VoiceforLiving.com

 

For a wide range of conditions that affect a loved one’s ability to speak, many families are finding an answer in augmentative and alternative communications (AAC) – a class of electronic devices and software that serve as a substitute for the human voice. One of the most amazing things about AAC is that the more people learn about it, the more they wish they’d heard about it sooner. So we’ve made sure to give you enough information to dive right in.

---

Common questions and answers about AAC

When you or a loved one cannot speak, you have lots of questions for which it seems hard to find answers. Here are some of the most common questions and their answers.

What is AAC?
AAC is any device, system or method that improves the ability of a Person with a speech or language impairment to communicate effectively. While AAC often refers to formal devices and systems, including sign language, communication boards and speech-generating devices (SGDs), it can include less sophisticated means of communication such as facial expressions, non-speech vocalizations and gestures. An SGD is a device that is used to generate audible spoken words or phrases from a user’s input. This input may use symbols, letters or text, depending on the person’s cognitive abilities.

AAC is not merely a substitute for current communication methods; it is used to augment that communication, replacing only elements that are unintelligible.

What is an SGD?
A speech-generating AAC device or SGD is similar to a laptop computer and is specifically designed to assist a Person with communicating. These devices can incorporate touch screens, keyboards or switches, and employ symbols and letters that allow someone to generate meaningful words and phrases to convey feelings, thoughts, needs and desires. SGDs can use either a recorded voice that is “played back,” or speech synthesizers that generate audible sounds and words using a speech engine that resides inside the software. Devices come in a range of sizes and types to AACommodate a spectrum of user cognitive and motor abilities.

How does AAC work?
AAC works by supplementing or augmenting the elements of communication that the person is unable of doing on their own.  For instance, many people with conditions like Autism or Cerebral Palsy often can communicate some of their needs and wants, but are more challenged to communicate complex concepts or those requiring a higher level of language formulation.  For example, John may be able to answer “no” to the question “are you hot?”, but unable to extend that response to say “ But I would like you to turn on the fan.”  With an AAC device, and the proper language application, John would be able to give that more specific response.

Are there different kinds of AAC devices?
AAC devices come in a variety of sizes, shapes and capabilities.  In general, they vary by screen size, input method (keyboard, dynamic or touch screen display, static button) and even more by the software or applications that they use.  Even with these various types of devices, individuals often require an alternate method of AACess. 

Keyboard devices operate much like a computer keyboard, where text is entered to form the phrase or sentence and then the device is used to speak the message.  With dynamic displays, the device has added flexibility and can be programmed to display a wide variety of symbols, words and pictures for the user to select from either directly, by touching the screen, or indirectly with an alternate AACess method.  For instance, someone with limited mobility and motor skills may require a special button or switch to AACess the device.  In fact, many AAC users even use what is referred to as “scanning” AACess in which a laser or infrared transmitter is attached to the individual’s head.

Another category that is used to classify AAC devices is the way in which the “voice” is generated.  Basically, this includes either “digital” or “synthesized” speech generation.  With digital voice generation, the actual words or phrases must be recorded into the device and then “played back” when the user selects those words or phrases.  With synthesized speech generation, the device software is actually generating the voice using a “speech engine” which is simply a program that turns letters, words, and phrase combinations into actual audible speech.  These programs are similar to those in use today on GPS or Global Positioning Systems in cars; in automated elevators and a variety of other applications.  Speech engines can be very sophisticated and can simulate voices of male and female children, adults and even some regional AACents!  In the end, the more sophisticated AAC devices include capabilities that help make communication faster, easier and more natural for the user.

How will AAC technology help me or my loved one?
AAC technology can help close the communication gap that separates those who can’t speak from their peers, parents, spouses and family members.  Someone who is unable to communicate effectively is also unable to participate meaningfully in many activities, and is at greater risk for delays in cognitive, social and emotional development. On the other hand, those who use AAC have shown improvements in behavior, attention, independence, self-confidence, class participation, academic progress and social interaction.

Will these devices impede my loved one’s ability to speak?
This is a common concern raised in regard to AAC technology solutions as this technology is frequently viewed as the solution of last resort and the end of hope of achieving natural speech. However, numerous studies* have shown that the introduction of AAC correlates with the improvement of natural speech even in situations in which there has been no speech therapy.

*Berry, 1987; Daniels, 1994; Romski & Sevcik, 1993; Konstantareas, 1984; Silverman, 1980

How do I get a device for myself or my loved one?
AAC devices are usually recommended by a Speech-Language Pathologist  (SLP) following an evaluation of individual abilities, needs and communication goals. The evaluations also assess and compare different devices to determine the system that will achieve the highest level of communication success. In cases where the device will be paid for by insurance or other funding, a prescription from your child’s physician may also be required.

How do I pay for the device?
In most instances, AAC devices are paid for by one or several available funding sources. These can include, but are not limited to, school districts, Medicare, Medicaid and private insurance. There are also nonprofit organizations, such as the National Organization Caring for Kids (NOCKonline.org), that work to provide devices for those who do not qualify or who do not have AACess to funding sources for AAC. Some device manufacturers also assist with the funding process – and that can be a huge help for you.

How and who actually implements the device?
The most effective AAC solution involves an integrated team consisting of anyone who has an interest in or is involved with the child, or has knowledge or expertise that would be helpful in developing and implementing a communication program. The team could include parents or caregivers, family members and friends, Speech-Language Pathologists (SLPs), physical therapists (PTs), occupational therapists (OTs), special education teachers, regular education teachers, assistive technology specialists and medical doctors. Most often, the SLP takes a lead role in integrating the AAC device into an individual’s communication system. The SLP assists with programming the device and working with the child to ensure success with the system selected.

Sources for locating an SLP experienced in AAC technology include the American Speech-Language-Hearing Association (ASHA.org) and speechtherapist.net.