Augmentative and Alternative Communication (AAC)
Overview
Augmentative and alternative communication (AAC) is a term used to describe various methods of communication that can help people who have limited speech or who are unable to use verbal speech to communicate. AAC can support both receptive language and expressive language skills.
Augmentative means to add to someone’s speech. Examples of that include waving, gestures/signing, pointing to pictures or objects.
Alternative means to use something other than speech. An example of that is using an AAC device. There are different types of devices that are used where children can point to pictures, or click buttons that give voice output, etc.
Type of AAC Devices
Simple communication devices can include simple picture books, PECS (Picture Exchange Communication Systems), picture boards, and basic recorded speech devices (Go Talk Communication Aid, BIGmack Communicator).
More advanced options include electronic tablet speech applications (examples: ProLoQuo2Go, Snap Core First utilized on an iPad). More advanced options also include dedicated speech devices that are devices that can only be used as a communication device (no other applications can be run on the device). These include devices by Dynavox and Saltillo.
Since there are different types of devices a child can use, the evaluation process will help determine the child’s communication strengths and find the best fit for the child.
Benefits of AAC
AAC devices improve ability to functionally communicate with others. AAC devices also provide other therapeutic benefits. Simply using a device has been shown to improve language skills. Research results indicate that AAC interventions do not impede speech production. In fact, most studies report an increase in speech production.
AAC devices allow children to practice using their language in social and real-life situations, which is is essential for development, especially when verbal communication is challenging.
How to Know if AAC is Appropriate for Your Child
Your child might benefit from AAC if your child is not talking at all (beyond the age of 2), your child isn’t talking much (preschool or early elementary age) or your child is talking, but it is extremely difficult for others to understand his/her speech.
Early communication intervention that incorporates AAC use can aid intentional communication behaviors in children.
Prerequisites for Using a High-Tech AAC Device
There are no prerequisites for learning to use an AAC device, other than the ability to produce a purposeful movement. “All individuals should have access to AAC systems or devices that promote effective communication.” (ASHA)
In normal development, children learn meanings of first words by playing with sounds made in the mouth and seeing the reaction of others. Consistent motor movements result in consistent voice output that when integrated with social responses provides meaning to the word. A high-tech device with consistent motor patterns and voice output allows the non-speaking child to learn language in this same manner.
Learning to Use an AAC Device
It is different for every child. There will be times when a child is excited to use the device and there are times when there will likely be push-back to use it. Both of these times are a normal part of learning AAC and it is important that family and team members keep modeling vocabulary, showing enthusiasm about communication, and having the device available for use.
Modeling using an AAC can be similar to modeling on how to use verbal communication. A child can learn by seeing their family using the device to request, express emotion, ask questions, etc.
Bilingual Speakers
Talk to your evaluating speech-pathologist about AAC options that include multiple languages. There are programs designed for children that are learning to communicate in a bilingual environment.
AAC Evaluation Process
AAC Evaluations are completed by licensed and certified speech language pathologists who are specifically trained in the area of AAC. The evaluation typically takes place during a 90 minute appointment. The goal is to determine what AAC supports are the most appropriate for an individual’s communication needs.
At the end of the evaluation, the therapists, child and family spend time with each device, and at the end of the trial period, will decide which AAC is most appropriate. Key factors looked at include: motivation, communication autonomy and communication efficiency.
Ongoing Therapy
Ongoing therapy will be necessary following completion of the AAC assessment and gaining a device. In therapy, the speech/language pathologist will model use of the device in a variety of situations. Opportunities will be set up for the child to use the device functionally. As therapy progresses, the goal is for the child to independently utilize the device for functional communication with a variety of conversational partners in a variety of settings (therapy, home, school, community). Therapy should also include family education which will include guidance on how to become familiar with their child’s device, how to model use of the device and ways to encourage the child’s attempts to use the device.
As a child progresses in their development and ability to use their AAC, more buttons or functions can be added to their device to keep increasing communication.
AAC Evaluation Costs
There are specific CPT billing codes that are used for AAC device evaluations. Most commercial insurance plans recognize and cover these codes. The degree of coverage will vary based on each person’s insurance plan details. The cost also depends on whether the evaluation is for a low-tech non-speaking device or a higher-tech speaking device. In either case, the billed out cost is approximately the same or less than a standard speech therapy evaluation. With insurance coverage, this becomes even more affordable.
Scheduling an AAC Evaluation
Contact Westside Children’s Therapy to gain additional information or to discuss scheduling an assessment. A script from a physician indicating the need for an AAC Assessment will be necessary prior to scheduling the appointment.