Patricia Ourand - More than words: Augmentative and alternative communication
More than Words:
AUGMENTATIVE AND ALTERNATIVE COMMUNICATION
PATRICIA OURAND, MS, CCC-SLP
ASSOCIATED SPEECH & LANGUAGE SERVICES, INC.
The Big Picture
The Power of Communication
"If all my possessions were taken from me
with one exception, I would choose to
keep the power of communication, for by
it I would soon regain all the rest“
• Identify, demonstrate, and
discuss strategies that facilitate
using expressions, gestures,
symbols, photographs and/or
illustrations, and text, among
others RFS’s copy of a B, which he is able to see
clearly, and an 8, which he sees only as a
jumble of lines with color in the background
• RFS is a 61-year-old geological engineer with a progressive
• In October 2010 he suddenly found himself unable to perceive Arabic
digits, such as 4 or 8
• Since that time, he sees digits only as uninterpretable jumbles of lines
(which he calls ‘spaghetti’)
• RFS can perceive most, but not all letters normally
• He has been diagnosed with AlphanumericVisual Awareness
• Newly devised digit character set • Calculator app using new characters
• your power of speech never works well for you.
• you are nearly always misunderstood, not heard, not noticed, not
considered part of a conversation.
• you are often ignored because you can’t do this simple thing (i.e.,
speak) that everyone else around you seems to do so well and so fast.
• when you try to write a note to a friend or a term paper for a class,
you can’t, either because you don’t know how or because your hands
and arms won’t perform the writing and typing movements that
everyone else does so effortlessly.
This discussion is about how people
• It’s about how we can augment, support, and often compensate for
communication abilities that have not developed functionally or that
are lost at some point in an individual’s life due to injury, illness, or
some other acquired disorder.
• How we augment spoken and/or written communication and how we
use alternative methods to get the message through will be discussed
throughout this discussion.
AAC within the realm of: Assistive Technology (AT)
• Augmentative and Alternative Communication (AAC)
• AdaptedComputer Access
• Devices to Assist Listening and Seeing
• Environmental Control and Manipulation
• Adapted Play and Recreation
• Wheeled and Powered Mobility
• Seating and Positioning
• Rehabilitation Robotics
• Integration ofTechnologies
Church & Glennen (1992), King (1999),
Cook & Hussey (2002), Scherer (2003)
Talking or “saying” is communication
SOME PEOPLE USE THEIR SPEECH TO TALK. OTHER
PEOPLE USE GESTURES, OBJECTS, PICTURES AND/OR
ELECTRONIC DEVICES TO TALK.
• To communicate one person must “say”
something by using: any combination of
speech, gestures, writing, pictures, and/or
• To communicate at least one person must
“understand” what is meant by the: speech,
gestures, writing, pictures, and/or objects.
environments and over time
LOCATION, LANGUAGE, ABILITIES, LITERACY LEVELS, AND CULTURE
Barriers to information access:
• language that is too complex
• text that is not accessible
• lack of availability of alternative languages and formats (e.g., Braille,
large print, audio, and electronic formats)
• use of disabling language
• the physical inaccessibility of various hard copy formats (Newel 1994)
Goals of AAC
• provide a
• provide a long-
term means of
• facilitate the
• provide a
• Communication is central to human life.
• Everyone communicates ...
• availability of written communication across multiple formats and
• control of the environment using speech, writing, and/or other
• concept and skill development, maintenance, or re-development
Recommendations addressing some
written communication barriers:
1. Simplify language and terminology
2. Include alternative formats
3. Print should be a font size larger than 12
4. Use full name / words / word combinations instead of acronyms
5. Incorporate colors that provide contrast between the text and the
6. Use photos, graphics, and pictures that make document interesting
and enhance accessibility to the text-based message
Literacy in these terms refers to the ability of the individual and his or
her family to obtain, process, and understand the basic information
and services necessary to make adequate and appropriate decisions
It has been noted that individuals with speech-language and hearing
disorders are at risk for poor health literacy.
Communication, while basic, is also
a complex, multifaceted, multi-
modal process shared among
humans and others.
Volkmann (2002) noted, if you have a heartbeat,
more than “talking”
IT ENCOMPASSES A HOST OF ENVIRONMENTS, TECHNOLOGIES,
AND STRATEGIES. NEW KNOWLEDGE COMING FORWARD WILL
ASSIST WITH THE IDENTIFICATION OF NEW AND ADDITIONAL
AAC TECHNOLOGIES, STAKEHOLDERS, AND FINDERS.
Hearing Association (ASHA)
HEALTH LITERACY RESOURCES