Alternative and augmentative communication
Many children are unable to understand and to express themselves effectively using spoken language alone due to specific difficulties such as severe speech disorder, physical disabilities, hearing loss, learning difficulties/disabilities etc.
Alternative and augmentative communication (AAC) is the term used to describe a wide range of resources and strategies to help people who struggle with speech. These range from simple picture boards up to complex computer-based systems.
The goal of AAC is to enable individuals to communicate as effectively as possible and in as many situations as possible using a means of expression which works best for them.
We all use aspects of AAC in our daily life to support our communication e.g. gestures such as 'thumbs up' and waving, or pointing to objects or pictures when we are communicating with someone who speaks a different language from us.
Many AAC approaches involve 'using something visual', (e.g. key word signs, symbols and photos), which supports children's understanding of spoken language as well as providing them with a means of expression to use alongside or in place of speech.
Whichever AAC system a child uses it is vital that the people around them model communicating using that same system. Research shows that children need to have language input using the same method they use to express themselves in order to learn it effectively.
AAC tools can be divided into three main groups.
a) No-tech
This term refers to strategies which do not require any additional resources e.g. gestures, signing, facial expressions, finger or eye-pointing.
In Dorset, SLT staff use the 'Signalong' key word signing system and can provide training on this for families and key staff.
b) Low-tech
This term refers to systems which do not require power/batteries to work e.g. paper-based photo and symbol books, objects of reference and pictorial choice boards.
Low-tech systems include PODD communication books and the Picture Exchange Communication System (PECS).
c) High-tech
This term refers to systems which need batteries or mains power to work e.g. apps on tablet devices and dedicated communication aids. These systems generally have software which produces speech.
Some examples of specific communication apps are ProLoQuo2Go and LAMP-Words for Life.
Assessment
Before an AAC system can be provided, full assessment needs to be carried out, taking account of the individual child's abilities and motivations, the important people in their lives and the skills and support available in their environment. AAC assessment and provision often involves a degree of 'trial and error' and this is to be expected as part of the process in finding the best approach for an individual child.
Some children with very complex needs who have a significant discrepancy between their ability to understand and their ability to express themselves may meet the criteria for referral to NHS England Specialised AAC Services. The ACE Centre in Abingdon, Oxfordshire is the local specialist centre for children living in Dorset.
AAC Provision in Dorset
Consideration of the need for AAC assessment and provision is made by the community speech and language therapy team working alongside families and key staff in education and health. Additional advice and support is available when necessary from therapists with specialist skills and experience in the area of AAC.