What is AAC?
AAC stands for alternative augmentative communication. AAC is used to support people of all ages to communicate when their use of spoken language does not meet their everyday needs. AAC is not just limited to young children, but is also used to support adults with complex communication needs or even older adults after a stroke or brain injury. When thinking of AAC, we often think of iPads with apps or devices that help someone communicate. However, AAC is much more broad than that. AAC is simply the use of anything other than spoken words to communicate. This includes using gestures, facial expressions, sign language, pictures, and drawn symbols. Unaided AAC are methods that involve our bodies such as facial expressions, gestures and sign language. Aided AAC involves the use of an external tool such as pictures, an iPad with an app, or a communication board.
Aided AAC can be used as either an alternate way to communicate when a person cannot use spoken words or it can be used to augment or supplement speech. This means that a person who can use spoken words may still benefit from AAC to support their communication. For example, some people may be difficult to understand when they speak, and AAC can be a tool to help repair communication. Some people may only have a limited number of spoken words, and AAC can help them to expand and communicate more fully. Others may not be able to access their spoken language during times of high emotion or dysregulation. For example, a child may have difficulty expressing him or herself when very upset and may need AAC in those heightened moments.
There are many different forms of AAC and reasons for AAC, but how is someone supposed to know if their child would benefit from it? The important thing to remember when thinking about pursuing AAC is that research has shown that AAC will not harm language development or decrease the use of spoken words. Introducing AAC can only help to support further language and communication.
Who can AAC help?
AAC can help anyone whose daily communication needs are not being met by speech alone.
Daily communication needs is a very big idea. When thinking about language, I like to reflect back on my own use of communication. Throughout my day, I talk for many different reasons. I communicate to interact socially with friends and family, to share information about my day and my interests, to greet people at the store and ask questions when I can’t find something, to tell a funny story or something unexpected that happened to me, to ask the opinion of others or share my own opinion, to ask for help, to express when I don’t want to do something or don’t like something, and to meet my basic daily needs.
Sometimes, when working with children with complex communication needs, we get stuck focusing on language to meet basic needs such as requests for food, drinks, and favorite items. We often forget that language is so much bigger than just requests. When thinking about who would benefit from AAC, we need to ask ourselves if our child or student is really able to meet their daily communication needs with speech alone. Do they have access to the same amount of language as their neurotypical peers? Is the majority of their language single word requests for food items or favorite things? Can they advocate for themselves when overstimulated? Can they share safety information like their name and address? Can they express their emotions? Can they let you know when they don’t want to do something? If you answered no to some or all of these, AAC may be an idea to explore further.
Of course, when starting out with AAC or therapy in general, we don’t expect a child to make drastic changes over night. Our initial goals may not be all the ideas listed above, but we want to think big and presume that each child has the potential to use complex language. Just like spoken language development, AAC takes years to reach higher level language. But we have to give every child the chance to try and provide access to AAC, if it’s a needed support.
AAC may be beneficial if your child...
Has minimal or no use of spoken words
At 18 months, a child should have at least 10 words, but most have around 50
It’s never too early to introduce AAC. AAC can even support development of spoken words. The longer you wait, the further behind they can get.
Starting AAC early rather than taking a "wait and see" approach can help to reduce frustration around communication
Is more difficult to understand than other kids their age
Children should be understood 50% of the time at 2, 75% at 3, and 90-100% at 4
Not being understood can lead to a lot of frustration around communication. AAC can help repair during breakdowns
Children with severe phonological disorders or apraxia may benefit from AAC to support communication
Has some words but uses them inconsistently
Some parents report that their child knows the words but won’t always say them. This may because they have difficulty consistently accessing their words
It is especially difficult to access language when experiencing high emotions
AAC can help a child have consistent access to language and the visual aspect of AAC can help to generate ideas and words
Is experiencing a lot of frustration around communication
If a child cannot express their wants, needs, and opinions, it can create frustration
AAC can help to decrease frustration by giving the cold a reliable means to communicate
Many children with limited communication rely on parents and caregivers to interpret their needs. AAC allows the child to communication more independently with more people.
Has many single words or nouns mainly to ask for things
Around 2 years old, many children begin to combine words to create short phrases. They communicate for many reasons including to protest, request, comment, and ask questions.
Some children get stuck in a single word phase and don’t communicate for a variety of reasons
AAC can give access to power words that help them communicate for many purposes and expand on single words.
Uses scripts or echolalia but cannot express wants, needs, and opinions
Some children are gestalt language processors and communicate through echolalia. Some GLP’s may hum, sing, or use unintelligible speech with up and down intonation.
Some GLP’s cannot express their wants, needs, and opinions with speech alone and may need AAC to support their communication
AAC can give consistent and reliable access to gestalts or scripted phrases and language when they cannot access or use speech.
Note: Developmental norms are based on analytic language development in order to help parents identify differences in their child. These norms are not reflective of gestalt language development
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