Augmentative and alternative communication (AAC) leads many children to success in school and life. It is generally associated with electronic speech-generating devices resembling laptop or hand-held computers, which young people may adopt as a primary voice when they are significantly affected by speech deficits related to conditions like cerebral palsy, Down syndrome, autism spectrum disorders and traumatic brain injuries. These “high-tech” devices work in unison with low-tech tools under the AAC umbrella—picture symbols, photographs, and alphabet or word boards accessed by pointing, for example—as well as body language, eye contact, written notes and other universal communication methods.
AAC (sometimes called assistive communication, or AT) devices feature realistic-sounding synthesized speech with a digitized (pre-recorded) speech option and dynamic display technology controlled by the user. Vocabulary presented in images, words or phrases changes according to his or her selections in a logical sequence. Some devices have onscreen keyboards for typing text-based messages. Ready-to-use vocabulary reduces programming demands. Device content may be organized by age and intellectual appropriateness, and personalized so the technology can grow with the child, encouraging smooth life transitions. Access methods are flexible, accommodating a range of physical abilities. Children may touch the device screen directly. Those with limited use of their hands may scan and select vocabulary by activating switches with their head, foot, or another body part they can control reliably, or use eye-gaze techniques.
Using AAC does not preclude speech development–and may actually encourage it. It may be introduced at any age, and typically begins with an evaluation by a speech-language pathologist (SLP) to determine technologies and access methods physically, cognitively and linguistically compatible with the child. Implementation is often a joint effort involving the child, SLP, family, school staff, caregivers and even the device manufacturer.
AAC goes far beyond merely expressing needs and wants. Audio and visual aspects of the technology support individuals in daily activities. Some devices allow you to preset reminders of tasks and hear a reminder when a task needs to be done. School days may be simplified and optimized with pictorial schedules or seating charts with digital photos of classmates on a device. Because use of these devices is the most effective and efficient way for some children to demonstrate expressive and receptive language skills, it can be helpful in gauging academic ability. With their Internet, cell phone and text-messaging capabilities, devices can foster learning outside the classroom while expanding meaningful social communication opportunities.