Augmentative and Alternative Communication (AAC)
Augmentative and alternative communication (AAC) refers to any non-speech method of expressing thoughts and needs. People with communication disorders may need AAC to supplement their spoken language or, in very severe cases, to replace it. AAC may consist of very simple systems using the body alone (e.g., facial expressions, gesture, or sign language), or aided systems that use external equipment. The aids may be low-tech, like paper/pencil or communication boards with pictures, letters, or words. They may also be high-tech electronic devices that have voice output and can be used to pre-program words or sentences or to create unique utterances.
AAC may need to be used for a short time while a person's speech and language skills recover/improve, or it may be a permanent means of communication. Some people who use AAC have had communication problems since birth due to conditions like autism or cerebral palsy. Some acquire communication impairments later in life from causes like stroke or cancer, or have degenerative diseases like ALS (Lou Gehrig's Disease) that cause speech to gradually worsen.
Assessment and Treatment for AAC
The speech-language pathologist (SLP) may recommend an evaluation for AAC based on the severity of speech or language problems and prognosis for recovery. The SLP will do a complete speech and language assessment to measure current communication skills. Other factors that affect ability to use an AAC system (e.g., vision, hearing, motor coordination, etc.) must also be assessed, so a team of professionals may take part in the evaluation. Physical or occupational therapists help with positioning and physical access issues, and teachers or job counselors may assist with issues related to AAC use in the classroom or at work. The team may do trials with different types of AAC to find the best match for the client and family's specific needs, goals, and abilities.
Treatment focuses on using AAC to provide effective, interactive communication. The SLP and team train clients and families to use the device and, if it is high-tech, to program it. The client may need ongoing treatment if AAC is being used to develop speech and language skills, or may only need a couple of training sessions and then occasional follow-up sessions as communication skills and needs change.