What Is Augmentative-Alternative Communication (AAC) and Who Uses It?

What Is Augmentative-Alternative Communication (AAC) and Who Uses It?
Most people cannot even imagine not being able to speak. Maybe you have travelled in a country where you didn't speak the language or maybe you have suffered from a bad case of laryngitis and lost your voice? How did this temporary inability to speak make you feel? You may have felt frustrated, but at least you new it was temporary and you were able to use compensatory strategies such as a translation dictionary, gestures, pointing or writing to communicate.

Many individuals who require the use of augmentative-alternative communication (AAC) are also unable to use compensatory strategies such as gestures and pointing due to either cognitive, social skills challenges and/or physical disabilities. AAC is vital for any person who is unable to meet their communication needs using natural speech.

American Speech-Language-Hearing Association (ASHA) estimate that approximately 2 million Americans are unable to speak well enough to meet their communication needs. Without appropriate AAC systems these individuals are unable to communicate even they're most basic wants and needs. This article will explain different types of AAC and how AAC can help non-verbal individuals become more independent, functional communicators.

ASHA defines AAC as:

"...an area of clinical practice that attempts to compensate (either temporarily or permanently) for the impairment and disability patterns of individuals with severe expressive communication disorders (i.e., the severe speech-language and writing impaired) (ASHA, 1989, p.107)."

Who Uses AAC?

There are numerous types of disabilities that may result in an individual needing an AAC system. These disabilities include congenital disorders such as developmental apraxia of speech, autism spectrum disorders, developmental delay, specific language disorders, intellectual disability, cerebral palsy as well as acquired disorders such as ALS (amyotrophic lateral sclerosis), multiple sclerosis, stroke, traumatic brain injury and spinal cord injury.

What are some examples of AAC?

AAC is broken into two categories: Unaided methods which require no equipment include gestures, sign language, and finger spelling. Aided methods include: communication books or boards that may contain pictures, photographs, words and/or speech generating devices (SGD).

Many AAC users use a combination of methods including both unaided and aided methods. For example, a child AAC user may use a SGD through most of his day but uses a no-tech communication wallet containing pictures while on the playground so as not to risk damage to his SGD during this activity (aided). The same child may use head nods to answer yes/no questions through out his day (unaided). Thus, this AAC user uses both unaided and aided AAC.

Why use AAC?

The idea of alternative forms of communication may sound scary to parents of young children who are non-speaking. Every parent wants their child to learn to speak naturally. There is hope that young children will develop natural speech and in many cases speech production should be targeted aggressively in speech therapy. However, it is not advised to wait for speech to develop before teaching language and communication skills to non-speaking children. While you wait for natural speech to develop, your child is missing out on learning how to use complex language structures, develop social skills and pre-literacy skills. All of which significantly contribute to school readiness. Additionally, poor communication skills often result in frustration and the development of problem behaviors.

I am afraid my child will not learn to talk if he uses AAC?

When a child has adequate speech skills to meet his communication needs he will always prefer to use natural speech over a communication device. It is much easier to speak than to find your communication device....go through the pages.... find your message and show your communication partner. If a child has the ability to consistently speak his message he will prefer to use natural speech.

Many parents of non-speaking children desperately want to hear their child's voice and are sometimes reluctant to implement AAC strategies for fear that their child will prefer the AAC system to natural speech. This is an unfortunate misconception held by some parents and some misinformed professionals. This belief could not be further from the truth. Clinical research in the field of speech-language pathology has proven that the use of AAC strategies improves natural speech production and in no way inhibits the use of speech.

How can the use of AAC strategies improve natural speech?

When children learn to use an AAC system they are learning the power of communication (maybe for the first time). When children learn to communicate effectively they tend to want to communicate more often and for different reasons (e.g., expressing feelings, commenting and greeting). Thus, AAC strategies foster independence through communication. Language skills improve as children learn to put words together and create longer messages, learn new vocabulary words and concepts. Research also shows that social interaction skills improve as a result of the use of AAC strategies. Also, children will often try to imitate words they hear produced through their communication devices thus, facilitating natural speech production.


  1. AAC Institute. (n.d.) What is AAC? In www.aacinstitute.org Retrieved July 14, 2009. Available
    from http://www.aacinstitute.org/AAC.html

  2. American Speech-Language-Hearing Association. (2005). Roles and Responsibilities of
    Speech-Language Pathologists With Respect to Augmentative and Alternative
    Communication: Position Statement. In www.ASHA.org. Retrieved July 14, 2009. Available
    from http://www.asha.org/docs/html/PS2005-00113.html

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