AAC Devices for Speech: Tools for Non-Verbal Communication

An AAC device is an augmentative and alternative communication device designed to provide individuals with a robust communication system that is an alternative to verbal speech. AAC are found in all settings; whether it is in a school or the hospital, these devices are a flexible means to communication, granting accessibility to enriched language for all users.

What is an AAC Device?

AAC stands for augmentative and alternative communication. AAC comes in all different forms and styles, seamlessly integrating into a person’s daily routine based on their needs, strengths, and preferences. An AAC is not limited to just a tablet or a picture communication system, it can encompass a wide range of devices that promote robust language. AAC can come in many forms, from text to speech, picture board, visual schedules, buttons, and even joysticks and video game controllers.

Types of AAC Devices

AAC devices can be divided into different categories based on the technology utilized for each model. Low-tech devices require no technology and can include pictures, visual schedules, and joysticks. Mid-tech devices typically involve battery operated capabilities with features including pre-recorded speech or simple button mechanisms. High-tech devices include speech-generating devices, eye tracking systems, and specialized programs and apps. These communications for non-verbal adults can provide a safe and robust form of communicating with consistency and ease.

Who Uses AAC Devices?

AAC devices can be utilized by virtually any individual who may benefit from an alternate means to verbal speech. This can include the following conditions:

• Autism Spectrum Disorder (ASD) - AAC can be integrated into daily routines to enable autistic individuals to communicate effectively. Autism encompasses natural and anticipated neurological variations in understanding, expression, and interaction. AAC empowers these individuals by accommodating their diverse needs, preferences, and strengths.
• Cerebral Palsy - Is a congenital condition affecting muscle coordination, balance, control, and posture. AAC can be personalized to provide consistent communication that meets individual needs.
• Stroke recovery
• ALS and other neurodegenerative diseases - ALS, dementia, Alzheimer's, and other neurological diseases can affect cognition, motor planning, and executive functioning. Implementing an AAC can help a patient communicate with their loved ones through pictures, pointing, or tablets while reducing frustration due to the lack of verbal communication.
• Traumatic Brain Injury (TBI) -Verbal speech can be significantly affected by accidents and injuries such as traumatic brain injury (TBI), stroke, or spinal cord injuries. AAC systems can restore communication between patients and their loved ones, empowering them to express their wants, needs, and preferences.

Key Features of AAC Devices

The most important aspect of any AAC system involves the implementation of a robust communication model. An AAC should have the client’s communication skills, preferences, and interests in mind as it is developed, ensuring a personalized method of communicating with loved ones and peers.

To achieve robust language in a device, it is vital to customize vocabulary for functionality. For example, if the client enjoys a particular fast food restaurant, the SLP will work with their teams and the client to set up vocabulary surrounding the restaurant. This could include menu items, meal sizes, descriptors, and even verbs and small words that can help bridge non-speaking communication to outside settings. Using features like text-to-speech allows for real time reactions and voice output, creating conversational opportunities with AAC users with their peers, colleagues, or family.

Popular AAC Devices for Speech

As previously mentioned, AAC comes in different shapes, sizes, and modalities. It is important to work with a licensed speech and language pathologist to find the device that best fits your needs. Here are some popular AAC devices:

• Tablet devices with a specified program - Tablet devices such as iPads have become a popular means of AAC when paired with a program such as Proloquo2go, Flexpseak, TouchChat, or LAMP Words for Life.
• GoTalk - An example of a mid-tech device that is battery-powered and has recording capabilities and utilizes visuals and pictures to allow clients to communicate by simply pressing the corresponding button.
• Eye Gaze Technologies - Tobii Dynavox is one of the leading AAC companies that utilizes eye gaze technology to provide communication for those who are unable to utilize pointing or button pressing. With a quick modification, a user may use their eyes to communicate with peers through a software program with a robust language model provided.

How Speech Therapy Supports AAC Users

While AAC helps non-speaking clients or patients with communication, it is still addressed under the practice of a licensed speech-language pathologist. Other clinical professionals, such as psychologists, OTs, PTs, and BCBAs, may refer or recommend another modality for communication. An SLP needs to facilitate the assessment, treatment, and goals for an AAC.

Once a team and client have been trained on the maintenance and troubleshooting of an AAC, speech therapy can provide language instruction no different than if the client used verbal speech. For example, if an autistic client was working on self-advocacy skills, the SLP would assist them in navigating their device to find the words needed to request or communicate. The SLP still uses the same activities, goals, and strategies; the only thing that is different is the SLP is modeling on the device in addition to providing the verbal prompt.

How to Choose the Right AAC Device

Choosing an AAC device involves an evaluation of speech and language, an AAC needs assessment, and a trial period to determine what device would work best for the client.

In the speech and language evaluation, the SLP will assess general receptive and expressive language skills, speech and oral motor skills, voice and resonance, and fluency. This will involve a variety of formal and informal assessment in order to gather a complete picture of the client.

An AAC Needs assessment will then look at several factors to determine the appropriateness of a device. This includes the client’s operational skills, cognition, social skills, strategic/vocation skills, gross and fine motor capabilities (with support from an OT or PT), and linguistic skills.

If the AAC Needs assessment determines the client would benefit from a device, the SLP will then start the trialing process of various devices and modalities to determine which device is the most appropriate for the client.

In terms of financing a device, there are several options available in different settings to fund a device. If you are in the schools, you can ask your school team for an assessment in Assistive Technology AND AAC. If the school determines your child would benefit from a device, they will fund the device with district funds. Insurances like Medicaid, Medicare, and private insurance also cover AAC devices if found to be “medically necessary" under Durable Medical Equipment (DME). Be sure to check with you insurance to see detailed coverage of an AAC device.

Empowering Communication Through AAC Devices

An AAC is a person’s voice; it empowers individuals to communicate in a way that values their needs and promotes independence. Speech therapy and SLPs are there every step of the way to help you find and utilize an AAC device that is personalized to your needs. Once the SLP covers the trouble shooting and maintenance, an AAC can enhance speech therapy activities and communication skills. Verse Therapy works with some of the country’s leading SLPs in Augmentative and ALternative Communication (AAC) and are ready to help you navigate towards a robust and individualized AAC program.

Ready to Find the Right Voice for You or Your Loved One?

AAC, while it may seem overwhelming at first, can become a vital and typical part of your loved one’s daily routine by fostering independent communication. You can continue to learn more about AAC and speech therapy here at Verse Therapy or checking out resources like the American Speech and Hearing Association.

Are you ready to find out more about AAC? Do you have more questions? You can schedule a free consultation with one of our partnered SLPs to see if AAC is right for you or your loved ones!