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Augmentative and alternative communication

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Augmentative and alternative communication (AAC) refers "to an area of research, clinical, and educational practice. AAC involves attempts to study and when necessary compensate for temporary or permanent impairments, activity limitations, and participation restrictions of individuals with severe disorders of speech-language production and/or comprehension, including spoken and written modes of communication".[1]



Aided and Unaided AAC

AAC is used by individuals with severe communication disorders for whom gestures, speech, and/or writing is temporarily or permanently inadequate to meet all of their communication needs. Speech may be replaced or augmented by using a variety of modes:

Aided AAC

An AAC aid is any "device, either electronic or non-electronic, that is used to transmit or receive messages".[2] The skills, areas of difficulty and communication requirements vary greatly within the AAC user community, and so an equally diverse range of communication aids exists to meet these demands.

Low Tech

Low tech aids are devices which do not need batteries or electricity to meet the user's communication needs.[3] These are often very simple devices created by placing phrases letters, pictures or symbols on a board or in a book. Depending on their physical abilities and limitations, the user then accesses the device by pointing to the appropriate message with their fingers, a non-electronic pointer, or eye gaze.[4]

Low tech aids are limited in terms of the amount of messages a single device can convey: Only so many messages can fit on a single low tech communication board or communication book. In comparison, natural speech can convey infinite messages, and high tech aids are only limited in terms of their memory stores.

High Tech

High-tech AAC includes a diverse range of electronic devices that permit the user to communicate with others by producing digitized or synthesized speech or by typing out messages. [5][6] These devices can also be referred to as Speech Generating Devices (SGD) or Voice Output Communication Aids (VOCAs). [7] A diverse array of such electronic devices is presently available and each user is matched with the device that is most suitable for their needs and skills. Such devices can be simple electronic communication boards that produce the word, phrase or a story stored under a chosen symbol, other devices would say the words or the letters that are typed by the user. [8] The more sophisticated electronic AAC devices consist of communication software installed on fully functional computers, adapted to the users' physical capabilities. The users can switch from the communication program to PC and use it to access internet, email, play games etc.
These devices vary in their size, the amount of information they can store and naturally their price. Some are easier to carry around and others can be mounted to a wheelchair. Moreover, there is often more than one way to operate these electronic devices. In accordance with the users’ abilities they can be operated by using touch screen, switches, joystick, and mouth operated mouse or by installing a program that would track the eye gaze of the user. [9]
Finally, it is important to keep in mind that electronic devices operate on batteries which need to be frequently changed or charged. In the event that a device stops working, the user should have access to a low-tech device until the electronic one is fixed. [10]

Unaided AAC

Unaided AAC includes sign language and gesture systems, as well as body language.

Symbols

Some people who use AAC can read and spell; others cannot, and need communication aids on which language elements are represented by pictures or graphic symbols such as Picture Exchange Communication System (PECS) or Blissymbols.

Access

Traditional communication is accessed through the mouth (by speaking), the ears (by hearing), the eyes (by seeing) and the brain (by appropriately processing meaning). People with impairments to any of these organs may require augmented or alternative access to communication.

Some people with severe communication impairments can use their hands; others cannot, and have to use alternatives, such as mouth sticks, headsticks, switches or eye-pointing.

  • Direct Selection: An individual points to the desired symbol using a finger or alternative selection technique (i.e., headpointer or eyegaze pointing).
  • Scanning: An individual is offered an array of symbols. As the communication system or partner scans through the symbols, the AAC user indicates his/her desired choice by using the alternative selection technique (i.e., pointing, switch access, head nodding) to select the desired symbol.

Rate enhancement strategies

Rate enhancement strategies increase the rate of communication output of the user and as a result, enhance the efficiency of communication. There are two main options for increasing the rate of communication for AAC devices: encoding and prediction. [11]

  • Encoding is the way a user is able to produce messages using the device. If an entire word, phrase or sentence can be retrieved with a one or two symbol code, communication will occur faster. [12] [13]
  • Prediction is when the device offers choices in message output to the user. If the guess is correct, the user no longer has to type their desired word. If it is incorrect, the user can select from additional choices. The way the device determines the possibilities is based on frequency in language, word association, recency, past choices, or grammar. [14] [15]

Team

Assessments for individuals with AAC needs may be undertaken by a communication consultancy team who may consist of a speech and language therapy professional, an occupational therapist and/or a clinical scientist.

Terminology Used in AAC

Symbol: Something used to represent another thing or concept. For example, a picture or line drawing of a dog to represent dog.

Symbol Set: A set of symbol that is closed in nature; symbol set can be expanded, but it does not have clearly defined rules for expansion (e.g., Picture communication symbols).

Symbol System: A set of symbol; includes rules or a logic for the development of symbols (e.g., Blissymbols).

Speech Generating Device: An electronic assistive device that produces speech (e.g., Dynavox, Mercury).

VOCA: Voice Output Communication Aid; other term for electronic assistive device producing speech

Assistive Communication Device: Electronic or non-electronic assistive technology device that provides external assistance for communication.

AAC System: An integrated network of symbols, techniques, aids, strategies, and skills.

Input Method: Technique used to select representations of the wanted utterances from an electronic device (e.g., touchscreen selection, eyegaze pointing, switch access)

Tangible Symbols: Tangible symbols are objects or pictures that are used as symbols by individuals who are not able to communicate using more conventional symbol systems. Tangible symbols bear an obvious and concrete relationship to the visual or tactile properties of the entities that they represent. They are a type of “augmentative and alternative communication” (AAC).

See also: Blissymbolics

References

  1. ^ "Roles and Responsibilities of Speech-Language Pathologists With Respect to Augmentative and Alternative Communication: Position Statement". www.asha.org. 2005. Retrieved 2009-01-23.
  2. ^ Beukelman, D.R., and Mirenda, P: Augmentative & Alternative Communication, page 4. Paul H Brookes Publishing Co., 2005
  3. ^ Technology. Retrieved March 19 2009 from International Society for Augmentative and Alternative Communication (ISAAC). Website: http://www.isaac-online.org/en/aac/technology.html
  4. ^ Technology. Retrieved March 19 2009 from International Society for Augmentative and Alternative Communication (ISAAC). Website: http://www.isaac-online.org/en/aac/technology.html
  5. ^ Technology. Retrieved March 19 2009 from International Society for Augmentative and Alternative Communication (ISAAC). Website: http://www.isaac-online.org/en/aac/technology.html
  6. ^ Connections. Retrieved March 20 2009 from Learning Independence through Computers Inc. Website: http://www.linc.org/augcom.html
  7. ^ Technology. Retrieved March 19 2009 from International Society for Augmentative and Alternative Communication (ISAAC). Website: http://www.isaac-online.org/en/aac/technology.html
  8. ^ Technology. Retrieved March 19 2009 from International Society for Augmentative and Alternative Communication (ISAAC). Website: http://www.isaac-online.org/en/aac/technology.html
  9. ^ Connections. Retrieved March 20 2009 from Learning Independence through Computers Inc. Website: http://www.linc.org/augcom.html
  10. ^ Technology. Retrieved March 19 2009 from International Society for Augmentative and Alternative Communication (ISAAC). Website: http://www.isaac-online.org/en/aac/technology.html
  11. ^ Rate Enhancement. Retrieved March 20 2009 from Augmentative and Alternative Communication at the University of Washington, Seattle. Website: http://depts.washington.edu/augcomm/02_features/04d_rateenhance.htm
  12. ^ Rate Enhancement. Retrieved March 20 2009 from Augmentative and Alternative Communication at the University of Washington, Seattle. Website: http://depts.washington.edu/augcomm/02_features/04d_rateenhance.htm
  13. ^ Types of AAC Devices. Retrieved March 20 2009 from Augmentative Communication, Incorporated. Website: http://www.augcominc.com/whatsnew/ncss.html
  14. ^ Rate Enhancement. Retrieved March 20 2009 from Augmentative and Alternative Communication at the University of Washington, Seattle. Website: http://depts.washington.edu/augcomm/02_features/04d_rateenhance.htm
  15. ^ Types of AAC Devices. Retrieved March 20 2009 from Augmentative Communication, Incorporated. Website: http://www.augcominc.com/whatsnew/ncss.html

Works Cited

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