What Is Augmentative and Alternative Communication (AAC)?

Introduction

The words Augmentative and Alternative Communication (AAC) refer to "a set of tools and strategies that an individual uses to solve everyday communicative challenges. Communication can take many forms such as: speech, a shared glance, text, gestures, facial expressions, touch, sign language, symbols, pictures, speech-generating devices, etc. Everyone uses multiple forms of communication, based upon the context and our communication partner. Effective communication occurs when the intent and meaning of one individual is understood by another person. The form is less important than the successful understanding of the message." (Linda J. Burkhart) https://www.isaac-online.org/english/what-is-aac

Augmentative and alternative communication involves an individual with a severe communication impairment, a device or mode for constructing and relaying a message (pictures, communication board, computer), a method for access to the device, a communication partner who helps by providing any needed supports to the individual or within the environment, and someone (conversation partner) who receives the message and engages in the interaction. Some people think primarily of equipment when they hear the term AAC, but that is just one element. AAC is communication and should be an ongoing and creative interactive process, involving the richness of the many forms and purposes of language.

Many people at some time in their life will encounter difficulty with speech or writing. A case of laryngitis may precipitate a day or two of forced silence, requiring one to resort to pantomime, gesture and writing as a backup. A more pronounced short-term or long-term speech impairment may result from a developmental disability, autism, stroke, injury, medical procedure, degenerative disease, or other condition. Whether one has a speech impairment that lasts for a short time or a lifetime, augmentative and alternative communication (hereafter termed AAC or augmentative communication) methods may help. With AAC methods, a young child, adolescent, or adult who has a severe communication impairment may develop the ability to communicate through use of gestures, sign language, pictures, spelling, pointing to words, and using a computer or other electronic devices.

It is important to recognize that whether a particular individual with a severe communication impairment is successful in learning to communicate depends to a large extent on the social support from people around him or her. Communication does not happen in a social vacuum, and the ability to communicate does not rest solely within an individual. Communication depends on the individual having a social environment in which communication and ongoing interaction are expected, encouraged, and nurtured. In such a supportive environment,

people expect everyone to have something to say and to be able to express themselves in some way when the circumstances are right
everyone has the opportunity to communicate and interact
communication devices or aids are readily available
people provide assistance with access to devices and with interactions as needed
people listen and respond to each other.

Specifically, in order to be communicate successfully using AAC, an individual with a severe communication impairment needs

to be treated as a competent person who can and will communicate when the right opportunity, training, and access to an effective method to communicate is provided
access to training in the use of alternative communication methods and devices in order to develop skills in communicating and interacting
the opportunity to try out and use various communication methods and devices
ongoing access to a range of methods for communicating in various situations and environments and for various purposes
continuous access to skilled communication partners who assist as needed with communication, equipment, and interactions on an ongoing basis

In order to be successful communication partners with an individual who has a severe communication impairment, the family members, friends, co-workers, neighbors, and professionals need

to understand the importance of presuming competence in an individual who has a severe communication impairment,
to understand that a presumption of incompetence must be avoided because it leads to restricted opportunity to gain the skills needed to communicate,
access to information about methods, equipment, and strategies
access to training to become an effective communication partner
access to training on assisting and interacting with an individual who uses an augmentative communication system.

It is vitally important that people in the life of individuals who have a severe communication impairment presume that the individuals are competent to communicate in some way under the right circumstances. When we presume that individuals have the capacity to learn to communicate more effectively, then we focus on continuing to work to create the circumstances in which the individuals can do so. We keep trying additional teaching strategies, support strategies, access strategies, environmental conditions, social strategies, devices and equipment, modifications, adaptations, and so forth, in a continuing effort to find just the right fit that enables the individuals to communicate more effectively and fluently about whatever they want, whenever they want, with whomever they want.

On the other hand, when we presume that an individual is probably not competent to learn to communicate more effectively nor in a highly effective way, then we may try a method with little expectation of success. If the individual fails with one method or another, then we may soon stop looking for other methods. We may preemptively confirm in our own minds that unfortunately we were right in our original presumption that the individual could not communicate more effectively. Even with the best intentions, our presumption of incompetence will limit our efforts and may make it impossible for the individual ever to prove us wrong.

Presumption of competence (and hope of the possibility of competence and greater understanding) leads family, friends, and professionals to create more opportunities, to continue to try new ideas until something finally works effectively, and to work on continuous improvement in communication on an ongoing basis.
Presumption of incompetence leads to limiting opportunities and giving up on trying new methods, without realizing that the presumption itself confounds the disability and stifles the individual who is stuck without effective communication.

It is imperative that parents, family members, teachers, and other professionals presume competence and actively explore new methods and strategies. Individuals who need alternative communication methods are not able to do so without assistance from someone who believes in the possibility that they can communicate more effectively. Communicating from her own experience (see Anne's Coming Out which she co-authored), Australian Anne McDonald explained it in this way:

"Unless someone makes a jump by going outside the handicapped person's previous stage of communication, there is no way the speechless person can do so. Failure is no crime. Failure to give someone the benefit of the doubt is."

The Everyone Communicates website was established to provide information and resources that may help people with severe communication impairments to gain access to more effective communication, and that may help the people in their lives to become more effective communication partners with them. We hope that people who currently speak to communicate will become familiar with augmentative communication methods so that they may be able to provide information and communication access to others. We also hope that they and their families will gain the knowledge that will help them to maintain their own communication using AAC if they should experience a short-term or long-term speech impairment in the future.

What if a person is not able to point or to activate a device effectively?

Even with training, some individuals are not successful using gestures, sign language, or independently using an AAC device. Others may be minimally successful but they and their families would like to achieve more effective and fluent communication and interaction. In some cases, the individual may not be highly successful primarily because he or she has not yet developed the ability to point reliably in order to activate a device or to make individual selections of pictures, symbols, words, or letters. For an individual who does not point reliably and for whom other methods of communication have not been highly effective (gestures, sign language, pointing to pictures, speech), facilitated communication training may help her/him to develop reliable pointing or device access skills. A growing number of individuals have demonstrated to their families and others that they have developed independent communication through facilitated communication training. They have sometimes been able to demonstrate unexpected intelligence and literacy once they could communicate effectively by pointing. Some have explained that their difficulties with communication have been due to difficulties with developing consistent reliable voluntary control of their movement, including their speech. Facilitated communication training is a complex process that requires good initial training and ongoing followup as facilitators and communicators develop their skills. The Facilitated Communication Training Standards (available from the Facilitated Communication Institute) provide an extensive list of knowledge and skills for facilitators and FC users. If you wish to learn more about facilitated communication training, or other methods for improving pointing skills in order to spell or type to convey information and to communicate, here is a link to more information: http://everyonecommunicates.org/methods.html (see Facilitated Communication, Rapid Prompting Method, or Informative Pointing Method).

For more information about AAC, visit our Resource Area.