Augmentative and Alternative Communication

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While Amy is not able to use her voice to convey her wants, needs and thoughts, she has a lot to say. Amy, a little girl with brown hair and a huge smile, has cerebral palsy and has used augmentative communication systems all of her life. When Amy was just a toddler, her parents and therapists taught her to use her eyes to look at the things she wanted. Amy would look at the person she wanted to talk to, look at what she wanted, and then look at the person again. Amy learned very early that communication had power. Because Amy's cerebral palsy affected her ability to use her hands and control her head movements, an augmentative system that involved directly selecting pictures through pointing was not the fastest or most efficient for Amy. Her special education team decided that eye gaze and scanning methods were the most efficient methods for Amy to select symbols. Amy used an eye gaze board with basic vocabulary at home and preschool. Additionally, Amy used a scanning communication device during some routine home and classroom activities. As Amy moved into elementary school her communication devices became more sophisticated. She needed a device that would allow her to do homework as well as communicate her thoughts and ideas. Today Amy uses a computer eye gaze system that reads her eye movements as she looks at letters on the computer screen and provides voice output. The technology that Amy uses today was not available when she was a young child, but through the development of her communication skills, she has been able to use newer technologies as they become available. Today, Amy still has a lot to say, especially to her friends on the phone.

Augmentative and Alternative Communication
Picture of a girl with communication device Augmentative/alternative communication systems (AAC) involve the use of personalized methods or devices to supplement a person's ability to communicate. There are many types and methods of AAC and most individuals use a combination of systems/devices depending on the communication situation.

Unaided AAC systems are those that require no additional pieces of equipment. These include manual signing, gestures, facial, expressions, pantomime, pointing, and/or eye gaze Picture of a boy making choice

Aided AAC systems include some kind of external device, and can include a wide variety of methods ranging from no tech/low tech to high tech. Aided AAC systems generally involve devices that display symbols a person selects to convey messages to listeners.

An evaluation by a team of qualified professionals from a variety of disciplines, including speech-language pathologists, educators, occupational therapists, physical therapists, rehabilitation engineering, psychology and medicine to explore all options is an important component in the selection of appropriate systems

The AAC Process
According to Kangas and Lloyd (1998) there are three areas for consideration in the AAC process.

A Method to Represent Symbols
A Method to Select Symbols
A Method to Transmit the Message

Ideas to Encourage AAC in Natural Environments
Beukelman and Mirenda (1992)

Daily routines provide many opportunities for communication. Picture of a peer helping her friend's  work

Arrival / Departure / Transition
Bathroom & Snack
Circle & Story Time
Art & Cooking
Free Play & Making Choices
Other Ideas


Kangas, K. A. and Lloyd, L.L., (1998). Augmentative and Alternative Communication. Human Communication Disorders: An Introduction, (5th ed.) Shames, G.H., Wiig, E. H., and Secord, W. A. ed. Boston: Allyn and Bacon.

Beukelman, D.R. and Mirenda, P. (1992). Augmentative and Alternative Communication: Management of Severe Communication Disorders Children and Adults. Baltimore: Paul H. Brookes Publishing Co.

Flippo, K. F., Inge, K. J., and Barcus, J. M. (1995). Assistive Technology: A Resource For School, Work, and Community. Baltimore: Paul H. Brookes Publishing Co.
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