What is augmentative and alternative communication (AAC)?

AAC is any device, system or method that improves the ability of a child with a communication impairment to communicate effectively. Although AAC is often used to refer to formal communication devices and systems such as sign language, communication boards or voice output communication aids (VOCAs), it can include less sophisticated means of communication such as facial expressions, non-speech vocalizations, idiosyncratic gestures, etc. AAC is used when a child does not develop communication in the normal fashion, or experiences a significant delay in its development. AAC is not merely a substitute for how the child is currently communicating. It is used to augment that communication, replacing only elements that are unintelligible, socially unacceptable, or harmful to the child or others. Ideally, an AAC system includes more than one mode of communication, with the child using whichever is the most efficient given the persons, setting and activity at hand. Very often one of the modes of communication in an AAC program is natural speech. (See Multimodal communication.)

Broadly speaking, communication occurs with at least one other person and in the context of the environment, and serves the following functions:

• To indirectly control the environment, for example to obtain or reject something.
• To regulate social interactions, for example to express an emotion or to interact with a friend.
• To receive and convey information and ideas.

What is often thought of as communication is formal, symbolic language, usually speech. Actually, communication can be thought of as occurring on a continuum. On one end is nonsymbolic, unintentional communication, such as a baby's instinctive crying whose meaning can be interpreted by a parent. On the other end is abstract, symbolic communication, such as speech or sign language. (See Normal speech and language development.) Communication can even be a behavior. For example, when we see a child acting up and say "Oh, she is only doing that to get attention," we are indicating that the child is "communicating" a need for attention, albeit in an indirect and socially unacceptable manner. (See Children with severe behavioral issues.)

In the past, some children with moderate to severe disabilities were considered too cognitively impaired to learn how to communicate effectively. These individuals were not even considered candidates for AAC. However, studies have since shown that children with multiple and diverse disabilities do benefit from AAC (Romski, Sevcik, Robinson, & Bakeman, 1994; Silverman, 1980). (See A historical perspective on AAC.) Currently, it is widely believed that any child, from those with severe and multiple disabilities to those with temporary impairments, can benefit from an AAC program that is appropriate and individualized. AAC, therefore, can include anything from a sophisticated electronic voice output communication aid (VOCA) to teaching a child to extend a hand during snack to indicate the desire for another cookie.

OTHER RESOURCES:

Help me—and everyone who reads this site—by mailing your suggestions, criticisms and personal experiences to Ruth Ballinger at yaack@iname.com

• "Twenty Frequently-Asked Questions about AAC Service Delivery with Children" by Cynthia J. Cress, Ph.D., CCC-SLP, University of Nebraska-Lincoln at http://www.unl.edu/barkley/present/cress/questions.shtml.

• "What We Are Learning About Augmentative Communication and Early Learners" by Linda J. Burkhart at www.lburkhart.com/gphb.htm.

• "Introduction to Augmentative and Alternative Communication (AAC)" at http://callcentre.education.ed.ac.uk/SCN/Intro_SCA/intro_sca.html.