Augmentative and Alternative Communication

          The American Speech and Language-Hearing Association states that AAC includes all forms of communication, other than oral speech, that are used to express thoughts, needs, wants and ideas.  Everyone uses AAC when they use body language, facial expressions, and gestures, or with pictures, symbols or when writing.  It includes symbols, aids, strategies, and technique to improve communication (ASHA, 1997).  AAC tools are to augment incoherent speech and to provide an alternative when speech and language development is incomprehensible. As a part of normal development, children learn to communicate.  When a child cannot verbally communicate, it can cause frustration, and can lead to behavior issues (AAC and Autism, 2009).  AAC provides children with disabilities with the means to communicate and therefore, express themselves.  It supplements existing speech or sometimes is the only means of speech.  The tools used to for AAC are assistive technology tools.  These tools increase social emotional development and language development in children and include anything that assists communication, such as American Sign Language (ASL), a picture exchange communication system (PECS), and low and high technology speech output devices, including Apple’s IPad (ASHA, 1997). 
            There are many types of AAC tools.  A low-tech tool is simply a tool that does not need batteries.  Users may use a simple head nod or eye gaze to communicate.  These tools can be as straight forward as a picture, and include ASL or Picture Exchange Communication System (PECS).  According to an article in the Journal of Applied Behavior Analysis, PECS is a pictorial system developed for children with communication needs.  The pictures are adhered with Velcro on either a notebook or their PECS board (Charlop-Christy, Carpenter, Le, LeBlanc, & Kellet, 2002). The goal is for the child to not only identify the pictures, but also eventually make sentences.  At the start, they will make “I want” sentences by choosing a picture of the snack item they want for snack, water or milk for example.  A child uses this system to initiate requests, respond to questions, and make social comments (Charlop-Christy, Carpenter, Le, LeBlanc, & Kellet, 2002, p. 214).  Children learn to scan with PECS, once they understood this technology, they move onto more high technology tools. 
               A high-tech tool is a tool that needs batteries. These tools include voice output devices that produce sound when activated.  These devices offer a nonverbal child an opportunity to voice their needs (Why use a voice output communication device?, 2009).  They can be activated directly (direct selection/manual selection) by touching the device or indirectly (alternative activation) using another type of switch (ASHA, 1997).  The Center for AAC & Autism website states that an advantage to voice output devices is that they allow the child to “talk.”  This in turn allows the communication partner to understand what the child wants or intends.  The output also allows the child to know immediately if what the voice output device said is what they meant to communicate providing immediate clarity in their communication (Why use a voice output communication device?, 2009).  These systems allow a child to begin to advocate verbally for himself by allowing them to ask for what they want or need.