What is AAC?

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.

Why would people use AAC?

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 the time. Helping people to communicate improves their quality of life through enhancement of opportunities to education, social life, jobs and ultimately independence. 

So what does AAC include?

AAC is a whole range of different activities including 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 systems: unaided and aided. Most people who depend on  AAC combine the use of unaided and aided methods.

Unaided Communication

This is how we describe methods of communication that do not involve the use of equipment. Body language, gestures, pointing, eye pointing, facial expressions, vocalisations, British Sign Language and Makaton are examples of unaided methods of augmentative communication.

Aided Communication

This is how we describe methods of communication which involve the use of 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.

• Low-tech communication systems may take many forms including those which do not need battery to function. Low-tech communication systems include  pen and paper to write messages, alphabet charts, charts and books with picture symbols or photos and tangible symbols.
• High-tech communication systems are devices requiring at least a battery to operate. High-tech communication systems range from simple high-tech (e.g. single message devices, pointer boards, toys or books which speak when touched) to very sophisticated systems (e.g. specialised computers and programs, electronic aids which speak and/or print).

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.

What is the best kind of AAC system to use?

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 what training you will need. Contact a speech and language therapist at your locality or a specialist  in AAC.

Will AAC affect speech development?

AAC does not stop someone learning to speak. In some cases, AAC can even help to improve speech which 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 any particular time.

How long does it take to learn to use an AAC system?

The time needed to learn the basics of AAC depends on the person and the  type of system. Learning to communicate using an AAC system can be a difficult task for some. Learning how to operate an AAC system can sometimes be relatively straightforward, but it may take longer to learn how to use an AAC system effectively during conversation.

Learning to communicate with some of the aids available is a bit like learning to communicate in a foreign language – you need lots of learning and opportunities to practise before you begin to feel confident.

As communication is for life, we need to understand that people using AAC systems must never stop learning how to express themselves fluently. Ongoing support and training for both the person using AAC and their family and carers are very important.

Is it difficult to communicate with a person using AAC?

Communication is a two way process. A successful conversation depends on the comfort of the persons commmunicating.

When you first have a conversation with someone using AAC, it may 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’.  Effort is needed on both sides but it is worth your while. Any AAC system is far better than not being able to communicate at all.