AAC

AAC; AAC devices; AAC apps; AAC CEUs; how to choose AAC; what is AAC

AAC (Augmentative Alternative Communication) will be covered in this blog. SLPs will learn the following: what AAC is; the benefits and challenges of AAC; most common AAC devices and apps and AAC CEUs.

 

Communication comes in many different forms. Of course, verbal communication is one. But due to certain medical diagnoses, motor impairments, and language disorders, not all individuals are able to consistently communicate through verbal speech.

 

Fortunately, there are many other ways that individuals of all ages can communicate. That’s where AAC comes in.

 

What is AAC?

AAC stands for Augmentative Alternative Communication. The first “A” is for “Augmentative”, and refers to various means of communication that individuals can use to supplement a verbal communication impairment.

 

The second “A” in “AAC” stands for “Alternative”. That term represents the multiple modalities that individuals can communicate with in order to compensate for difficulties with speech production. It might include gestures, sign language, and aided communication.

 

Speech Language Pathologists can introduce AAC to clients to improve their communication abilities across the lifespan. AAC users might have difficulty producing verbal speech due to a congenital disability present at birth (including Cerebral Palsy, genetic syndromes,  and Autism Spectrum Disorder) or an acquired condition (such as a stroke or Traumatic Brain Injury).

 

AAC includes aided and unaided forms of communication.

 

Unaided communication includes facial expressions, gestures, and signs - modes of communication other than speech that individuals may produce naturally. Using signs and gestures requires the individual to have the gross and fine motor skills necessary to produce them. The communication partner must also have the knowledge of what the signs mean in order to interpret the individual’s message.

 

Aided communication includes the modes of communication that require external support. That might include use of PECS (Picture Exchange Communication System), a picture board, or a Speech Generating Device (SGD).


 

Benefits & Challenges of AAC

 

Everyone deserves to have a voice.

AAC can be that voice for individuals who have difficulty producing clear, intelligible verbal speech. According to the American Speech Language Hearing Association (ASHA), “there are no specific prerequisites (e.g., age, cognitive, linguistic, motor) for getting started with AAC.”

 

Studies have shown that AAC benefits individuals in numerous ways, including positive effects on speech production, social communication, and expressive language skills, for children with developmental disabilities. 

 

AAC can be beneficial for preschool aged children with expressive language delays, as research has shown AAC can actually enhance speech development for some. Therefore, AAC could potentially be used by SLP’s in Speech Therapy sessions to improve language skills for late talkers. Baby signs are often used in this population, however, children do not always have the fine motor skills needed to use signs. AAC could be a positive alternative.


AAC can be used by children and adults with a variety of medical diagnoses and speech and language impairments, including:

●      Autism Spectrum DIsorder

●      Developmental Delays

●      Cerebral Palsy

●      Genetic Disorders, including Down Syndrome

●      Traumatic Brain Injury (TBI)

●      Stroke

●      Expressive Language Delays

●      Childhood Apraxia of Speech

●      Dysarthria

●      Articulation and Phonological Disorders (resulting in reduced speech intelligibility)

 

AAC users may benefit from alternative communication long term, or short term, such as a post-surgery solution for communicating if unable to do so verbally. 


Through the use of AAC, individuals may benefit by:

●      Improving expressive language skills

●      Improving receptive language skills

●      Increasing social-emotional skills

●      Strengthening pragmatic abilities/social interaction skills

●      Decreasing frustration and behavior difficulties

●      Improving cognitive skills

●      Increasing independence


Unfortunately, some individuals who could benefit from AAC are not introduced to alternative communication systems until they are older, and may have missed out on several years of communicating and learning language. 

 

Speech Language Pathologists sometimes face certain challenges when implementing AAC with a client.

 

The SLP may not feel confident in assessing the client for AAC use due to limited exposure, training, or knowledge within this specialty area. Some SLPs may not have the necessary time or materials for creating low-tech AAC systems, such as PECS binders, which can involve taking and printing pictures, laminating them, and organizing with velcro.

 

There are also several factors to consider when assessing and treating a client using AAC. That includes behavior challenges, motor impairments, visual impairments, and cognitive abilities.

 

Implementing AAC within their practice can mean a little extra time and research for SLPs. However, the benefits to a range of clients are numerous, and SLPs can work through some increased challenges in order to serve these clients.


 

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How SLPs Can Learn About AAC

There are several easily accessible resources available online to help SLPs learn about Augmentative and Alternative Communication (AAC).

 

Courses

 

One of the best places to gain or improve knowledge on AAC use, including assessment and intervention, is by taking continuing education courses within this subject area.

 

The American Speech Language Hearing Association (ASHA) offers several of these courses on demand. They provide education to participants on everything from AAC for preschoolers with Autism Spectrum Disorder to AAC considerations for individuals with ALS.

 

CEUs specific to AAC are also available on other sites, such as SpeechPathology.com.

 

Several companies that manufacture speech generating devices offer free online resources such as training videos and webinars (for both families and professionals) through their websites and YouTube channel. These include:

●      PRC-Saltillo

●      Tobii-Dynavox

 

Many of these companies also offer live training events. SLPs can contact the AAC device company to get in touch with the local representative who can provide one on one assistance with using a device. It’s also possible to set up a training session for all of the SLPs in your practice, hospital, or school.

 

The Assistive Technology Industry Association (ATIA) offers memberships and hosts a national conference annually. This is a great opportunity for SLPs to attend courses, trainings, and familiarize themselves with various speech generating devices. 


Common AAC Devices/Apps for Children

 

An estimated 18.2% of students were reported to use a form of AAC in one study among U.S. students who required support communicating. AAC devices (speech generating devices) are typically costly, and may be covered by insurance, grants, school districts, scholarships, or paid for out of pocket.


AAC Devices commonly used with children include:

●      NovaChat, by PRC-Saltillo

●      Accent, by PRC-Saltillo

●      Tobii Dynavox [BM1] [BM2] (several models and software, including TD Snap)

●      AbleNet QuickTalker 

 

These devices can benefit children with a variety of communication disorders, including those with Autism Spectrum Disorder. Children with Autism and other diagnoses can also benefit from using AAC apps.

Some of the top AAC apps for these children include:

●      TouchChat HD

●      TD Snap

●      Proloquo2go

●      Lil Requester

●      Leeloo AAC

●      Avaz AAC

●      Speak for Yourself

AAC apps such as these are sometimes offered at a discounted rate for SLPs, or may offer a free trial for SLPs to use with their clients. AAC apps can be downloaded onto an iPad or other tablet by the SLP, family, and/or other professionals such as teachers, to be used with the child to help him or her communicate.


Tips for Selecting the Best AAC Mode for a Child

Every child is different, and it’s important to consider several factors when selecting the best AAC mode for a child.

  1. Motor Skills. Does the child have the ability to use their hands to select buttons on an AAC device or app? If not, the SLP may consider an AAC device that offers eye tracking, head tracking, or an adaptive switch.
  2. Device’s Language System.  Each AAC device has a unique language system - how the words and phrases are organized. Research potential devices and determine which one you feel matches and could most highly benefit your client.
  3. Customizable. An AAC app or device should be customizable, and allow your client to have personalized information such as their picture or favorite foods.  
  4. Look for AAC that offers Speech Generation. Printed pictures and communication boards can be limiting in the vocabulary they give a child, and do not generate a speech model when used. Look for a mode of AAC for a child that offers speech output upon activation.

Resources

TheraPlatform provides more resources on other topics through the TheraPlatform resource center. Check it out for free therapy worksheets, tools, e-books, videos, and handouts.

If you own a private practice or consider starting a private practice, you can use TheraPlatform to manage several aspects of your practice, from documentation to financial organization and scheduling. Not to mention, some amazing resources for Speech Language Pathologists!

TheraPlatform, an all-in-one EHR, practice management and teletherapy tool was built for therapists to help them save time on admin tasks. Consider starting with a free trial of TheraPlatform today.

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