Choosing an Augmentative and Alternative Communication (AAC) system involves a thorough, individualized process that carefully considers a person's unique abilities, communication needs, and future potential. It's a journey to find the right tools that empower effective and independent communication.
The Assessment Process: A Critical First Step
The selection of an aided AAC system is not a one-size-fits-all decision; it requires careful consideration of an individual's current skills, strengths, and needs. It is equally important to approach this process with an open mind, ensuring that the chosen system does not restrict the individual's future potential for growth and expanded communication.
A comprehensive assessment is the cornerstone of effective AAC selection. This process is typically led by a Speech-Language Pathologist (SLP) specializing in AAC, often collaborating with an interdisciplinary team including occupational therapists, physical therapists, educators, family members, and the individual themselves.
Assessment strategies are designed to lead to a deep understanding of:
- Options for different symbols: What types of visual or auditory representations (e.g., pictures, text, objects) are most meaningful and accessible?
- Systems: Which specific devices or methods (e.g., communication boards, speech-generating devices, apps) best fit the individual's communication profile?
- Access modes: How will the individual physically interact with the system (e.g., direct touch, eye gaze, switch scanning, head tracking)?
Key Considerations for Choosing an AAC System
When evaluating potential AAC solutions, several factors come into play:
Individual's Skills, Strengths, and Needs
- Cognitive Abilities: Understanding and processing information, memory, problem-solving.
- Motor Skills: Fine and gross motor control for accessing devices (e.g., pointing, typing, using switches).
- Sensory Skills: Visual acuity, hearing, tactile sensitivity.
- Linguistic Skills: Understanding of language, vocabulary size, sentence structure.
- Communication Needs: What messages does the individual need to convey? In what environments? With whom?
Symbol Systems
The choice of symbols directly impacts how a person expresses themselves. Considerations include:
- Iconicity: How easily recognizable are the symbols? (e.g., a picture of an apple is highly iconic).
- Transparency: Do the symbols clearly represent their meaning?
- Learnability: How easy is it for the individual and their communication partners to learn and use the symbols?
- Types:
- Real Objects: For early communicators or those with significant cognitive impairments.
- Photographs: Highly specific and recognizable.
- Line Drawings/Pictographs: Standardized symbol sets like Picture Communication Symbols (PCS) or SymbolStix.
- Text: For individuals with literacy skills.
- Blissymbols: A semantic graphic system.
AAC System Type and Features
AAC systems vary greatly in complexity and technology level.
- Vocabulary Size and Organization: Does it offer a robust vocabulary that can grow? Is it organized logically (e.g., by topic, grammar, core vocabulary)?
- Speech Output: Is the voice natural-sounding? Can it be customized?
- Portability and Durability: Will it be used in various settings? Can it withstand daily wear and tear?
- Customization: Can vocabulary, layout, and settings be easily adapted?
- Cost and Funding: High-tech devices can be expensive, requiring research into insurance coverage or funding options.
Access Methods
This refers to how the individual physically interacts with the device to make a selection.
- Direct Selection:
- Touch: Using a finger, hand, or stylus to directly touch icons on a screen.
- Pointing: Using a head pointer, light pointer, or eye gaze to indicate choices.
- Indirect Selection:
- Scanning: A cursor or light moves across options, and the user activates a switch when their desired choice is highlighted.
- Eye Gaze: Using specialized cameras to track eye movement and select items on a screen.
- Head Tracking: Using a device to track head movements to control a cursor.
Communication Environment & Partners
Consider where and with whom the AAC system will be primarily used.
- Home: Family members, caregivers.
- School: Teachers, peers, therapists.
- Community: Store clerks, friends, service providers.
- A system that works well in a quiet one-on-one setting might not be effective in a noisy classroom or public space.
Future Potential and Growth
Crucially, the chosen system should support the individual's evolving communication needs without limiting their potential. Look for systems that are scalable, allowing for increased vocabulary, more complex sentence structures, and advanced features as skills develop.
Types of AAC Systems
AAC systems can be broadly categorized, each with unique advantages:
| AAC Type | Description | Best For | Key Considerations |
|---|---|---|---|
| Unaided AAC | Does not require external tools or equipment; relies solely on the user's body. | Individuals with intact motor control for gestures or sign language. | Requires communication partners to understand the system. Always available. |
| Low-Tech AAC | Non-electronic, physical tools. | Emergent communicators, quick access, backup systems, budget-friendly. | Limited vocabulary, less dynamic, requires manual updates. |
| High-Tech AAC | Electronic devices (speech-generating devices, tablets with apps) that produce synthesized or digitized speech. | Diverse communication needs, large and dynamic vocabulary, varying access methods. | Cost, durability, battery life, learning curve for user and partners. |
For more detailed information on various AAC types, visit the American Speech-Language-Hearing Association (ASHA).
Practical Steps for Implementation and Support
- Trial Periods: Whenever possible, engage in trial periods with different AAC systems in real-life settings. This practical experience is invaluable for determining the best fit.
- Training and Support: Comprehensive training is vital for the individual using AAC, their family, educators, and all communication partners. Everyone needs to understand how to use and support the system.
- Ongoing Evaluation and Customization: Communication needs change over time. Regular reviews and adjustments to the AAC system (e.g., adding new vocabulary, updating access methods) are essential to ensure its continued effectiveness.
- Team Approach: Successful AAC implementation thrives on a collaborative team effort, continuously adapting strategies to best support the individual's communication journey.
