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By: Jennifer Schubring, M.S., CCC-SLP

What is AAC?


I was recently asked, "What is AAC? I'd love to share your website/Facebook page/contact information, but I don't really know what you do!" Usually when people ask me this question I give a generic answer that most people can relate to that goes something like this, "Well, you know Steven Hawking? Kind of like that! I help people who cannot communicate through verbal speech. Dr. Hawking used a high-tech communication system to share his profound wisdom." People seem to understand that and he is arguably one of the most famous AAC users, but this is a very simplistic and narrow look into what AAC actually is. AAC is an acronym for Augmentative and Alternative Communication. Well, that's pretty darn wordy, so what does that mean? Here's what dictionary.com says "augment" means:

I love this definition, making something greater, because by saying "greater" we are already saying their natural mode of communication is pretty darn awesome, but now we are giving that individual with complex communication needs (CCN) another modality for communicating, enhancing their natural mode of communication. We are all multimodal communicators. For example, have you ever given your husband or wife "the look" when you're with a group of friends, not uttering a single word, that's communication! If someone has asked you where something is and you pointed to the item, you're communicating. Crying, laughing, frowning, and smiling are all forms of communication. Texting, writing a blog post, using emojis, and emailing is communicating in a written form. Everyone enhances their natural speech throughout their day by using augmented and alternative modes of communication. For individuals with complex communication needs, these forms mentioned above and more are their primary mode of communication.

AAC is broken into aided language and unaided language.

Let's start with unaided language. These forms of communication do not require anything "extra." Unaided language is the facial expressions you use, "the look" you might give to kids when they're misbehaving in public, pointing, gesturing, or using sign language.

Aided language is an object that you use to communicate. Aided language can be further sub-divided into low tech, mid tech, and high tech. Low tech consists of actual objects, 3D symbols, communication boards and books, picture symbols, Picture Exchange Communication Systems (PECS), and PODD systems, to name just a few.

Project Core Low Tech Communication board
PECS book

Mid tech tools are your simple voice output devices: BigMACK, a single message switch; Step-by-Step, a multi-message sequential switch; and a GoTalk button, are a few examples. This category also includes static display, multi-level communication devices such as the GoTalk 9+, Communication Builder, or TechSpeak. These devices will allow you to record pre-programmed messages on multiple "levels" of the device, but require you to manually change the overlay of words or pictures when you change each level. For example, level 1 might have breakfast vocabulary, level 2 will be programmed with tv shows, level 3 will have self-care words, and level 4 will have lunch/dinner words. These are traditionally set-up with a whole message on each button (i.e., "I want a drink of milk.")

Last, are high tech communication devices. These devices will provide individuals with complex communication needs a robust communication system using a speech synthesizer to speak their thoughts independently. This is what Dr. Steven Hawking used. It's hard to provide a clear definition of these devices as they change rapidly as newer, better technology is developed. These systems are complex. There are many choices out there, and many ways to access the devices. These devices are referred to as speech generating devices (SGD). A dedicated speech generating device can cost between $1000 and $17,000. With the addition of mobile technology, there are many communication apps that are available to users at more affordable prices. Users can use direct selection via their hands or head pointers, scanning via a variety of switches to include eye blink, sip and puff, microlight, etc. Eye gaze technology has become more dependable and accurate giving many individuals with very limited mobility access to highly efficient communication.

In the United States, approximately 3 1/2 million Americans cannot communicate their thoughts using verbal speech and are considered to have a significant speech disability due to a congenital (born with it) or acquired (something happened after birth) disability. A significant speech disability can be as unique as the individual. As you can see, "What is AAC?" is a complex question and this post is just the tip of the iceburg.

Finding someone who specializes in providing a comprehensive evaluation in AAC is so important. This is an area of speech/language pathology that is constantly evolving, therefore, finding a Speech/Language Pathologist that is an AAC Specialist, not just knowing one or two tools and recommending those apps or devices, is essential to helping individuals with CCNs build communicative competence. The availability of apps and mobile technology has made high tech AAC more accessible to many individuals, but it should come with a huge flashing CAUTION sign before you hit "purchase." An AAC Specialist can help individuals and families make well educated decisions, planning for systems that will grow with the individual, give individuals a "language for a lifetime." Don't waste your money and your time on an app that doesn't work and won't meet the long-term needs of the individual with CCNs. We don't teach our young verbal children one language and then when they're in 2nd grade, 5th grade, or 10th grade tell them that they need to learn an all new language so that they can say more and have access to the vocabulary they now need.

It is Building AAC's mission to build better communication systems, unaided and aided-low and high tech, helping to pick the right tools to enhance multimodal communication, making it greater through coaching the individual and their circle of support in the natural environment. Evaluations and therapy don't happen within the walls of a traditional therapy practice. At Building AAC, we come to you to find out how communication works in your home, with your family, at your job, and in your community. This is how we build better communication systems! Building AAC also offers FREE 15 minute phone consultations to help guide you if you are unsure of what direction to go. If you are interested in scheduling a comprehensive AAC evaluation or therapy, please contact Building AAC at: jennifer@buildingaac.com or using the contact field on our website: www.buildingaac.com

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