October is AAC Awareness Month. AAC stands for Augmentative and Alternative Communication, but what does that mean? What is it, who is it for ,and where can I find good resources to learn more, if AAC is something that could benefit my child, or someone else I know?
Those are questions I aim to answer in this post. But first…
Last night I had a dream. I didn’t remember it straight away when I woke up today, but as I was getting my breakfast ready, the memory of my dream hit me. In this dream, I was walking along with my son, and he was chatting away. And I was smiling and excited and pinching myself, while looking around and mumbling “This time it isn’t a dream! It’s for real this time, he’s finally talking”. And I was thinking to myself, in the dream, that I knew this day would come, I was right to never give up.
If you’ve followed us for a while here on the blog, or on social media, you probably already know that my son is autistic and nonverbal. He doesn’t talk. He does make some attempts at using a small number of words, but overall he has no spoken language.
Our boy, who for online purposes goes under one of his nicknames, ‘Penguin’, is 13 years old now, and him being nonverbal is our normal. Despite the excitement I felt about him talking in my dream (and I’ve had similar dreams a few times before), I’m no longer desperate for him to talk, like I was during much of his pre-school years. I am however very keen for him to gain a functional way (or ways) of communicating, so that he can express himself and make himself understood, not only by me and hubby, but by anyone he wishes to communicate with.
And this is where AAC comes in.
So, what is AAC?
AAC stands for Augmentative and Alternative Communication. The term is used for describing any kind of communication method which can be used instead of – or in addition to – speech, for anyone who cannot currently use spoken language, for whatever reason. It can be something needed as a more or less temporary solution (for example due to an injury or medical procedure involving the mouth or larynx, or speech loss due to stroke), or it can be needed long term due to a life-long disability causing lack of speech, or very unclear speech, or occasional/situational loss of speech due to severe anxiety etc.
Some forms of AAC are very low-tech or ‘no-tech’. For example using hand signs (such as Makaton), pen and paper for writing or drawing, printed PECS (Picture Exchange Communication System) pictures, printed communication boards, PODD communication books, a simple battery powered device offering a very limited number of buttons with pre-recorded messages, or tactile symbols for individuals with impaired eye-sight.
Body language and facial expressions are also forms of no-tech ‘augmentative and alternative communication’, though what can be communicated through those is relatively limited.
High-tech AAC can be in the form of a robust communication system on a designated, speech generating computer device (like a large tablet), with an almost indefinite amount of words. It usually has pictures (with or with out text) that you press in order to communicate. Such AAC systems often also exist in an app version, which you can use on an iPad or similar (which is less expensive than a designated device).
There can also be text to speech, meaning that you write something and the device then reads it out. This can be as part of a high-tech AAC system, or as a separate app.
Who can use AAC?
Well basically, anyone who needs to! There are no actual prerequisites, no specific skill sets that need to exist in a person before they can start learning to use AAC of some kind. There is also no hierarchy between the different types of AAC, so for example there’s nothing that says you should start with low-tech and work your way ‘up’ to high-tech. If you are told that your child has to master a low-tech system first before they can advance to a high-tech, this is probably not based on your child’s best interest, but rather on a wish to save money or a lack of knowledge (or both).
The type of AAC that will be suitable for a person depends on the individuals needs and preferences, as well as on what is physically possible for them to use. If a person is unable to point with their hands, there’s technology which allows them to use their eyes to make choices on a device. If someone is literate and able to write, then a text-to-speech app might serve them really well.
The important thing is to find a functional method of communicating, which serves the indivudual well. It can be really hard to know in advance if a person will take to PECS or signing or an AAC app or device, so often it’s a good idea to offer more than one option, and see what works.
It can also be a good thing to have more than one way of communicating. For example, if you run out of battery on your high-tech device, it’s helpful to have some kind of low-/no-tech option. And if you use signs, that only works if the person you’re communicating with can see you and understands the signs, so another alternative can be needed too.
Before we move onto more about actually starting to use AAC, here’s a brilliant 5 min short film about AAC made by filmmaker Jemima Hughes, who herself uses a high-tech AAC device: https://www.bbc.co.uk/ideas/videos/how-to-speak-when-you-dont-have-a-voice/p07693kc?playlist=redefining-disability
Learning to use AAC & Using AAC in learning: A collection of helpful resources
If you’re lucky to have a network of passionate professionals around your nonverbal child, or other speech impaired person you are caring for, you may be able to rely on them for help with figuring out what AAC to use, how to get access to it, and how to implement use of it. However, many of us don’t have the level of support we could wish for, or don’t find it reasonable to wait for referrals etc before getting started with AAC.
The good news is that unless you are in need of any of the most highly advanced technological features, you can take it into your own hands and get started straight away! There is an abundance of helpful material available online, on how to get started etc, and when it comes to AAC apps for iPad (or similar) there are often free trial versions available.
Right now, during AAC Awareness Month this October, there are also several generous special offers available (note that most are for a few select dates only, not for the full month). Click on my fb post below to find out more!
We are currently ourselves learning to use Grid by Smartbox on iPad. We’ve had it for quite some time now (I think it’s about a year?), and before then we had another AAC app, which got outdated, and before that one we had yet another app but in Swedish (I’m originally from Sweden, Penguin was born there, and we were living in Sweden when he was younger).
We’ve previously used PECS, and have tried to use some Makaton. Penguin was quite happy to use PECS to request his preferred snacks, but we never really got further than that. He isn’t keen on signing, but I use a few signs now and then so that he learns to recognise them, and has the option to use them if he’d like to.
This post isn’t meant to focus too much on our own ‘AAC journey’ though, so I’ll move swiftly on to sharing some of the many great online resources that I’ve come across, which I think will be helpful to you if you’d like to work on using AAC with your child (or other person).
All links below will open in a new window, when you click on them.
PrAACtical AAC Fantastic site run by SLP professor Carol Zangari. Sharing activity ideas, research, webinars, videos etc. I would recommend following on facebook or other social media as well.
Project Core A super helpful website focusing on getting people started with a ‘universal core vocabulary’ of 36 very versatile words. Core words are words that can be used in many different conexts and for many purposes (words like: put, not, look, go, want, on, like, good, off, etc.). From the Project Core website, you can print out communication boards with those 36 core words, for free. They also have a free course consisting of 12 modules which you can take online at your own pace! I did the pilot version of that course in 2017, but I’m taking it again at the moment, to refresh my knowledge.
Communication Matters is a UK charity and the UK section of the International Society for Augmentative and Alternative Communication (ISAAC). Their website can be helpful if you are looking into getting AAC needs professionaly assessed and possibly getting an AAC device via NHS. They are also quite active on social media, and organise events of various kinds (online and IRL).
Smartbox This is the UK based company who makes the Grid software we’re currently using, and they have some helpful resources for getting started with AAC (as well as of course info on their own products). They also offer face to face visits to try out their AAC devices etc.
Fab facebook pages to follow:
Mrs Speechie P Texas-based SLP with an interest in AAC and autism.
SENSEable Literacy Another US SLP, focusing on literacy and AAC.
The AAC websites mentioned above also have pages on social media that can be well worth a follow!
AAC videos available on YouTube:
There are loads of great webinars, short films, home videos, instructional videos etc available on YouTube. I have a playlist on there, which I add to now and then when I come across something which I find useful or inspirational. Please take a look at it HERE to see what videos might interest you.
One of the most recent additions to my playlist is this webinar called ‘I Have a Device, Now What?’, which I found via PrAACtical AAC. It discusses the foundations for getting started with high-tech AAC, basic strategies for learning, and goes through a lot of further resources for finding activities, support etc (some of which I’ve mentioned in this post):
The Autism Page has this great post about what PECS is and how to use it. After reading that, take a look at some of the other posts about PECS on the same site: https://www.theautismpage.com/?s=PECS
There is also an official UK website for all things PECS.
If you’ve been watching programs on CBeebies over the last few years, you might already be familiar with Makaton, as it is what Mr Tumble and his friends use in series like ‘Something Special’. If you wish to learn Makaton together with a little one, the official YouTube channel for Mr Tumble & Friends can be great resource.
There’s also a super helpful video on the’ Something Special’ section of the CBeebies website, about getting started with Makaton.
To find more information about starting to use Makaton, courses and training etc, check out the Makaton Charity’s website.
For more video clips of Makaton signs, follow MagicMum3Stars on fb (also on YouTube, Instagram etc) and Makaton with Lucinda on Twitter (also on fb, Instagram etc), and the Makaton Charity’s social media.
AAC groups on facebook:
(These are four of the biggest groups. Search ‘AAC’ to find more that may be of interest to you.)
A few final words…
Some of things I’ve learnt over the years are:
- The best time to get started is… today. Don’t put it off, and don’t mull over whether it’s ‘too late’. There’s no time like the present.
- Presume potential. Don’t let anyone tell you (even your inner voice) that your child is ‘too disabled’ to learn any kind of AAC.
- Be patient. It takes time to learn a language, so let it take time to learn how to communicate using AAC.
- Model. That means to use AAC yourself, so that your child sees how it can be used. This is easier said than done, and definitely something I feel I could have done more.
- Be open to all forms of communication, and remember that behaviour is communication too, so when someone is behaving ‘badly’, try and figure out the reasons behind and what they might be trying to communicate, rather than just extinguish their behaviour. Some children (and adults) will also figure out their own forms of AAC, such as Miriam’s son Isaac who is nonverbal and uses Google Maps for some of his communication needs.
The resources I’ve linked to in this post are just a selection of what I’ve come across online, and I’m sure there are many more. Please feel free to suggest additional resources in the comments! I will most likely also update this post now and then to add more websites etc, and when I do so I’ll put a note at the top with date of latest update.
If you too are on an AAC journey (whether no-tech, low-tech or high-tech), I’d love to hear about it in the comments below. Please feel free to ask questions as well, and I will try to answer them.
I was kind of surprised that I dreamt about Penguin talking again, as it’s been quite a while since the last time I had one of those dreams, and I would have said that I’ve accepted that he most likely won’t develop fluent speech (like what he had in my dream). Helping him learn to communicate more efficiently, in whatever forms that may suite him, is however a constantly ongoing project.
Thank you so much for reading! I hope that you’ve learnt something useful from this post, and if you think it might be helpful for others to read too, please share it!
PS. The abstract illustrations used in this post are from paintings made by our Penguin. I have always had an interest in artistic expression such as art, photography, music etc, and these can also be alternative forms of communication!