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Augmentative and Alternative Communication

Michelle Lange, OTR/L, ABDA, ATP/SMS

November 30, 2022

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Question

I am studying for the Assistive Technology Professional (ATP) exam.  Can you explain AAC and what is considered AAC? 

 

 

Answer

AAC

AAC stands for Augmentative and Alternative Communication. AAC is defined by ASHA, the American Speech Language Hearing Association. They define AAC as an area of clinical practice that supplements or compensates for impairments in speech-language production and/or comprehension, including spoken and written modes of communication. Augmented communication supplements existing speech. For example, perhaps someone has some difficulty with their speech and they might be difficult to understand or have difficulty communicating throughout the day. They might require their speech to be augmented by other strategies. Alternative communication replaces speech that's absent or not functional. 

AAC uses a variety of techniques and tools that help someone express their wants, thoughts, needs, feelings, and ideas.  It can include many different strategies such as manual signs like sign language or gestures. We all use gestures throughout our day. We might use finger spelling which is a specific type of manual signing. We might use tangible objects to point to something that we're talking about. We might use line drawings to represent something that we are communicating. There are also picture communication boards and letter boards that use just as it sounds, pictures, letters, and or symbols in a low-tech fashion. Someone can look at their desired vocabulary or touch their desired vocabulary or all the way up to our highest tech option which is a speech-generating device. Centers for Medicaid and Medicare refer to these as speech-generating devices, sometimes shorthanded to SGD. They might also be referred to as communication devices.

Unaided communication systems

For AAC, we might have unaided communication systems.  Unaided communication systems include gestures, body language, and sign language. Ther term "unaided" is used because the patient does not have to carry something around with him/her. I have my method of communication on me. Instead of using my voice, I might be using sign language, for example.

Aided communication systems

Aided communication systems may include something as simple as pen and paper. It may also include the texting feature on your phone, communication boards, books, and devices that provide an actual voice input or written output so that someone can hear what I am telling them or they can read what I am telling them, or both. A SGD or speech-generating device produces speech or voice output. Typically there is a display that will also show what the person has just spoken, and that can be really handy. If it's a busy day and there is a lot of noise in the background, I may not have heard everything this person said. I can quickly glance down at their display and say, "Oh, hi, my name is Michelle" because perhaps they just asked me what my name is. An SGD  produces speech or voice output as well as usually some type of displayed output of what has just been spoken. There are multiple access methods that allow someone to control the device. The displays are almost always dynamic now, meaning that the display can change. So let's say I have a home page and I select food. I want to tell you what food I would like to eat. I will now see a new page of all of my options for food-related vocabulary, and there are multiple communication strategies built into these very sophisticated devices.

Keep in mind that many people using a wheelchair may have difficulty with their communication, either difficulty understanding or being nonverbal. Those people need their communication devices with their wheelchairs. They may be controlling the communication device through a power wheelchair driving method, for example. There are a number of areas where our practice areas in assistive technology overlap, and this is certainly one of them.

This Ask the Expert is an edited excerpt from the course, Let’s Talk Augmentative And Alternative Communication: Preparing For The ATP Exam presented by Michelle Lange, OTR/L, ABDA, ATP/SMS


michelle lange

Michelle Lange, OTR/L, ABDA, ATP/SMS

Michelle is an occupational therapist with over 30 years of experience and has been in private practice, Access to Independence, for over 15 years. She is a well-respected lecturer, both nationally and internationally and has authored numerous texts, chapters, and articles. She is the co-editor of Seating and Wheeled Mobility: a clinical resource guide, editor of Fundamentals in Assistive Technology, 4th ed., NRRTS Continuing Education Curriculum Coordinator and Clinical Editor of NRRTS Directions magazine. Michelle is a RESNA Fellow and member of the Clinician Task Force. Michelle is a certified ATP, certified SMS, and is a Senior Disability Analyst of the ABDA.


Related Courses

Matching Products to Seating Needs
Presented by Michelle Lange, OTR, ABDA, ATP/SMS
Recorded Webinar

Presenter

Michelle Lange, OTR, ABDA, ATP/SMS
Course: #4099Level: Introductory1 Hour
  'easy to follow, well organized, very clear'   Read Reviews
Once the wheelchair seating assessment has been completed and seating interventions considered, it is time to match specific client needs to product interventions. This course presents various categories of seating systems. Seating systems, whether linear, contoured, or molded, are comprised of primary support surfaces, secondary support components, and materials. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.

Dependent Mobility Intervention
Presented by Michelle Lange, OTR, ABDA, ATP/SMS
Recorded Webinar

Presenter

Michelle Lange, OTR, ABDA, ATP/SMS
Course: #4102Level: Introductory1 Hour
  'well organized, clearly presented, easy to follow, a lot of tips and illustrations'   Read Reviews
Dependent mobility devices are not designed for self-propulsion. These include adaptive strollers, transport chairs, tilt-in space manual wheelchairs, reclining manual wheelchairs, and standard manual wheelchairs. For very small children, adaptive strollers are often required to meet positional and dependent mobility needs. Other dependent mobility bases, such as transport chairs and standard wheelchairs, are used for quick trips or for temporary use. Clients may also use a dependent mobility base as a backup to a power wheelchair. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.

Let’s Talk Augmentative And Alternative Communication: Preparing For The ATP Exam
Presented by Michelle Lange, OTR/L, ABDA, ATP/SMS
Recorded Webinar

Presenter

Michelle Lange, OTR/L, ABDA, ATP/SMS
Course: #4621Level: Intermediate1 Hour
  'good presenter, concise, good basic overview for those unfamiliar'   Read Reviews
Augmentative and alternative communication (AAC) in the context of preparing for the ATP examination is presented in this course. The course will address terminology as well as the HAAT model to explore key features including access, display layout, optimizing access, programming, mounting, and integration of systems.

Recreational Technology For People With Disabilities: Preparing For The ATP Exam
Presented by Michelle Lange, OTR/L, ABDA, ATP/SMS
Recorded Webinar

Presenter

Michelle Lange, OTR/L, ABDA, ATP/SMS
Course: #4626Level: Introductory1 Hour
  'Great ideas for recreation for those with disabilities'   Read Reviews
This course presents recreational technologies in the context of preparing for the ATP examination. The course addresses a wide variety of important recreational and exercise technologies available for people with disabilities.

Computer and Tablet Access
Presented by Michelle Lange, OTR, ABDA, ATP/SMS
Recorded Webinar

Presenter

Michelle Lange, OTR, ABDA, ATP/SMS
Course: #4128Level: Intermediate1 Hour
  'It was structured well and organized, containing clear concise information'   Read Reviews
This course will present a hierarchy of computer and tablet access options for clients unable to use standard access, such as a keyboard, mouse, and touch screen. Access assessment requires analysis of motor skills, vision, cognition, and functional applications. Alternative keyboards and mice will be presented, as well as other alternative access options. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.

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