All About AAC (Augmentative and Alternative Communication)
October 4, 2017
By: Samantha Lyle, M.A., CCC-SLP
AAC awareness month is here again! Say what?!? AAC stands for Augmentative and Alternative Communication. The American Speech and Hearing Association (ASHA), the governing body of the field of speech-language pathology, defines AAC as, “…all forms of communication (other than oral speech) that are used to express thoughts, needs, wants, and ideas. AAC is augmentative when used to supplement existing speech, and alternative when used in place of speech that is absent or not functional.”
AAC includes a number of supports from picture symbols, communication boards, sign language, gestures and electronic devices. All of these supports are used at Bridgeway Academy, where we believe every voice matters. When faced with the decision to initiate or continue use of AAC, individuals and families often have many questions and hesitations. ASHA highlights many common myths and research findings that can influence decisions or motivation to use AAC.
Myth 1: Introducing AAC will reduce an individual’s motivation to improve natural speech and will hinder language development (including the development of social communication skills). AAC should be introduced only after the ability to use natural speech has been completely ruled out.
- The use of AAC does not affect motivation to use natural speech and can, in fact, help improve natural speech when therapy focuses simultaneously on natural speech development and use of AAC in a multimodal approach (Millar, Light, & Schlosser, 2006; Sedey, Rosin, & Miller, 1991).
- Intervention for minimally verbal school-age children with ASD that included use of an SGD increased spontaneous output and use of novel utterances compared with the same interventions that did not include use of an SGD (Kasari et al., 2014).
- AAC can help decrease the frequency of challenging behaviors that may arise from frustration or communication breakdowns (Carr & Durand, 1985; Drager, Light, & McNaughton, 2010; Mirenda, 1997; Robinson & Owens, 1995).
At Bridgeway Academy nearly all clients who use AAC develop some speech and many have become completely verbal communicators!
Myth 2: Young children are not ready for AAC and will not require AAC until they reach school age.
- Early implementation of AAC can aid in the development of natural speech and language (Lüke, 2014; Romski et al., 2010; Wright, Kaiser, Reikowsky, & Roberts, 2013) and can increase vocabulary for children ages 3 years and younger (Romski, Sevcik, Barton-Hulsey, & Whitmore, 2015).
- AAC use with preschool-age children has been associated with increased use of multisymbol utterances and development of grammar (Binger & Light, 2007; L. Harris, Doyle, & Haff, 1996; see Romski et al.  for a review).
- AAC use can lead to increases in receptive vocabulary in young children (Brady, 2000; Drager et al., 2006).
Bridgeway Academy students often get AAC devices as early as three but we have had success using the devices with children as young as 12 months.
Myth 3: Prerequisite skills such as understanding of cause and effect and showing communicative intent must be demonstrated before AAC should be considered; individuals with cognitive deficits are not able to learn to use AAC.
- Measures of pre-communicative cognitive ability may be invalid for some populations, and research suggests that impaired cognition does not preclude communication (Kangas & Lloyd, 1988; Zangari & Kangas, 1997). Development of language skills can lead to functional cognitive gains (Goossens’, 1989).
- AAC intervention for children with complex communication needs helps develop functional communication skills, promotes cognitive development, provides a foundation for literacy development, and improves social communication (Drager et al., 2010).
At Bridgeway Academy we see that the foundations of language development can be established while using AAC devices rather than waiting for these skills to be developed.
Currently, over 100 Education Center students and Therapy Center clients use high-tech speech-generating devices. Bridgeway Academy is one of nine LAMP Centers of Excellence in the nation, with six LAMP Certified Professionals. LAMP, or Language Acquisition through Motor Planning, is defined as “… a therapeutic approach based on neurological and motor learning principles. The goal is to give individuals who are nonverbal or have limited verbal abilities a method of independently and spontaneously expressing themselves in any setting.”
With several papers ready for publication and presentations at national conferences, Bridgeway Academy, partnering with The Ohio State University’s Autism & Child Language Learning Lab is at the forefront of research in the field of AAC. We are proud to be supporting the development in the field at the global and local levels.
Several years ago, the speech department coined the term “Chatterbox Challenge” to represent an immersive language experience to practice using speech-generating devices to become better teachers, models, and prompters for our students and clients. The speech therapy department will be taking the Chatterbox Challenge again this year and plan to help facilitate any other groups of teachers, parents, caregivers and professionals that would like to accept the challenge as well. Please get in touch with your child’s Speech-Language Pathologist for more information on AAC or the Chatterbox Challenge!