Augmentative and alternative communication (AAC) is any form of communication that helps someone who has trouble speaking to communicate. It can take a variety of forms including sign language, gestures, pictures, and speech generating devices, which now include tablets, such as iPads, with specific apps.
Many children with CAS use some form of AAC at some point in their communication journey. For most children with CAS, AAC is a bridge to speech, a temporary means to increase communication abilities and decrease frustration while working to improve speech. For a small number of children with severe CAS, AAC may be their primary form of communication long-term.
Selecting an AAC System
There is not one particular form of AAC that is best for every child with CAS. The most important thing is that the method of communicating works for the child and the people around them. It is also vital to remember that AAC should not be used silently. Regardless of the system, speech is still modeled and encouraged.
See the table below for different examples of AAC systems, including some of their pros and cons.
|“Low-tech” (low-technology) picture communication systems||
|“Mid-tech” (mid-technology) systems, like simple apps with voice output||
|“High-tech” (high-technology) systems/apps with expanded vocabulary and features that facilitate language development||
When to Refer to an AAC Specialist?
Probably the most important question to consider when selecting an AAC system for a child is how long the child is expected to use it as a primary means of communication. This is important because committing to learn a high-tech AAC system can be a big investment of time and resources, so it may be most appropriate for a child who is going to rely on that system for an extended period of time. Most children with CAS who do not have other disorders impacting speech/language development are able to use simple signs and low or mid-tech communication systems for a period of time while working intensively on speech production. For these children, the focus of the speech therapy should be remediating the CAS by improving motor speech planning and programming, not on teaching a complicated AAC system.
However, children with CAS who have other speech/language disorders may rely on AAC methods for a longer period of time and therefore finding the best “fit” for the child is important and a full AAC evaluation is in order. If you are not comfortable and qualified to provide a full AAC evaluation, a referral to an SLP with this expertise is recommended. The following are factors to consider when selecting an AAC system for longer-term use:
The following are common misconceptions about AAC.
Benefits of Using AAC
There are many benefits to using AAC while continuing to work on speech.