex communication needs. Below are the most common myths we come across:

Fact: AAC does not stop the development of speech or someone’s motivation to use verbal speech. In fact, AAC has been shown to enhance the development of natural verbal speech and language.

Fact: AAC can be used in many ways during early communication development. “Research has shown it to have better outcomes in encouraging more spoken output, expressive and receptive language and decrease frustration and challenging behaviors when introduced early on. There have also been studies that show significant benefits in socialization, independence, and self-esteem” (citation, year, p. X).

Fact: AAC is for any person who does not have reliable communication 100% of the time. A student who would be a good candidate for AAC would exhibit speech or language skills that do not meet their need to participate in all aspects of life.  Language is very complex, and it is important to consider all the functions of communication that the student may be missing. See the diagram below:

Note. From Kate Ahem, Motivate, Model, Move out of the Way Project (2018).

Team Interventions and Support

If the SLP has recommended an AAC system for your student, you might be wondering what to do next.  You may feel as though you do not need to use the AAC device with your student because you always know what they are saying.  However, we cannot assume that our AAC users are saying all they need to. Encouraging AAC use at both home and school also gives students more practice with their system – whether that is picture symbols, signs, or a speech- generating device, so they can use it more independently and with other people who are less familiar with them and who might not know what they are saying.

Below are some recommended tips for individuals who are still learning their AAC system and who are not yet communicating independently.  Special education teachers and paraprofessionals play an important role in helping the student use communication throughout their day.

1. Always Have It Available

It is important for your student to have access to their AAC system at all times.   It should be out, charged, and within reach or always in the same place.

2. Model, Model, Model

Typically, developing children (as well as children using AAC) learn to talk by hearing their parents and other people around them speak. It is helpful for them to see what using an AAC system looks like when communicating with others. Some people may have the misconception that AAC is “magic,” and that a student should be able to fluently use it immediately, but that is not true. Students need to be taught how to use their systems. We cannot expect them to learn to use AAC without showing them how to use it.

You can model their system by pointing to words as you talk with your AAC user. One valuable tool when learning AAC is called Aided Language Stimulation (ALS).  Start by modeling the most important or core words.  It is not necessary to model every single word you say, and always model your speech at or slightly above the language level of your AAC user. Frequent modeling within routines will provide the AAC user with plenty of opportunities to see AAC in use. As you continue to provide multiple models of frequently used words, the student will begin to use them when they are ready.

Video: Aided Language Stimulation Explained (2:31)

Note. From Loudon County Public Schools.

3. Find Opportunities to Use AAC in Your Day

Once you feel comfortable modeling AAC for your student, find natural opportunities in your student’s daily routine to use it. Your student will learn their AAC system faster the more you build in opportunities for them to use it. However, if you are feeling overwhelmed with the pressure to find opportunities, start with just one!  You may choose a time that is highly motivating such as snack or play time.  The more opportunities your student gets to practice, the more likely they will generalize their language skills across settings and communication partners.  It is always helpful to consult with the school speech-language pathologist on creative ways to incorporate AAC use in your special education classroom!

If your student does not have effective communication, consider referring them to an SLP for an AAC consultation. The SLP will conduct an assessment of your student’s speech and language abilities and will recommend the system that best fits your student’s needs.