Augmentative and Alternative Communication (AAC) Programs and Devices

Article
Dec. 20, 2021Updated Sep. 9, 2022

Communication is an essential part of life. We rely on communication to express our wants and needs, form friendships, exchange ideas, and engage in our communities. For the many people with disabilities who have difficulties with spoken communication, augmentative and alternative communication (AAC) devices and programs can bring language alive and make communication possible.

So, what is AAC, and what kinds of AAC devices are out there? How do you know if your child could benefit from one? What kinds of support and funding are available? We sat down with speech-language pathologist (SLP) and AAC specialist Ali Steers, and Undivided’s Head of Health Plan Advocacy Services, Leslie Lobel, to learn more.

What is AAC?

“AAC looks like so many things,” Steers says, “so it can be really hard for someone to wrap their brain around what exactly AAC is.” Functionally speaking, AAC can be anything from an iPad app to a computer with text-to-speech software to a dedicated, portable device. “We can all kind of think of ourselves as AAC users,” Steers says. “All of us are sending text messages. All of us are writing emails. All of us are using emojis.”

Steers adds that it’s important to recognize that all children already communicate in some way, whether it’s verbal, with their eyes, or vocalizations, and that AAC devices are used to augment or add to a child’s communication.

For more on what AAC is from Ali Steers, watch this clip:

How do I know if my child needs AAC?

A child could benefit from an AAC device if they:

  • have difficulties speaking verbally,

  • are speaking verbally unreliably, or

  • are unable to speak verbally.

“If your child is not developing intelligible speech with their mouth on par with their typically developing peers, then, in theory, you should be talking with a speech therapist, and that speech therapist should be giving you good advice about whether or not your child has the ability to develop intelligible speech without augmenting their communication,” Steers explains.

Note that it's never too early or too late to start with AAC, according to Steers:

How will I know what kind of AAC my child needs?

Steers suggests that parents think about AAC in the same way they think about German or French — it really is “a language that we use all day to communicate.” So, it’s crucial that the right device and system are chosen for your child’s unique needs.

An essential first step is speaking with a professional who is knowledgeable about AAC programs and devices, and who will take many variables into account when helping you determine what system is going to work best for your child.

An evaluator will look at the following:

  • Access: Can the child use this device?

    • For example, a child who does not have the fine motor control to use an iPad shouldn’t be given one for communication. In that case, other options should be considered.
  • Environment: Who is the child going to be communicating with?

    • Language organization: How is the child going to be communicating? What words do they need access to, and how should these words be organized?

      • Steers tells us that a language system should be set up for durability and longevity because the system will need to grow with the child.

      • The way the system is set up is essential to whether your child will be able to communicate effectively with their device. Are high-frequency words easily accessible? Are there enough words available to them?

        • Steers suggests trying the device out for yourself. Can you talk to your child using the system? If not, the layout may need to be redesigned, because if you are not able to communicate with the device, they will likely struggle as well.

  • Portability: How will the device move around with the child?
    • For example, a child can use a cross-body strap to carry the device, or it can be mounted on their wheelchair. Whether a mount or strap will work well depends on the needs of the child and the device itself.

Programs and devices

Steers suggests testing a program or device before committing to it whenever possible to ensure it will work for your child. Working with a knowledgeable SLP will help you start narrowing down the best apps or speech-generating devices (SGDs), as there are many options currently available on the market, including:

  • Direct Selection programs and devices, where the child will directly point to, press, or gaze at an image or word they wish to select.

  • Dedicated devices such as Tobii Dynavox’s I-110 or Prentrom’s Accent series

  • Tactile or auditory devices for children who are visually impaired, such as Enabling Device’s Tactile Symbol Communicator

  • Standard USB joystick or mouse

    • A joystick or mouse can be used to control the pointer on some AAC devices such as those in the PCR Accent series.
  • Head pointing devices, such as NuPoint’s Head Tracking for Accent 1400

    • Head pointing is a great option for users who need a hands-free device.

    • NuPoint’s device works by placing a reflective dot on the user’s face, which is tracked by the device and used to control the pointer on screen.

    • Pointer sticks that are worn on the user’s head are also available.

  • Eye-gaze devices, such as:

    • PCR’s Look Eye Tracking systems

    • The MegaBee Eye Pointing Communication Tablet

    • The I-Series by Tobii Dynavox

      • Eye-gaze devices are most beneficial for children who don’t have the fine motor control to use direct-select or switch control systems.

      • Eye gaze has recently become available on iPads but can be less reliable than when used with a dedicated device. The success of the software will often depend on the quality of the iPad’s camera.

  • Switch Scanning, such as Enabling Devices Announcer

    • Steers tells us that “for individuals who would not be good candidates for using their eyes or their hands, they’ll be controlling a screen with, ideally, two switches. Maybe they’re on both sides of their face, and they’re using one switch to scan and the other switch to pick.”

    • They can be auditory or visual, depending on the needs of your child.

How are AAC devices funded?

Who should receive training to use an AAC program or device?

For your child to get the most from their AAC program or device, everyone who interacts with them will need to receive proper training, including family members, teachers, and peers.

In most cases, an SLP will provide initial training on using the device for a child’s family members, teachers, aides, peers, and any other person they interact with on a regular basis. Parents can also request that group time with their child’s classmates be written into their IEP, so the SLP can help other students learn to use the device alongside their child.

Once a person is thoroughly trained and proficient, they can then train others. Steers tells us she has had great success with parents teaching other family members and teachers instructing a child’s peers and friends.

Where can parents find resources and support?

Learning to work with AAC programs and devices will take time and practice and can be an overwhelming experience. If you feel like you need more support, you can:

  • Speak with an SLP who is knowledgeable about AAC devices.

    • Steers tells us that not all SLPs are fully trained in AAC, and parents should ask detailed questions.
  • Once you’ve determined your device and program, you can visit the company’s website. Many of them offer articles, webinars, or training to help you learn more.

  • Reach out to your Regional Center for support and training.

  • Remember that it's a journey and a process that requires patience, practice, and perseverance. Watch this clip of parent Lelah Coppedge, whose son Jack works with Steers:

Did we answer your questions about AAC devices? What other concerns do you have? Let us know in the comments!

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Contents


Overview

What is AAC?

How do I know if my child needs AAC?

How will I know what kind of AAC my child needs?

Programs and devices

How are AAC devices funded?

Who should receive training to use an AAC program or device?

Where can parents find resources and support?

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