What is AAC?

What is AAC?

AAC is short for Augmentative and Alternative Communication.

Communication devices, systems, strategies and tools that replace or support spoken language are known as augmentative and alternative communication (AAC). These tools support a person who has difficulties communicating using speech.

The first “A” in AAC stands for Augmentative Communication. When you augment something, you add to it or supplement. Augmentative communication is when you add something to your speech (eg. sign language, pictures, a letter board). This can make your message clearer to your listener.

The second “A” in AAC stands for Alternative Communication. This is when you are not able to speak. It is also when your speech is not understood by others. In this case, you need a different way to communicate.

Basically, AAC can be tools, systems, devices or strategies. These tools help a person communicate, when they cannot rely on speech. Perhaps your child has not started talking. Perhaps you have lost your ability to speak. Perhaps your speech comes and goes. Maybe speaking is harder than other ways to communicate. AAC can help.

Who is AAC for?

There are many reasons why a person may not be able to communicate using speech. They may have a developmental disability which has affected the development of speech. They may have an acquired disorder that has affected the person’s ability to speak. Many people with different communication difficulties, speech impediments and disorders can benefit from AAC.

AAC finders may help discover who could use AAC, using the AAC finders checklist.

Communicating without speech

Communicating without speech is difficult. People who do not speak are at a disadvantage in a speaking world. It can be confusing and frustrating when messages cannot be given effectively. This is frustrating for both the non-speaking person and their communication partner.

Often a non-speaking person will have many thoughts they wish to communicate. How do they get these thoughts out?

When a person is not able to speak, others often make judgements about their competence, potential, and ability to think and learn.

A person who does not speak will quickly learn that some things are easy to communicate (e.g. reaching for the TV remote to suggest you want to change the channel). They also learn that some things are hard to communicate (e.g. that the TV show reminds you of a family member who is gone).

What types of AAC are often used?

AAC incorporates all the tools and strategies a person can use to communicate, when they are not able to speak. Often we break them into 2 groups: Unaided and Aided AAC.

1. Unaided AAC – or AAC that does not require a physical aid or tool.

• Facial expressions
• Body language
• Gestures
• Sign language

2. Aided AAC – or AAC that uses tools or materials.

• Symbol boards
• Choice cards
• Communication books
• PODD books
• Keyboards and alphabet charts
• Speech-generating devices or communication devices
• AAC apps on mobile devices

We may use a high-tech tool (e.g. a Speech Generating Device, or AAC app on an iPad), or a light-tech/paper-based tool (e.g. a communication book, or board).

Text-based AAC

An AAC system may be a text-based system with a keyboard. This is generally for a person who types the words they want to say. They can often read and spell. Proloquo4Text is AssistiveWare’s text-based AAC solution.

Symbol-based AAC

Many people might need symbols or pictures when communicating. This includes those people who cannot yet read or spell. We can introduce visual symbols that represent words or maybe phrases. Proloquo and Proloquo2Go are AssistiveWare’s symbol-based AAC solutions.

Other people may use Gayle Porter's PODD system. simPODD is AssistiveWare's digital and print PODD solution.

Multimodal communicators

Many people who cannot speak but use AAC are multimodal communicators. This means they have multiple ways to communicate their messages. As well as AAC, they might use vocalizations, word approximations, and maybe some gesture and sign language. Many people show photos from their camera roll to add to what they are saying. All different methods of communication should be valued and respected. Different communication still tells us something!

Even people with some spoken communication, may benefit from AAC. If speech is limited, AAC can help. It can give a person more words and language. They may communicate far more with AAC than they can with speech alone.

Benefits of AAC

Many people who cannot rely on speech, could benefit from AAC. And there are challenges when people do not have AAC.

People who use AAC describe benefits

These include:

• stronger friendships and deeper relationships
• richer, more frequent social interactions
• deeper social roles: family member, friend, professional, student
• increased autonomy and decision-making power over their own life
• increased independence
• more respect from others
• greater participation in their family lives and communities
• improved information sharing with physicians
• improved personal safety in a variety of care settings, such as hospitals or long-term facilities
• more employment and volunteer opportunities
• improved physical and mental health

Challenges for people without AAC

There are often difficulties without AAC, when someone cannot talk reliably.

People who use AAC say that, prior to having a communication system, they experienced:

• more social isolation and loneliness
• increased frustration and acting out with loved ones
• greater vulnerability, especially when alone in a care setting
• feeling shut out of important decisions over their own life
• inability to show what they know or can learn

The AAC journey

Communication is a fundamental human right. A person with speech impediments or disorders can communicate with AAC.

Before starting, you may still wonder whether AAC is really needed. Will AAC be beneficial? When should we consider AAC? If you need help answering these questions, please check the “Do we need AAC?” article.

If you are using symbols and wish to make plans that support change and progress, please use our Learn AAC Guide. This may help you to consider selecting the right AAC system for a person, getting set up for AAC and then helping to build language and real communication.

Good luck, please reach out to our support team if you need any help along the way!

Links & references

• ASHA. Augmentative and Alternative Communication. [Article and references]
• Ahern, Kate. (2014). Why "prove it with low tech first" doesn't work. [Blog post]
• Beukelman, D., & Mirenda, P. (2013). Augmentative and Alternative Communication (4th Ed.). Baltimore: Paul H. Brookes.
• Brady, N. C., Bruce, S., Goldman, A., Erickson, K., Mineo, B., Ogletree, B. T., Paul, D., Romski, M., Sevcik, R., Siegel, E., Schoonover, J., Snell, M., Sylvester, L., & Wilkinson, K. (2016). Communication services and supports for individuals with severe disabilities: Guidance for assessment and intervention. American Journal on Intellectual and Developmental Disabilities, 121(2), 121–138.
• Farrall, Jane. (2015). AAC: Don’t Demand Prerequisite Skills. [Blog post]
• Kangas, Kathleen & Lloyd, Lyle. (2009). Early Cognitive Skills As Prerequisites to Augmentative and Alternative Communication Use: What Are We Waiting For?. Augmentative and Alternative Communication. 4. 211-221.
• Light, J., & McNaughton, D. (2014). Communicative competence for individuals who require augmentative and alternative communication: A new definition for a new era of communication? Augmentative and Alternative Communication, 30, 1–18.
• LoStracco, Heidi. (2014).The Myth of Augmentative and Alternative Communication (AAC) Pre-Requisite Skills. [Blog post]
• National Joint Committee for the Communication Needs of Persons With Severe Disabilities. NJC on AAC. [Article]
• Romski, M.A. & Sevcik, R.A. (2005). Augmentative communication and early intervention: myths and realities. Infants and Young Children 18 (3), 174.