Alternative and Augmentative Communication (AAC) and Autism

Speaking helps us to communicate with people around us. It allows us to interact and influence the world around us and help to meet our needs. But autism spectrum disorder (ASD) impairs the speaking ability in many children, so for people with autism, speech is not an option. Autistic children show pervasive deficits in social interactions and communication.

Children with autism spectrum disorder can have difficulties understanding or using spoken language. May children might have a language delay, and communication can be difficult for autistics even after implementing language development programs.

These children with ASD are often “non-verbal” They may have plenty to communicate and share with us, but they cannot speak and express themselves.

Therefore, children with communication deficits due to ASD need help to develop spoken language. They need alternate ways to communicate, express their needs and share their views. They need options for communicating and understanding communication, including speech, gestures, or writing.

For these children with autism, alternative and augmentative communication (AAC) is the option. Alternative and Augmentative Communication (AAC) are means and ways of communication, aside from traditional speech, that allows someone to use language.

AAC comprises various ways to augment or replace speech and other communication skills in people with ASD. AAP encompasses communication modalities like pictures, gestures, visual aids, or speech-output devices like computers.

Here, we will see how alternative and augmentative communication (AAC) techniques, strategies, and devices can help people with ASD learn to communicate.

What is Augmentative and alternative communication (AAC)?

As per American Speech-Language-Hearing Association, AAC encompasses a set of procedures and processes that enhances communication skills for functional and effective communication.

Other than speech, augmentative and alternative communication comprises all forms of communication that help express thoughts, needs, wants, and ideas. We use AAC when making facial expressions or gestures, writing, or using symbols or pictures.

People with autism spectrum disorder who have speech or language difficulties may benefit from using AAC. They can use AAC to supplement existing speaking skills or replace non-functional communication skills.

Devices and aids, like communication boards, electronic devices, hand signs, or pictures, are available to help people with impaired communication express themselves. AAC enhances social interaction, school performance, self-worth, and quality of life.

Types of AAC

Did you know that we all use forms of AAC each day?

Diaries, stop signs, menus, thumbs up, and many more are all forms of AAC. Some other forms of AAC are:

• Facial expressions, gestures, and body language
• Keyword signs
• Picture Exchange Communication (PECS)
• Communication Boards and visual boards
• Speech Generating Devices

Two types of augmentative and alternative communication systems are there. They are:

• Unaided augmentative and alternative communication systems
• Aided augmentative and alternative communication systems

Unaided augmentative and alternative communication systems don’t need any object or a device to communicate. It is always accessible because you need only the body parts to express and convey the message. People with ASD may use gestures and hand signs to support speech as a way of communication.

Aided augmentative and alternative communication systems rely on equipment and tools to communicate. These tools ranges from paper and pencil to high-tech equipment like speech-generating devices. Aided AAC can be low-tech or high-tech:

• Low-tech systems: It uses inexpensive equipment that is freely available, like cards, boards, or books with photos or pictures. These types of equipment can help autistic children understand what people are saying, convey their needs, answer people, and express ideas. Examples of low-tech aided AAC are Picture Exchange Communication Systems (PECS) and visual timetables.
• High-tech systems: These types of equipment include expensive and technically developed tools and equipment like speech-generating devices. Many applications are also available that help

What are the most common forms of AAC?

Due to the advent of technology, various tools, techniques, and devices are available for people with an autism spectrum disorder to learn and communicate. Unaided and inexpensive AAC systems are still the most common forms of AAC that are in use for aiding communication.

The most common forms of AAC are:

• Sign language, exchange communication, and Speech Generating Devices (SGDs) are the most common forms of AAC in people with ASD.
• Sign language uses movements of hands for communication. Sign language is a complete language with which most people are familiar. Deaf or people who are hard of hearing use sign language.
• The use and exchange of objects form exchange communication. It involves the transfer of an object to convey the desired want or need. People with ASD give a real object, a miniature object, a drawing, a photograph, or a written word to communicate their needs.
• The use of pictures is the most common form of exchange communication. Parents and teachers can also use drawings of the object for exchange.
• Many teachers also use programs like Clip Art or Google Images to find favorite pictures of the student, toys, or foods for picture exchange.
• The use of speech-generating devices (SGDs) has become popular in autistics. People communicate by touching a picture or word on a device. On touching, it provides speech output. Popular SGDs include:

1. 1. 1. Go Talk,
      2. Partner Four,
      3. Quick Talker,
      4. Tech Talk,
      5. DynaVox,
      6. Maestro,
      7. Accent
      8. Vantage Lite

• Tablets and Smart Phones are the latest gadgets that have become a popular form of AAC. They are less bulky than traditional SGDs and inexpensive. Smart Phones and Tablets are easy to navigate for most users with ASD.

There is a belief that a child should acquire some skills before trying AAC. It is not correct. Children can learn the skills required for AAC, like the ability to push a button while using it to communicate.

If the child with autism can understand the benefits of learning these skills, they will be more motivated to work hard to master them.

Choosing AAC systems for autistic children

Choosing an appropriate augmentative and alternative communication system varies from person to person. It depends on the strengths and needs of the child with ASD. The ability and understanding to use the system consistently are also critical when choosing an AAC system.

Here are some questions for which you should find appropriate answers when choosing an augmentative and alternative communication system:

• Are you taking the AAC system as temporary support until spoken language develops, or use it as a way of communicating?
• Can the child physically use the system?
• Is the system suitable for the child’s strengths and needs?
• Is the system easy to carry?
• Can the child learn and use the system easily?

Considering the above requirements and aspects, you can select the AAC system that suits the child and the caregivers.

The Benefits of AAC

People with Autism require and use AAC when they find it hard to communicate their needs and fail to interact socially. Their inability to express themselves due to lack of developed speech and the problem of understanding their language makes it hard to engage in everyday life.

The followings are the benefits of using AAC in people with autism spectrum disorder:

• Express themselves and help people understand them better
• Communicate more clearly their needs in different environments and with people
• Develop language and communication skills

Augmentative and alternative communication systems are an effective way to learn and use early words. It helps remember the speech, sounds, and visual images of the objects, pictures, or hand signs that correspond to the wording.

AAC can also improve the understanding of words in autistics. Spoken language is often quick, whereas a visual image lasts longer and stays still in the memory. It gives children with ASD more time to understand and process the information.

Conclusion

The practice and the studies confirmed the potential benefits of AAC for people with autism. However, there is a need for more studies and research on targeted outcomes. If an augmentative and alternative communication system is applied as early as possible, the child will use it to communicate more effectively.

Research has also shown that some AAC interventions facilitate speech production. Since every person is unique with varied strengths, each will benefit from a different type of communication system. There is a wide range of AAC systems, but regardless of how you select them; each individual must have an effective means of communication.