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Q&A Article on Alternative/Augmentative Communication Devices (AAC) - January 2010

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Q&A Article on Alternative/Augmentative Communication Devices

By: Vicki Clarke, MS CCC-SLP and Elisa Sarosi, BS SLPA

What is your experience with AAC?
I began working with AAC in 1990 in graduate school at UNC-Chapel Hill and continued through the present.

How would you define augmentative communication?
Any form of communication that aids natural speech in order to allow a person the ability to deliver a message to another person(s).

What are some examples of AAC?
Sign language, communication boards, picture/object exchange, communication boards, single message switches, sequential message switches, static display speech generating devices (with changeable overlays), dynamic display speech generating devices.

Could one communication device work for everyone?
No although more adaptable dynamic display systems have the most potential for more people and to allow for changing needs for an individual.

What are some misconceptions when it comes to AAC devices?
The primary misconception is that use of AAC will “replace” or “diminish” natural speech development. Despite the over 20 years of research to the contrary, this is the most common misconception both lay people and professionals have regarding AAC. We encounter this question from nearly 100% of families initially considering AAC. We also encounter an extremely high number of professionals (educators, SLPs, counselors, behavior specialists and psychologists) who continue to regularly share this misinformation with families.

The second most concerning misperception about AAC is that you have to be “ready” for AAC; that there are prerequisites to AAC use and that there are a series of skills that must be mastered in order to use higher technology communication devices. There is a prevalence of augmenting people so that they can communicate what they already know and not taking into account the more significant needs of more seriously handicapped individuals. No one will argue the need to augment intellectually capable nonverbal people. Individuals who have more severe/profound intellectual difficulties are often overlooked as there is a misperception that these individuals don’t need the same level of technology supports as their more intellectually capable peers. In fact, we’ve seen that these are the patients who require the most advanced, adaptable technology in order to meet their needs.

What advice would you give to Speech and Language Therapist who is not familiar with AAC but has a client who may benefit?
Seek out the support of a therapist who specializes in AAC. AAC Specialists can be found through ISAAC, USAAC and ASHA Division 12 Membership. Attendance at a national assistive technology conference is also a wonderful way to become acquainted with equipment and implementation of AAC (ATIA Orlando/Chicago, Closing the Gap, CSUN, ASHA Division 12 Annual Conference). In addition, many of the manufacturers of assistive technology products have training and support information, webinars and workshops available for free or significantly reduced rates accessible through their websites.

Is it true that language learning will be limited for a child with a communication device?
Not if the child has a partner who is fluent with his system and is able to model and teach appropriate communication for the child.

What skills do you consider when determining an appropriate device for someone?
Physical/motor access (hand, head, eye pointing skills, need for alternate input such as switches, eye gaze etc), intellectual access, visual skills, language skills, social skills; communication needs, environments, partner interest and willingness to follow through

How do you explain the need for AAC to a parent who “understands what their child needs at home”?
In order to be independent, a child must be able to communicate across all environments with everyone they encounter and to share complex thoughts. Although this may be possible with a very familiar partner, if they cannot do this independently they cannot mature normally. Even with familiar partners, children need to have the ability to talk about novel information, to change their mind and request unexpected items and activities, to introduce new subjects. This is extremely limited when the child is dependent on the partner to translate and predict the content of their messages.

Any other thoughts you feel it is important for SLPs to know about AAC?
If a person can’t communicate, don’t quit looking for a solution! There is a very good chance that someone can help you find an answer to your problem. Be very aware of what you don’t know and never stop seeking better answers!

This Month's Featured Authors:Vicki Clarke, MS CCC-SLP and Elisa Sarosi, BS SLPA

Elisa Sarosi earned a Bachelor of Science degree in Communication Sciences and Disorders from the University of South Florida. Having a cousin with Cerebral Palsy, she has a special interest in working with people with disabilities. Elisa worked as a Speech-Language Pathology Assistant for two Pasco County Schools, working with students from 2 to 21 years of age with a wide range of communication disabilities. Here she programmed augmentative communication devices appropriately for the student’s Individual Education Plan goals and, in turn, training the student, teacher and family how to use the device most effectively. After moving to Hillsborough County, Elisa worked as a Trainable Mentally Handicapped teacher. Her class contained students with various exceptionalities such as physical, language and speech impairments. She focused on each student’s ability to access the computer and improve skills using assistive technology. Most recently, Elisa worked as an Assistive Technology Program Specialist for Florida Alliance for Assistive Services and Technology. Here she demonstrated various assistive devices for people with disabilities such as computer access options, software for learning difficulties, products for hearing and vision impairments, and augmentative communication devices. She currently works as an AAC Consultant for the Saltillo Corporation, an Ohio-based company that manufactures portable and affordable communication devices. Elisa truly enjoys helping those with disabilities become more independent in their daily lives.

Vicki Clarke is Owner and President of Dynamic Therapy Associates, with 19 years of experience as Speech-Language Pathologist and Augmentative Communication Specialist specializing in state of the art AAC and AT equipment. Mrs. Clarke regularly attends and presents at local, state and national assistive technology and speech-language pathology conferences, school-based trainings and workshops and; family-focused meetings. She also consults for national and international AT service, equipment and software manufacturers. Mrs. Clarke actively serves her patients through assessment, treatment, consultation, programming, staff development and website/blog content management.

Saltillo Corporation develops, manufactures and distributes assistive technology for persons with physical disabilities. The company specializes in voice output communication devices. Saltillo also offers voice amplification and memory assistance products. Visit our website and explore the world of possibilities that is available through technology

Please support our contributing authors and visit Saltillo Corporation.

Tags: Q&A January 2010 Newsletter SLP AAC Article