Augmentative and Alternative Communication (AAC)

Augmentative and Alternative Communication (AAC): Augmentative and Alternative Communication is an umbrella term covering a wide range of techniques, systems and approaches used to support or replace spoken communication. This includes pictures, gestures and pointing as well as more complex techniques involving computer technology. AAC techniques are also used to support an individual’s understanding of what is said. Augmentative and Alternative Communication is part of everyday communication for everyone, for example, waving goodbye or giving a thumbs up instead of speaking. 

Aided communication: Methods of communication which involve additional equipment, such as a communication board or book. Aided methods of augmentative communication may involve:

• Object of reference: A particular object, or part of an object, that stands for an activity or event. For example, part of an identify badge used to indicate that it’s time for school. They can be used to help the child predict what is going to happen. They can also be used for choice making. 

• Paper based: This is equipment that does not need batteries or power. These resources have historically been referred to as 'low tech'. Paper based AAC includes:

  • ​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​Single photos and symbols e.g. for ‘toilet’. 
  • Use of writing and drawing.
  • Choice board. A minimum of two photos or symbols that can be used to develop meaningful choice making.
  • Picture Exchange Communication System (PECS). A highly structured approach based on Applied Behavioural Analysis. Symbols are used within the Picture Exchange Communication System and should not be referred to as a ‘PEC’. 
  • Communication board. These have also been known as communication charts, symbol sheets and aided language boards. A single sheet with photos, pictures or symbols displayed. These may consist purely of core vocabulary or organised into core and fringe vocabulary.  ​​​​​​​
  • Communication book. These provide pages of symbols usually organised by category, see ‘Developing and Using a Communication Book’ ACE Centre, often referred to as the Clare Latham book. Many will contain an alphabet (or spelling) page or the user may use a separate alphabet board. These are bespoke to the individual and will vary in symbol number and size and method of access. Other examples of communication books include Pragmatic Organisation Dynamic Display (PODD) and Look2Talk.  ​​​​​​​​​​​​
  • Topic board. Contains fringe vocabulary and would be used alongside a user’s core vocabulary within their existing communication system. For example, to cover a temporary school topic on the Egyptians.  
• Voice Output Communication Aids (VOCA): This is any device that has a voice output function (recorded or synthetic). VOCAs include:​​​​​​​]
  • Single message. A device that allows short single messages to be recorded and played back when activated by the user e.g. BIGmack. ​​​​​​​
  • Multiple message. A device that allows multiple words or short messages. Will often use a paper overlay to display the photos or symbols that represent the message e.g. Go Talk.
  • Dynamic screen. Software on an electronic device (e.g. ipad or tablet) that has the capacity to allow complex and multiple messages.  
• Unaided communication: Methods of communication that do not involve a piece of additional equipment. This includes speaking, gesturing or signing (e.g. Makaton).
• Aided language stimulation: The environment that the communication partner creates to promote and enhance a child’s use of AAC throughout the day. It includes being face to face with the child, following the child’s lead, commenting on events that are happening at the time, reducing questions, giving the child time to respond, repetition, adding to what the child communicates and modelling (see below). The use of AAC should be an integral part of this approach. 
• Modelling: When we talk with the child using their AAC method. For example, when we are saying, "Look, there’s Mum" we point to the symbols ‘look’ and ‘Mum’ in their communication book. It is a vital communication strategy that is embedded in everyday activities so that students can experience how their AAC system can be used to communicate for real reasons. This is a strategy within ‘Aided Language Stimulation’ (see above).

• Core vocabulary: A term used for a small number of words that make up the majority of what we say on a daily basis. These words are relevant across contexts and can have many meanings.  They are powerful because they allow communicators to express a wide variety of concepts with a very small number of words. Core words can include ‘you’, ‘go’ and ‘more’.

• ​​​Fringe vocabulary: A term used for vocabulary that is more specific to a topic, environment or individual. Fringe vocabulary is not generic and will likely not be used across environments.

• Symbol: A pictoral image that represents something, for example, the green fire exit. There are different published sets of symbols that are available e.g. Picture Communication System (PCS) or Wigit symbols.

• Access method (direct access or indirect access): The way in which the user selects items within their communication system. The user may have more than one access method. 

  • Direct access: where an item within their communication system is selected directly using a body part (e.g. finger, toe, eyes) or adapted tool (e.g. stylus).

  • Indirect access: where a tool is used to scan through items in order to select and communicate a message. For example, auditory scanning or switch scanning. (Switch: an assistive technology device that replaces the need to use a computer keyboard or a mouse).

• Eye pointing: A communicator uses their eyes to point at an object, picture, symbol or letter.

• Eye gaze: A direct method to access a dynamic screen. A camera will pick up the movement of one or both eyes to control a pointer.