What is AAC?

Augmentative Alternative Communication (AAC) is an evidence based intervention that is used to support communication development when speech alone is not effective or efficient enough to meet one’s daily communication needs.

Think about the speech that you use; you turn on your voice, then you move and shape sound energy using your articulators like your tongue, lips, palate and teeth to create distinct sounds (e.g. “d” “o” “g”). You then you combine these sounds in arbitrary ways to create meaningful words which are abstract and carry arbitrary meaning (e.g. “dog” represents a furry 4 legged animal). You can then combine these words to create sentences that add even more meaning to your everyday thoughts (e.g. “I like your dog”). As a speech communicator, the ability to use speech was your highway to also developing abstract language which is so much more than the act of speech itself. When you think about it, speech was your tool for being able to develop abstract adult-like language over time. Now you are able to communicate in a wide variety of ways such as through speech, pointing, facial expression, writing, texting, typing, and even GIFs and emojis…you have access to A LOT of different “tools”. With these “tools,” you were able to acquire a robust vocabulary, grammar and syntax that make your thoughts coherent and well understood by others. Perhaps more importantly, you have the freedom to choose how you communicate depending on the social situation.

For millions of children and adults across the US, they are not able to use speech as their gateway for language; rather they may be limited whole body communication. While whole body communication is a 100% a valid “tool” for communication, it comes with it’s limitations by not allowing for the same robust, abstract language development that speech as a “tool” can provide. As discussed above, language is a very abstract and robust way in which we communicate and every child and adult deserves equal access to the same; which is where AAC can help! The goal of AAC is to help someone be able to communicate, and give them equal access to other areas of development such as language, and positive social-emotional development.

AAC as an intervention may be temporary for some until speech is underway, while for others, use of AAC may be necessary for their lifespan. There are no pre-requisite skills for use of AAC, and there is no “age requirement” for when AAC should be considered (stay tuned for future blog posts on AAC Myths and Misconceptions).

AAC comes in many different forms and there are AAC options for everyone!

Generally speaking, check out some of the different types of AAC below…

1) No Tech - these are communication tools that do not require the use of anything external from your body. For example; pointing, whole body movements, smiling, home-signs such as for “more”

2) Low Tech - these are communication tools that are external and do not require any batteries/electronics. For example; printed pictures, or printed symbols.

3) Mid Tech - these are communication tools that are external and do require batteries/electronics but have overall simple functions and are often not as robust in vocabulary capacity compared to high tech.

4) High Tech - these are communication tools that are external and do require batteries/electronics but have complex functions. For example; an iPad with a communication app, or a prescribed communication device that operates on a language software with access to thousands of words, and other computer functions.

The beauty of AAC is that there is no “right” way to communicate, and people may have preferences for different communication tools compared to others and that is totally within their right! This is why it is so important that individuals are given access to multi-modal communication; access and instruction for use of a wide variety of different tools. For example, at KIEVA Speech Therapy our clients often use a combination of different no tech, low tech, mid tech, AND high tech communication tools and all of this is entirely individualized.

Getting Started with AAC

There are several different steps for getting started with AAC and these steps are listed and briefly described below

1) Find a skilled Speech Language Pathologist: I’m glad you’re here! It is important to find an SLP that is comfortable with AAC. We recently conducted a survey consisting of 268 Speech Language Pathologists, 70% of which indicated that they do not feel comfortable with the AAC evaluation process. Of these same participants, 90% indicated that they received 3 credits or less in college coursework for AAC; and 23% of participants shared that they received 0 credits in their college programs on AAC. Thus, when searching for an SLP that’s a good fit for you you may wish to ask about that SLP’s comfort level for AAC assessment and intervention.

2) AAC Trials/Evaluation Process - Your SLP will lead through a series of trials depending on what your needs are and depending on the AAC users strengths and needs. Rather than have the AAC user “conform” to what is readily available, your SLP will feature match, and make the technology conform to the AAC user. The technological capabilities of today’s world are endless and can be made inclusive to all! It is also important to note here that at least 3 high tech devices must be trialed before insurance will fund a high tech device.

3) AAC Implementation Process - Whether it’s parent and team training, teaching operational skills, and teaching how to use AAC tools for developing language and communication, your SLP will guide you through this process every step of the way. Here you should feel empowered with AAC!

4) AAC Funding Process - Once the best device is determined, your SLP will coordinate with you and other relevant stakeholders to ensure that all necessary AAC tools are funded and acquired; most often by going through insurance.

5) AAC Transition Process - A stage that is often overlooked! Planning and thinking ahead to the future is critical especially as the needs of the AAC user changes over time. It is important to know what to do and what resources are available to you. Your SLP will guide you through this stage as well!

Hopefully this article was able to provide you with some basic information on Augmentative Alternative Communication (AAC) and how to get started! Be sure to stay tuned for new article releases that you may find helpful! :)

Your AAC SLP,

Kieva D’Angelo M.A. CCC-SLP