Augmentative and alternative communication

According to the American Speech-Language-Hearing Association (ASHA), augmentative and alternative communication (AAC) “includes all forms of communication (other than oral speech) that are used to express thoughts, needs, wants, and ideas.” This can include signing, body language, symbols, or writing for persons unable either to produce or to understand spoken communication. These persons usually have a congenital condition such as cerebral palsy, autism, or a cognitive or developmental disability or delay or have acquired a condition such as traumatic brain injury, Parkinson’s disease, multiple sclerosis, amyotrophic lateral sclerosis, and dementia. AAC allows for these individuals the dignity, self-esteem, and increased independence that come with the ability to communicate. Physicist Stephen Hawking is probably the best-known user of AAC technology.

In 2005, AHSA included “comprehension” in its definition. The International Society for Augmentative and Alternative Communication (ISAAC) defines communication as “a basic human right, one essential to our quality of life of a social species.” This philosophy is enshrined in the United Nations’ Convention on the Rights of Persons with Disabilities. Furthermore, according to the AAC Institute, “The two most important values expressed by people who rely on AAC are (1) saying exactly what they want to say and (2) saying it as fast as they can.”

Background

The earliest forms of alternative communication no doubt go back to prehistoric times. The first documented use of AAC is probably from Plato’s Cratylus, in which Socrates asks: “Suppose that we had no voice or tongue, and wanted to communicate with one another; should we not, like the deaf and dumb, make signs with the hands and head and the rest of the body?” Other forms of AAC existed in the classical world. For persons unable to communicate orally, the only option was a form of sign language. Manual alphabets date to the seventeenth century in Europe, and many American Indian nations had systems of “hand talk.” French sign language dates to 1771 and American Sign Language to 1817. The first widely available communication board was developed by F. Hall Roe, a man with cerebral palsy. In Europe and North America during the 1950s, AAC was increasingly accepted, funded, and used. In the 1960s, sign language gained widespread acceptance in the deaf community as a form of AAC. More recently, AAC has enabled an increasingly greater number of students with disabilities to better participate in mainstream settings.

AAC allows two or more people to communicate without the use of the spoken word. AAC can include such simple means as hand gestures or pointing at an object or picture, a sign language, or an advanced-technology computer-based communication tool. ISAAC cautions that when an advanced tool is used, the selection must be made on the basis of the needs and abilities of the person requiring AAC. Furthermore, though new systems are introduced frequently, it is important that a person’s existing AAC system should never be taken away; rather, the new system should be added to the person’s tools and any decision to retire an earlier system should be left to the individual.

Topic Today

AAC comprises two fundamental types: aided and unaided AAC. The former involves external equipment, ranging from simple nontechnical displays (e.g., pictures) to advanced computerized speech-generating devices. The latter includes facial expressions, lipreading, sign language, pointing, and other gestures. Speech-generating devices fall into two categories: fixed- and dynamic-display devices. Fixed-display devices, such as communication boards, are easier to use and a good tool to teach users more advanced systems. The drawback is that these devices use a set of fixed symbols, which limit communication options, including vocabulary and sentence construction.

Dynamic-display devices allow the user to gain access to multiple categories of subjects and contexts, along with the ability to produce authentic conversation. (DynaVox is a well-known and pioneering maker of such devices.) The user can use a pointer, joystick, keyboard, or touch-screen technology to construct messages. These machines also include digitized and synthesized speech to translate user input into verbal output. Whatever the type of AAC used, persons with a variety of conditions and disabilities have the gift—and right—to communicate with other people.

Bibliography

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