The document discusses augmentative and alternative communication (AAC) methods, highlighting the distinction between speech and language and the various medical conditions that may require AAC intervention. It categorizes AAC solutions into no-tech, low-tech, and high-tech systems, emphasizing the importance of multimodal communication for users. Additionally, the document outlines the advancements in AAC technology and the potential benefits for individuals with speech disabilities, including improved social interactions and independence.

1. ANSHITA SINGH (AAC)

2.  In the broad context of speech and language,
speech is often associated with the motor
movements responsible for the production of
spoken words, whereas language is
associated with the cognitive processing
skills of communication.

3.  Due to the complex composition of the
human body, speech and communication
impairments requiring an AAC intervention
could result from diverse medical conditions.
These commonly include Autistic Spectrum
Disorders (ASD), strokes, learning disabilities,
Dementia, head and neck cancers, and brain
injuries. This also expands to include
patients with progressive diseases, such as
Parkinson’s disease and Sclerosis

4.  Other AAC users include patients in transient
post-operative states where interventions
and treatments, such as ventilator support,
may render them unable to speak normally,
or at all. In turn, the users benefiting from
AAC intervention could be classified into
three major groups.

5.  Communicating without speech is difficult.
People who do not speak are at a
disadvantage in a speaking world. It can be
confusing and frustrating when messages
cannot be given effectively. This is
frustrating for both the non-speaking person
and their communication partner.
 Often a non-speaking person will have many
thoughts they wish to communicate. How do
they get these thoughts out?

6.  When a person is not able to speak, others
often make judgements about their
competence, potential, and ability to think
and learn.
 A person who does not speak will quickly
learn that some things are easy to
communicate (e.g. reaching for the TV
remote to suggest you want to change the
channel). They also learn that some things
are hard to communicate (e.g. that the TV
show reminds you of a family member who is
gone).

7.  AAC solutions are classified into three
categories: no-tech, low-tech, and high-tech
AAC
 No-tech AAC is considered the oldest of the
three AAC categories, given its reliance on
the interpretation of facial expressions and
voluntary motor movements, such as sign
language, to deliver non-verbal messages

8.  Low-tech AAC utilizes basic tools, such as
books and display boards with extended
lexicons of images and phrases to aid the
communication process
 High-tech AAC encompasses the use of
electronic devices to achieve an AAC target.
Devices falling under this category, such as
smart devices and dedicated AAC devices,
integrate hardware and software to support
a user’s communication needs.

9.  AAC communication is also often classified as
either un-aided or aided, given the
dependence of the solution on the human
body solely or the interaction with an
external communicative aid for
communication, respectively

10.  The potential of AAC intervention has hence
been substantial over the last 30 years, with
the provision of innovative solutions to a
wide range of users with a speech disability
 However, although high-tech AAC systems are
rapidly evolving, several considerations are
yet pertinent to the provision of effective
solutions efficiently serving AAC users

11.  Low-tech AAC solutions are usually the first
techniques tried by speech and language
therapists, as the use of simplistic display
boards and communication books is both
cost-effective and easy to obtain.
 Predominantly, AAC users still use
combinations of unaided low-tech methods
together with an aided high-tech device as
suitable for the context of usage and the
person they are conversing with

12.  An AAC system may be a text-based system
with a keyboard. This is generally for a
person who types the words they want to
say. They can often read and spell.
Proloquo4Text is AssistiveWare’s text-based
AAC solution.

14.  Many people might need symbols or pictures
when communicating. This includes those
people who cannot yet read or spell. We can
introduce visual symbols that represent
words or maybe phrases. Proloquo and
Proloquo2Go are AssistiveWare’s symbol-
based AAC solutions

16.  Other people may use Gayle Porter's PODD
system. simPODD is AssistiveWare's digital
and print PODD solution.

19.  Many people who cannot speak but use AAC
are multimodal communicators. This means
they have multiple ways to communicate
their messages. As well as AAC, they might
use vocalizations, word approximations, and
maybe some gesture and sign language. Many
people show photos from their camera roll to
add to what they are saying. All different
methods of communication should be valued
and respected. Different communication still
tells us something!

20.  Even people with some spoken
communication, may benefit from AAC. If
speech is limited, AAC can help. It can give a
person more words and language. They may
communicate far more with AAC than they
can with speech alone.

21.  richer, more frequent social interactions
 deeper social roles: family member, friend,
professional, student
 increased autonomy and decision-making power over
their own life
 increased independence
 more respect from others
 greater participation in their family lives and
communities
 improved information sharing with physicians
 improved personal safety in a variety of care
settings, such as hospitals or long-term facilities
 more employment and volunteer opportunities
 improved physical and mental health

22.  People who use AAC say that, prior to having
a communication system, they experienced:
 more social isolation and loneliness
 increased frustration and acting out with
loved ones
 greater vulnerability, especially when alone
in a care setting
 feeling shut out of important decisions over
their own life
 inability to show what they know or can
learn

23.  Alternative-language users have a well-
established cognitive understanding of
language and speech, but have difficulties in
conversing. On the other hand,
augmentative-language users have
difficulties both in understanding speech and
in conversing.

24.  To be able to use an AAC device,
augmentative-language users need assistance
in the re-categorization of their surroundings
into labels and symbols they comprehend to
form a communication language

25.  Temporary AAC users require AAC
intervention only for a limited duration of
time. This category primarily includes
children with developmental conditions, and
adults who require transient speech
assistance following surgical intervention

26.  According to a great timeline by NDi Media,
one of the earliest communication devices
developed was the Patient Operated Selector
Mechanism (POSM), which was a sip-and-puff
typewriter controller designed by Reg Maling
in 1960. Following this invention, Orest Z.
Roy of the National Research Council of
Canada created a communication device
known as the Comhandi. This was an
electronic letter board that allowed people
to select letters and build words.

29.  In 1967, the Patient Initiated Light Operated
Telecontrol (PILOT) allowed people to
operate typewriters by directing a beam of
light. In the 1970s, transistorized devices
began to replace early mechanical systems.
These systems often used the electrical
activity generated by skeletal muscles to
control devices, which is known as
electromyography.

31.  At this time, Richard Foulds piloted the
design of the Tufts Interactive Communicator
(TIC), a scanning communication aid. He
ultimately developed the ANTIC, which was
the first aid that predicted the next most
likely letter to be typed. A few years later in
1973, the Talking Broach and the Light writer
became the first portable communication
devices.

35.  Since the unveiling of the iPad in 2010, AAC
has become more-widely accessible. While
individuals can use the notes or messages
app to communicate, they can also choose
from a plethora of AAC apps from the App
Store. These apps, which are available for
people of all ages, can be separated into
three categories: basic apps, moderate apps,
and robust apps,

36.  Additionally, there are numerous speech
generating devices on the market, including
TobiiDynavox, Prentke Romich (PRC), and
Saltillo. While these devices are more
expensive, they offer flexible access options
including eye-gaze, head tracking, joystick
and alternative mouse control, as well as
single and multiple switch control.

37.  There have been significant advancements in
AAC over the years with the advent of apps
and speech generating aids dovetailing with
disability advocacy efforts. What is even
more encouraging is that technology
continues to progress. Researchers at the
Media Lab at MIT are currently working on a
groundbreaking project called Official
Commalla, which will assist people who are
non-verbal or minimally verbal and
“communicate certain emotions and desires
through vocalizations that do not have
typical verbal content.”

38.  The mission of the project is to develop a
device that will interpret the vocalizations of
non- or minimally verbal people, allowing
them to communicate with people who are
not familiar with their atypical “verbal
content”. With such intelligent technology
being developed, it seems the future of AAC
is limited only by our collective imaginations.

39.  When deciding which AAC decide to use,
consider the following:
 Child’s current cognitive, visual, and fine
motor abilities.
 Consistent availability of the device.
 Collaborative decision-making.

40.  Model, model, model!
 Respond to all AAC communication promptly,
appropriately, and consistently.
 When the child engages in requesting
behaviors, prompt her to use the AAC device.
 When the child engages in challenging
behaviors, wait for the behavior to stop, and
then prompt her to use the AAC device.

41.  Make sure that the AAC device is consistently
available, within and across settings.
 Set up opportunities to teach use of the AAC
device, by scheduling daily practice sessions
and by embedding opportunities throughout
the day.
 Teach peers how to use the AAC device. If
possible, give peers their own AAC devices.

46.  A Review of Configurations for Individuals
with a Speech Disability-Yasmin Elsahar,
Sijung Hu, Kaddour Bouazza-Marouf, David
Kerr, and Annysa Mansor
 Assistiveware.com
 ASHA
 Therapyworks.com
 Jennifer Ledford, Ph.D., BCBA-D