There are so many acronyms when you enter the therapy world. Arguably, the most important acronym in pediatric speech therapy is AAC. AAC stands for augmentative and alternative communication, which are some pretty intimidating words, so let’s dive into them a little more...
When a child uses a device in an augmentative manner, it means they are adding to their own verbal speech. “Why would we need to add to their own speech?”, you may ask. There are quite a few reasons, but some of the main ones include a child being hard to understand, or a child having some verbal speech, but needing help adding in extra vocabulary words.
Frustrations can occur when a child knows what they are trying to say, but others aren’t understanding them. This is where AAC would come in handy. Augmentative communication gives the child a way to show someone what they are saying if their verbal speech is unintelligible.
Augmentative communication also is helpful in expanding a child’s language, or giving them access to vocabulary words when they are not yet verbalizing. AAC can be helpful to expand utterances as well; if a child is producing one-word utterances, modeling AAC may help the child put two words together.
Using AAC as an alternative communication device means a person is using it instead of verbal speech. Children may not use verbal speech for a variety of reasons, so giving an alternative method of communication allows the child a way to get their wants and needs met, as well as communicate for a variety of other functions.
As humans, we communicate for so many different reasons. We greet other people, we request items we need, we comment on activities, we ask and answer questions, we protest things we don’t like, and the list goes on. AAC being used as an alternative communication device allows the opportunity for a child who is not yet using words or producing minimal words to access these communication functions in an individualized way.
AAC looks different for every child. Typically, an AAC device falls into three categories; no- or low-technology, mid-technology and high technology. Each category has its own advantages, and one category is not considered better than the others. Choosing AAC is individualized and personalized, but we will touch more later in our AAC educational
content.
When you first think of AAC, you typically think of high-technology devices. iPads with apps and speech-generating devices (or computer-like devices that “talk”) are the most common high-technology devices. These devices are dynamic, which means the screens and icons will change and adapt while it’s in use. High-technology AAC devices can include options for many different disabilities, such as an eye-gaze device for people who have fine or gross motor control issues, devices that include different background colors for vision impairments, and various grid sizes that can allow for more or less vocabulary options on each page.
Some options are considered “static”, meaning the device screen doesn’t change. The pictures remain the same, but the device still produces speech when the buttons are pressed. This would be considered mid-technology. Examples include single overlay devices (for example a Go-Talk) or switch buttons that say one message.
No- or low-technology options include writing, drawing, facial expressions, gestures, or pointing to pictures.”Pictures” is a pretty wide term that encompasses: a picture exchange system, individual pictures, a core board, or a paper version of a high-technology device. These options do not produce speech out loud, but if a person is modeling these tools to a child, they would produce the word verbally. We call this aided language stimulation which is a researched strategy.
Personalization is an important part of AAC as this will really help a child to see the benefit of using the device and will help them feel seen and understood. Every child has their own specialized interests, cultures, and backgrounds and considering these components of who a child is, is essential when helping them have access to words that are and will be the most meaningful to them. Choosing specific vocabulary for children to have access to is important. It’s also valuable to have the child’s personal information stored for safety purposes. The team of professionals working with a child will assist with helping personalize their device to best meet the child’s needs. And we will give some examples of this as we continue to share more about AAC.
When choosing an AAC device, a team of professionals and family members should be included. Speech-language pathologists, occupational therapists, physical therapists are all great resources and members to have on a team, but don’t forget children’s teachers, close family members, and the child themself! Individuals that use AAC consider these devices their own voice, so we consider it a success when children take ownership of their “voice”. We will further outline this process that call - feature matching in more detail and will link that post here.
AAC is the most important tool when it comes to children who are learning to communicate. As a parent and/or therapist we have an important role in looking for a child’s cues that are demonstrating communication. Just because an individual is not yet speaking, doesn’t mean they have nothing to say. That’s the beauty of AAC - to find out the original thoughts and ideas of our children and connect them with the world around them.
Written By: Jordyn Peterson, MS CCC-SLP
Graphics: Kristin Weingart, MS CCC-SLP
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