Introduction to AAC and Recent developments in

the field

Alecia SamuelsCentre for Augmentative and Alternative Communication

Learning objectives

• Understand how AAC can be used to improve functional communication skills

• Understand different methods of AAC• Understand how AAC can benefit children and Adults• Understand the latest development in terms of • Understand the latest development in terms of

technology• How to access specialists and additional resources to

assist in AAC solutions for those with complex communication needs.

Tell me about

• What you have communicated about so far today?• How you communicated• Why did you communicate

Communication and Language

Communication and language skills allow a person to…� Initiate, maintain, and terminate conversations� Establish/maintain interpersonal relationships� Share ideas� Express feelings� Give information� Ask questions� Describe events� Solve problems� Direct others� Entertain� Show imagination� Refuse� Learn� Function with greater independence

WHAT IS AAC?

Augmentative and Alternative Communication refers to any strategy, technique or tool that strategy, technique or tool that enhances, replaces, augments or supplements an individual’s

communication capabilities.

What is AAC?

• Includes all forms of communication that are used to express thoughts, needs, wants, and ideas

• People with severe speech or language problems rely on AAC to supplement problems rely on AAC to supplement existing speech or replace speech that is not functional.

• We all use AAC when we make facial expressions or gestures, use symbols or pictures, or write.

Augmentative and Alternative Communication Approaches

• Speech• Vocalization• Gestures• Eye gaze• Body language

• Paper and pencil• Communication

books• Communication

boards and cards• Body language• Sign language

boards and cards• Speaking computers• Talking typewriters• Voice output

communication aids

WHO IS AN AAC USER?

Anyone whose communication is adversely affected by an adversely affected by an impairment in speech,

language, cognition, and/or physical abilities.

In education who relies on AAC ?

• Learners with significant problems in communicating using speech.

• Variety of disability groups: Physical-, intellectual-, sensory-, Physical-, intellectual-, sensory-, multiple disability, autism, DAS

• Learners whose 1st language differs from the language of teaching and learning (classroom language)

Benefits for the teacher

• Ensures that reach children with different learning styles e.g visual learners.

• Helps children to concentrate on the activity being presented

• Ensures that you reach children in your class with different home languages, as there is always a visual clue to help learn new vocabulary being taught in the classroom

How is AAC used in Education?

Graphic symbols are used to help the learners:– Understand classroom rules and instructions– Understand content– Express what they know about what they have been

taughttaught

Understand Classroom rules

Understand an activity e.g. Brushing teeth

Understand the curriculum

� “Try and see” vs “wait and see”

� Facilitate language development(receptive and expressive)

� Provide children with power and control

Goals of AAC in Education

� Provide children with power and control

� Enhance social interaction

� Increase independence

Aided visual strategiesAided language stimulation: Song

boards, story boards, activity boards

Helping learners to understand

boards

Did you know?

Did you know

•• The typically developing child will The typically developing child will demonstrate complete language demonstrate complete language competency around 9competency around 9--12 years of age 12 years of age having been immersed in and practicing having been immersed in and practicing having been immersed in and practicing having been immersed in and practicing oral language for approximately 36 500 oral language for approximately 36 500 waking hours.waking hours.

•• So for 9So for 9--12 years that child has been 12 years that child has been using and receiving corrective feedback using and receiving corrective feedback while practicing the spoken word.while practicing the spoken word.

Did you know

•• If a child receives intervention If a child receives intervention twice a week for 30 minutes it twice a week for 30 minutes it will take a child who is using will take a child who is using AAC 701 years to have the same AAC 701 years to have the same language competence and language competence and language competence and language competence and experience as a child who uses experience as a child who uses spoken language.spoken language.

Jane Jane KorstenKorsten (2011) QIAT list (2011) QIAT list serveserve

Importance of Aided language Input

• No one would dispute that it would be very difficult to become fluent in a new language if your instructor seldom used the language in your presence.

• In the same way it is difficult for a non speaker to become proficient in AAC if other people never model using it in an interactive way.using it in an interactive way.

• Prospective AAC users must be provided with frequent examples of interactive, generative use to acquire any semblance of proficiency.

• If an individual is to gain AAC proficiency in using their AAC system others must begin to use their AAC system with them.

Aided Language Stimulation

• Strategy that helps learners to understand instructions, ideas and the curriculum better.

• Teacher points to, or shows picture symbols on a communication display as she speaks.

• So the learner is not just hearing the message but also can see it i.e. making the message visible.

• 80:20 Ratio (Statements: Questions)

huis

House

burning come quickly

Aided Language Stimulation SONG BOARD

brand kom vinnig

Vuur gooi

pour

water

water

AAC Myths and Legends

• Introducing AAC will stop someone from developing speech.

• Low technology before high tech.• Has a little speech so does not need AAC.• Too cognitively impaired to use AAC.• Too cognitively impaired to use AAC.• AAC will fix communication difficulties• Too young for AAC• Does not need AAC because can express basic needs

Common Clinician mistakes

• All or nothing mentality considering AAC only when individuals are not succeeding with speech.

• Fearing AAC will impede progress with speech (“make ittoo easy”) – communication should be easy!

• Limiting AAC options to basic needs – most of us • Limiting AAC options to basic needs – most of us want to tell people other things than “I need to go to thebathroom”.

• Too little intervention - giving someone a device orcommunication board and expecting them to use it.

TECHNOLOGY

LOW TECHNOLOGY

Non Electronic Electronic

HIGH TECHNOLOGYMid Tech Advanced

Low tech and High tech

Single message SGD’s

Big MacStep by step

Italk 2

Ideas for single message SGDS

• Asking for “help”at computer, bathroom door, doing work• Place by door so student can say “go”• Attention getter (come here please)• Social (hi, how’s it going?, bye)• Making a choice partner presents choices verbally and

‐student hits VOD saying “That one‐I want that one”• Repetitive lines in stories• Delivering messages from home to school, from classroom

to the office• Requesting “more”• Book reading‐ “turn the page”

Multimessage SGD’s

Talara

Go Talk

Communication Builder

Talara

Ideas for multi message SGD’s

• Can have a separate overlay for a specific activity such as reading a book with generic comments. – “That’s funny/scary”. “I like that./don’t like that”– Read it again, etc)

• There are many stories that have either repeated text or • There are many stories that have either repeated text or just a few parts to the story. Goldilocks’, ‘who ate my porridge?’ etc.

High tech AAC

• Custom speech generating devices• Mainstream Technology

– Ipod touch/Ipad/– Android tablets– Android tablets– Laptops– AAC software and apps

High Tech AAC

Historically had• research and development before being released.• Vocabulary systems which reflected good practice• Accompanied by teaching materials and supportButBut• High production costs in a relatively small market • made the price inaccessible for most parents and

families.

Mainstream Mobile Devices for AAC

Mainstream mobile technologies

• Ipad changed the face of high tech AAC dramatically• AAC becoming consumer driven• More easy accessible and therefore AAC has become

more mainstream• There are now approximately 200 AAC apps on the • There are now approximately 200 AAC apps on the

itunes store there is also now alot of choice.• Anyone can now get a high tech AAC system for under

R10 000.

Media/stories

http://www.wired.com/geekdad/2011/03/ipads-are-not-a-miracle-for-autism-geekdad-opinion/

Questions to think about

• How do I know which mobile device or app to choose?• Are they worth the cost?• What DO they offer which mainstream speech

generating devices don’t.• What DON’T they offer which traditional SGD’s do?• What DON’T they offer which traditional SGD’s do?

AAC Apps

• Approximately 200 AAC apps (applications) on the itunesApp store

• 75% of apps are designed by people with no background in communication.

• Unfortunately many apps don't reflect good practice and research.research.

Example 1 • We know that category based AAC organisation slows

down communication and impedes the development of language and communication skills

• We have known this since the 80s • Despite this, 43 of the AAC Apps on the App store (at the

time of writing) are straight category based apps.

AAC Apps (Cont)Example 2 • We know that voice output encourages speech

development • Some app developers don't include speech in their AAC

Apps claiming that this is because speech output will impede speech developmentimpede speech development

Example 3• We know that providing an AAC system at all times and

modelling use of the system throughout the day in multiple situations leads to maximum language development and best outcomes

• In the instructions for several AAC Apps users are advised to allow access to the user only a couple of times a week until they become more competent

AAC Apps (cont)

• Good news is that there are some well designed apps which reflect good practice.

• And their numbers are slowly growing.• Too many apps still lacking a research base.

Proloquo2go SonoflexSounding board

What the current research is telling us

Question asked: Was an evaluation conducted to determine the iPod/iPad would be the most appropriate communication system?

• YES- 54.4%• NO- 55.6%• NO- 55.6%• What does this tell us?– How do we know if it is the best system?– Feature/Skill matching?

– Need to match the student to the tech not the tech to the student NB NB NB

Coming back to previous questions

• How do I know which mobile device or app to choose?• Are they worth the cost?• What DO they offer which mainstream speech

generating devices don’t.• What DON’T they offer which traditional SGD’s do?• What DON’T they offer which traditional SGD’s do?

MOBILE DEVICES &COMMUNICATION APPSAn AAC‐RERC White Paper

Assessment is crucial

• Need to know what the capabilities are of the user

Assessment-feature matching• And find a device which has feature which match the

users capabilities.

AAC app comparisons chart

Rubrics for Evaluating the Language of Apps for AAC

Some useful resources

• Centre for AAC -for consultations and contact information of therapists who are trained in AAC– www.caac.up.ac.za– (012) 420 2001

• AAC Tech connect http://www.aactechconnect.com/– AAC device assistant– AAC device assistant– AAC apps assistant– AAC feature matching resources

• Spectronicshttps://www.spectronicsinoz.com/iphoneipad-apps-for-aac

Nothing speaks of the success of AAC than examples of AAC users

Thank you

For more information:Contact the Centre for Augmentative and

Alternative Communication : 012 420 2001alecia.samuels@up.ac.za;