A Guide to Different Types of AAC and How SLPs Choose the Right One
This blog post will examine different types of augmentative and alternative communication (AAC), including their advantages and disadvantages, and discuss how a speech-language pathologist (SLP) determines the most appropriate AAC approach for a person.
What is AAC?
Augmentative and alternative communication (AAC) encompasses all of the ways that someone can communicate besides talking. AAC can be for people who have trouble speaking or understanding spoken language. AAC can be used to supplement spoken communication or to be the primary method of communication. People with a variety of disabilities and medical conditions can benefit from AAC, including cerebral palsy, autism, amyotrophic lateral sclerosis (ALS), stroke, and traumatic brain injury.
Advantages and disadvantages of Types of AAC
AAC can be broadly categorized as unaided or aided.
Unaided AAC
Unaided AAC involves only the individual’s own body and does not require any external tools.
| Type | Explanation | Examples | Advantages | Disadvantages |
|---|---|---|---|---|
| Gestures | Movements of the hands, arms, or body used to convey meaning. | Pointing, waving, nodding, shaking head | Readily available and require no materials. | Can be limited in expressiveness and may not be universally understood. |
| Facial Expressions | Using facial muscles to convey emotions and messages. | Smiling, frowning, raising eyebrows, sticking out tongue | Natural and readily available | Can be subtle and difficult to interpret, especially for those with social-communication challenges. |
| Vocalizations | Sounds made with the voice, but not necessarily words. | Crying, laughing, groaning, making sounds to get attention | Natural and can be used to express a range of emotions. | May be difficult to understand or interpret specific meanings. |
| Sign Language | A visual language that uses hand shapes, movements, and facial expressions to convey meaning. | American Sign Language (ASL), British Sign Language (BSL), Makaton | Can provide a rich and expressive means of communication. | Requires learning a new language and may not be widely understood by those unfamiliar with it. |
Aided AAC
Aided AAC involves the use of external tools or devices. Aided AAC can be further divided into low-tech and high-tech.
Low-Tech Aided AAC
Low-tech AAC refers to communication methods that use simple tools and materials that are relatively inexpensive and readily available.
| Type | Explanation | Examples | Advantages | Disadvantages |
|---|---|---|---|---|
| Communication Boards | Boards or books with pictures, symbols, letters, or words that individuals can point to or select. | PECS (Picture Exchange Communication System), alphabet boards, topic boards, schedules | Simple to use and understand, inexpensive, portable, can be customized to meet individual needs. | Limited vocabulary, can be bulky to transport, pictures or symbols may not be specific enough for some needs. |
| Writing Tools | Pen and paper, dry erase boards, or e-writers. | Individuals can write messages, draw pictures, or use a combination of methods. | Familiar and accessible, portable, allows for creativity. | Requires fine motor skills and literacy, messages may be difficult to read for some, can be slow and laborious. |
| Single-Message Devices | Devices that can record and play back a single message or a limited number of messages. | BigMack switch, GoTalk devices | Simple to use, can be helpful for individuals with limited motor abilities, can be programmed with personalized messages. | Limited vocabulary, can be inflexible for dynamic communication needs. |
High-Tech Aided AAC
High-tech AAC refers to more sophisticated electronic devices that can generate speech or written output.
| Type | Explanation | Examples | Advantages | Disadvantages |
|---|---|---|---|---|
| Speech Generating Devices (SGDs) | Devices with a dynamic display that changes based on user input and can produce synthesized speech or digitized speech. | Tobii Dynavox, PRC, Lingraphica | Can offer large vocabularies, allow for complex communication, provide auditory feedback, and be customized for individual needs. | Can be expensive, require training and support, can be fragile and prone to breakdowns. |
| AAC Apps on Tablets and Smartphones | Apps downloaded on personal devices like tablets and smartphones that allow users to communicate using pictures, symbols, text, or a combination of methods. | Proloquo2Go, TouchChat, LAMP Words for Life, Predictable | Portable, versatile, readily available, offer a wide range of features, customizable, often more affordable than dedicated SGDs. | May be smaller and less durable than dedicated devices, may not offer the same level of access options as dedicated SGDs, may require additional accessories for mounting and access, dependent on battery life. |
How Does an SLP Choose the Right AAC Approach?
An SLP determines the most appropriate AAC approach for an individual through careful and comprehensive assessment.
This involves:
- Evaluating the individual’s communication needs and abilities: This includes assessing their current communication skills, identifying any barriers to communication, understanding their communication goals and preferences, and considering the communication needs of their family and caregivers.
- Assessing cognitive and physical abilities: This includes the individual’s vision, hearing, motor skills, cognitive abilities, and literacy skills. The SLP considers how these factors might affect the individual’s ability to use various types of AAC systems. For instance, if fine motor skills are limited, the SLP might consider using a switch-activated device or eye gaze technology.
- Considering the individual’s environment: The SLP will consider the contexts in which the individual will be communicating and choose an AAC system that can be used effectively in those environments. For example, a portable device might be preferable for someone who needs to communicate in multiple locations.
- Collaborating with other professionals: The SLP will collaborate with other professionals, such as occupational therapists, physical therapists, teachers, and doctors, to ensure that the chosen AAC system meets the individual’s overall needs.
Ultimately, the goal is to choose an AAC approach that is individualized and meets the person’s unique needs to allow them to communicate effectively.
Conclusion
AAC plays a vital role in enabling individuals with communication impairments to express themselves, participate in their communities, and live fulfilling lives. By understanding the different types of AAC and how SLPs make decisions, we can better support those who rely on these communication methods. The choice of AAC system is not one-size-fits-all; rather, it is a collaborative process involving the individual, their family and caregivers, and a team of professionals. With the right support, individuals using AAC can overcome communication barriers and achieve their full potential.