People communicate in a variety of ways through verbal speech, facial expressions, gestures, and writing. When an individual has difficulty in verbal speech, using other means to augment or replace their verbal speech may be needed. Augmentative and alternative communication (AAC) refers to both a method of providing communication support to individuals who are unable to use their own verbal speech to communicate effectively, as well as the tools that may be used to provide that support. Many different diagnoses may result in a need for AAC because of their impact on the individual’s ability to talk and can include cerebral palsy, stroke, apraxia, Down syndrome, Autism, Parkinson’s disease, Rett’s syndrome, traumatic brain injury, throat/neck cancer, etc. AAC can assist people of varying ages from very young children to older adults.
Augmentative and alternative communication typically consists of two different approaches: unaided and aided. Unaided systems do not involve the use of special equipment; rather, unaided systems utilize the individual’s own body language, sign language, vocal signals and gestures. Aided systems consist of the use of pictures, objects, letter boards, and a variety of technology options that can include special apps on iPad or Android platforms and specialized computer systems that have multiple ways of representing language (pictures/words/letters/tactile symbols) for those in need of this type of support.
Since the type of individuals that may require augmentative and alternative communication are so varied, the type of AAC support and tools utilized can vary greatly, as well. Some individuals will need AAC supports for only a brief period of time, while others will require it throughout their lives. AAC can provide clarity to the speech of those who talk, but whose speech is difficult to understand. AAC can provide total communication support for others that have no ability to generate verbal speech. It is important to seek the services of a speech-language pathologist to help evaluate and prescribe appropriate AAC systems and identify supports needed. The evaluation process for use of AAC can be complex and involves review and consideration of a number of areas such as current speech skills, language skills, cognition, hearing, vision and fine motor abilities. Trials of different supports and systems are part of the evaluation process and assist in final determination of appropriate tools and methods to address personal communication needs.
When AAC is prescribed, therapy is also recommended. An individual may require the services of a speech-language pathologist to customize his/her communication system and train him/her to use it in a functional manner. This intervention is individualized and specific to the needs of the person and their caregivers. Periodic evaluation and updating of AAC supports is often required to enable to the individual to maintain functional communication and participation in daily life.
The Speech-Language Institute at Midwestern University offers assessment and treatment of individuals who may require AAC supports and tools. Professors with expertise in AAC work with graduate student clinicians to assess and treat individuals with these communication needs.
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