What is AAC?

People can have difficulty with face to face communication for many different reasons. Physical disabilities and motor co-ordination problems can make the production of speech difficult or impossible. People with some types of learning difficulties can find it hard to produce speech or handle spoken language.

The term AAC (Alternative and Augmentative Communication) is used to describe the different methods that can be used to help people with disabilities communicate with others. As the term suggests these methods can be used as an alternative to speech or to supplement it.

Communication Methods

It could be said that everyone employs augmentative communication methods for much of the time. When holding a conversation, we contribute to the meaning of the words used in many ways including facial expression, gesture and body language, or by yawning. These additions can add to the meaning of the words used, or even reverse them completely: a verbal expression of interest may be completely negated by a yawn!

For people with disabilities that give rise to speech production problems many different methods are used to support and augment their communication. These can include an individual method of sign and gesture, standardised signing and symbol systems or complex electronic devices.

Developing and using a system of AAC can be a long and complex process for many users and their likely communication partners. Training and practice will be needed - materials have to be prepared and kept up to date. It should always be recognised that these processes will involve everybody: a communication system or method should be mutually understood and recognised.

Systems and methods

These terms are sometimes used interchangeably but we have decided to view them as distinct terms. For example, the English language is a system of communication, speech and writing are two different methods of using this system.

Symbol systems

A variety of symbol systems are in common use. They have generally been developed to suit users and listeners who have difficulty with understanding written language, e.g. people with learning difficulties or young children. Systems can also be combined with individually designed symbols, objects and photographs if required.

Symbols can be useful for expressing longer messages and are often quick and easy to recognise as shown by the number in use today in all situations. There are mostly available as sets or libraries such as Picture Communication Symbols (PCS), Widgit Symbols and Symbolstix.  

Symbols can be presented in various ways including charts, boards, communication books and on individual cards. These can be produced by drawing the symbols, photocopying or using a computer program such as Matrix Maker and Boardmaker.

Signing and gesture systems

Manual signing systems have been in use for some time, especially in the deaf community. Different systems have been developed to meet the needs of individuals with learning and motor disabilities. Signing systems have the major advantage of not requiring any additional equipment or materials, but can be harder to learn.

Older learners may benefit from sign and symbol supported programs such as Life Skills 24 Hours a Day or open framework programs such as SwitchIt! Maker! 2 which allow you to quickly and easily incorporate signs and symbols in your activities.

AAC methods

The AAC user will require a system and method suited to their particular disability. They will have to be able to learn and understand the meaning and use of the system and be able to operate the chosen method.

Electronic systems such as the Go Talk communication aids are often a first choice as they can offer the added bonus of speech output and convey a positive image. They can often disappoint as successful use can be dependant on the support available to set up and maintain the machine and available vocabulary. They can be prone to breakdown and can be easily damaged. Some users will find them difficult to carry and inappropriate in some situations, such as in the bath.

Low-tech paper and chart-based systems are easier to set up and manage, though it must be stressed that choosing an appropriate vocabulary for any system and method is not a trivial task. They are often less intimidating for the listener and are easily carried. The lack of speech output can be a big restriction for some users whose peers may be unable to understand a printed system. A low-tech system may not carry the same status as an electronic aid.

Software

Boardmaker and Matrix Maker provide an excellent resource for creating low tech paper and chart based communication systems. Both include a large bank of ready-made templates to assist the user in producing symbol grids and overlays for communication devices. Each program also contains different symbol libraries – Boardmaker with PCS and Matrix Maker with SymbolStix, Widget and IT media library.

A communicating environment

People with communication difficulties will have often missed many of the early learning experiences which enable people to develop their communicative potential. Above all they will need a desire and context in which to communicate, which may come naturally, but will often need developing through the creation of structured situations. Helping someone to communicate means much more than simply buying them a communication aid!