People with intellectual disability have the right to communicate in the most appropriate means necessary in order to have some control of their life. About half of these individuals do not develop enough speech and language to meet their daily needs. Therefore augmentative and alternative communication strategies are needed to enhance learning, increase social interaction, and provide functional communication skills.

1. AUGMENTATIVE AND ALTERNATIVE
COMMUNICATION FOR PEOPLE WITH
INTELLECTUAL DISABILITY
Dr. Shazia Tahira
Child Mental Health Practitioner

2. AUGMENTATIVE AND ALTERNATIVE
COMMUNICATION

3. AUGMENTATIVE AND ALTERNATIVE COMMUNICATION
Augmentative Communication Alternative Communication
Adding something to speech or
language (e.g. sign language,
pictures, a letterboard) to
make the message clearer.
An alternativeto speech or
language and only means of
communication when there is
absence of speech or language
and the person is not able to
speak.
Augmentative and Alternative Communication (AAC) means the communication
methods used for those with impairments in the production or comprehension of
speech or language to supplement, augment or add to speech or language or in
cases of absence of speech or language, to replace as an alternative to speech or
language.

4. TYPES OF AUGMENTATIVE AND ALTERNATIVE COMMUNICATION
> Unaided AAC - Augmentative and Alternative Communication (AAC) that does not require a
physical aid or tool.
> Aided AAC - Augmentative and Alternative Communication (AAC) that uses tools or materials.
- Low-Tech AAC Aids are those that do not need batteries or electricity and is
usually a paper-based tool.
- High-Tech AAC Aids are those that require batteries or electricity and include
dedicated devices developed solely for AAC, or non-dedicated devices such
as mobile devices with an AAC app.

5. Unaided AAC
(without any tool)
Low-Tech AAC Aids
(tool without battery or electricity)
High-Tech AAC Aids
(tool with battery or electricity)
Facial
expressions
Symbol Boards/
Communication Boards
Speech-Generating Devices or
Communication Devices
Body language Choice Cards AAC Apps on Mobile Devicesand
Computer
Gestures Communication Books Tablet Books
Sign language Alphabet Charts Keyboards

6. INTELLECTUAL DISABILITY

7. INTELLECTUAL DISABILITY
Intellectual Disability, also known as General Learning Disability and previously known
as Mental Retardation is a generalized neurodevelopmental disorder characterized by
> Impairment in Intellectual Functioning - intelligence quotient under 70
> Impairment in Adaptive Functioning - deficits in two
or more adaptive behaviors that affect everyday, general living. These
adaptive behaviors may include daily living skills, communication skills,
social skills etc.

8. Level of Intellectual
Disability
IQ Range Adaptive Functioning
Mild 50–69 Can live independently with Intermittent support during
transitions or periods of uncertainty.
Moderate 36–49 Independent living may be achieved with limited support
in daily situations.
Severe 20–35 Requires daily assistance with self-care activities and
safety supervision.
Profound <20 Requires 24-hour care for everyaspect of daily routines.

9. VARYING COMMUNICATION ABILITIES
IN INTELLECTUAL DISABILITY

10. VARYING COMMUNICATION ABILITIES IN INTELLECTUAL DISABILITY
 People with Mild Intellectual Disability are most likely to communicate with speech.
 People with Moderate Intellectual Disability may also communicate with speech, but to a
limited degree, such as using incomplete sentences.
 People with Severe Intellectual Disability may demonstrate limited communication skills and
are more likely to communicate with informal communication such as gesturing (facial
expressions, eye contact) and by using body movements (shaking hands, pointing, pushing
things away).
 People with Profound Intellectual Disability often lack intentional communication. Instead,
they rely on others to interpret their facial expressions and behaviors as indicative of their
wants and needs.

11. Level of Intellectual
Disability
Communication
Mild Communicate withSpeech
Moderate Communicate withSpeech to a Limited Degree
using Incomplete Sentences
Severe Communicate withGestures & Vocalizations
Profound Lack Intentional Communication, Rely on Others to
Interpret Their Behaviors

12. AUGMENTATIVE AND ALTERNATIVE
COMMUNICATION IN INTELLECTUAL DISABILITY

13. AUGMENTATIVE AND ALTERNATIVE COMMUNICATION IN INTELLECTUAL DISABILITY
People with intellectual disability have the right to communicate in the most appropriate
means necessary in order to have some control of their life. Communication is an important
contributing factor for the quality of life of people with intellectual disability. About half of
these individuals do not develop enough speech and language to meet their daily needs.
Therefore augmentative and alternative communication strategies are needed to enhance
learning, increase social interaction, and provide functional communication skills. Some
people use more than one type of AAC strategy to communicate and many people show a
preference for using one type of AAC that varies across individuals.

14. COMMONLY USED AAC FOR PEOPLE WITH INTELLECTUAL DISABILITY
Unaided AAC Aided Low-Tech AAC Aided High-Tech AAC
Gestures & Vocalizations Communication Boards
and Books
Speech-Generating
Devices
Key Word Signing Picture Exchange
Communication Systems
Smartphone and Tablet
Devices with AAC Apps

15. GESTURES & VOCALIZATIONS

16. GESTURES & VOCALIZATIONS
In people with severe or profound intellectual disability, as they have
mostly limited communication skills, Unaided AAC may consists of efforts
to promote gestures (facial expression, eye contact body language, body
movements)and vocal behaviors that may convey information about
general feelings, or to indicate needs and wants.

17. KEY WORD SIGNING

18. KEY WORD SIGNING
Key word signing is a form of unaided augmentative and
alternative communication (AAC) that uses manual signing for the
words that carry the most important information as an additional
mode of communication along with natural speech with the
intention of strengthening the message
For example, if someone said, "Go wash your hands" the key words
that would be signed would be "wash" and "hand". A number of
signs are taught to enable those with intellectual disabilities to
communicate their wants and needs or to formulate messages for
other purposes depending on their relevance to an individual’s daily
routine.

19. COMMUNICATION BOARDS AND BOOKS

20. COMMUNICATION BOARDS AND BOOKS
Communication boards and books are low-tech AAC aids. Through pictures, symbols
and alphabets in communication boards and books, people with intellectual disability
can communicate specific messages.

21. PICTURE EXCHANGE COMMUNICATION SYSTEMS

22. PICTURE EXCHANGE COMMUNICATION SYSTEMS
Picture Exchange Communication Systems (PECS) is a form
of low-tech aided augmentative and alternative
communication (AAC) frequently used by individuals with
intellectual disability when speech development is delayed
or does not develop. People using PECS are taught to
approach another person and give them a picture of a
desired item in exchange for that item. By doing so, the
person is able to initiate communication. A child or adult
can use PECS to communicate a request, a thought, or
anything that can reasonably be displayed or symbolized on
a picture card.

23. SPEECH-GENERATING DEVICES

24. SPEECH-GENERATING DEVICES
Speech-generating devices (SGDs), also known as voice output communication
aids (VOCAs), are high-tech dedicated augmentative and alternative
communication (AAC) devices used to supplement or replace speech or writing for
individuals with severe speech impairments, enabling them to verbally communicate.
There are several input and display methods for users of varying abilities to make use of
SGDs. Speech-generating devices can produce electronic voice output by using digitized
recordings of natural speech or through speech synthesis which may carry less
emotional information but can permit the user to speak novel messages. The content,
organization, and updating of the vocabulary on an SGD is influenced by the user's
needs and the contexts that the device will be used in. SGD output is typically much
slower than speech, although rate enhancement strategies can increase the user's rate
of output, resulting in enhanced efficiency of communication.

25. SMARTPHONE AND TABLET DEVICES
WITH AAC APPS

26. SMARTPHONE AND TABLET DEVICES WITH AAC APPS
Individuals with intellectual disability may use
smartphone and tablet devices with AAC apps as
non-dedicated high-tech speech-generating AAC
devices to make requests for preferred objects, in
academic settings and social communication to
enhance the communication and social
functioning.

27. BENEFITS OF AUGMENTATIVE AND ALTERNATIVE
COMMUNICATION FOR PEOPLE WITH
INTELLECTUAL DISABILITY

28. BENEFITS OF AUGMENTATIVE AND ALTERNATIVE COMMUNICATION FOR
PEOPLE WITH INTELLECTUAL DISABILITY
> Helps people with intellectual disability to communicate
when they can’t rely on speech and provide functional
communication skills.
> Makes multimodal communication possible.
> Enhances spoken speech when speech is limited.
> Enhances daily interactions of people with intellectual
disability.
> Increases social communication and social
interaction to enhance the social functioning.
> Enhances learning in academic settings.
> Enhances quality of life of people with intellectual
disability.