Augmentative and Alternative Communication (AAC) is the term used to describe methods of communication which can be used to add to the more usual methods of speech and writing when these are impaired.
AAC includes unaided systems such as signing and gesture, as well as aided techniques ranging from picture charts to the most sophisticated computer technology currently available. AAC can be a way to help someone understand, as well as a means of expression.
Some people, both children and adults, find communication difficult because they have little or no clear speech. There are many reasons why this might be the case: for example, as a result of cerebral palsy, stroke, head injury, motor neurone disease or learning disability.
The idea behind AAC is to use the person's abilities, whatever they are, to compensate for their difficulties and to make communication as quick, simple and effective as possible when speech alone does not work.
Although we all use aspects of AAC from time to time (e.g. waving goodbye instead of saying it, pointing to a picture or gesturing to make yourself understood in a foreign country) some people rely on AAC all of the time.
Helping people to communicate improves their quality of life. It improves their opportunities, education, social life, friendships and independence.
AAC is a whole range of different activities – there is not just one type of AAC. AAC includes facial expression, eye pointing (looking hard at the object or person you want), gesture, signing, special symbols, spelling out a message on a letter board or computer, electronic speech output aids, etc.
There are two main types of AAC system: unaided and aided. Most people who use AAC use a combination of unaided and aided methods.
This is how we describe methods of communication that do not involve a piece of additional equipment. Body language, gestures, pointing, eye pointing, facial expressions, vocalisations, British Sign Language, and Makaton are examples of unaided methods of augmentative communication. (See Focus on...Let Your Hands do the Talking.)
This is how we describe methods of communication which involve additional equipment, such as a picture chart, a computer or a special communication aid. Aided methods of augmentative communication may be ‘low-tech’ or 'high-tech’. Both low and high-tech systems can be used by people who are unable to spell or read, as well as by people who are highly literate. (See Focus on...Using Symbols for Communication.)
Some people need to use a special device to control their aided AAC systems, such as a switch to control a scanning system or a specialised pointer. (See Focus on…Accessing Communication Aids and Computers.)
There is no ‘best’ type of AAC system. Each has its own pros and cons and to identify the most suitable one for an individual will depend on their personal preference as well as on their abilities and needs. Specialised assessment will help to identify the most appropriate AAC system or systems.
Remember that most people (including people who are able to speak effectively) communicate using several methods. It can be useful to talk to people who know about the pros and cons of different systems and to find out out what training you will need. Contact a speech and language therapist at your local health centre or hospital, or get in touch with a specialist AAC Centre (contact Communication Matters for a list of centres).
AAC does not stop someone learning to speak. In some cases, AAC can even help to improve speech. Speech is usually quicker and easier than AAC so people will always use speech when they can. All forms of communication should be encouraged – speech and AAC – whatever works best at the time.
How long is a piece of string? The time needed to learn the basics depends on the person and the system.
Learning to communicate using an AAC system is a difficult task. Learning how to operate an AAC system can sometimes be relatively straightforward, but it can take longer to learn how to use an AAC system effectively in conversation with other people.
Learning to communicate with some of the aids available is a bit like learning to communicate in a foreign language – you need lots of teaching and opportunities to practise before you begin to feel even slightly confident.
As communication is for life, we need to understand that people using AAC systems never stop learning how to express themselves more fluently. Ongoing support and training for both the person using AAC and their family and carers is very important.
Communication is a two way process. A successful conversation depends on everyone feeling comfortable.
When you first have a conversation with someone using AAC, it can seem strange and a bit awkward. However, remember that you are having the conversation with the person using the AAC system and not the AAC system itself. You don’t need to understand how the AAC system works, you just need to listen to what the person is ‘saying’ (see Focus on...How to be a Good Listener). It will take effort on both sides but this will be well worthwhile. Any AAC system is far, far better than not being able to communicate at all.
Please contact Communication Matters for more information on this topic or to obtain the printed leaflets in the Focus on… series.
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