Augmentative and Alternative Communication (AAC) is a range of strategies and tools to help people who struggle with speech. These may be simple letter or picture boards or sophisticated computer-based systems. AAC helps someone to communicate as effectively as possible, in as many situations as possible.

We use the term AAC to describe various methods of communication to get around problems with ordinary speech. Some kinds of AAC are actually part of how everyone communicates: for example, waving goodbye; giving a “thumbs up’ instead of speaking; pointing to a picture, or gesturing in a foreign country.

However, people with speech difficulties have to rely on AAC most of the time. Some AAC tools “add on” to verbal communication – simple methods such as pictures, gestures and pointing.

Some people need more complex help to communicate, such as powerful computer technology.

FIND HELP WITH AAC

Augmentative and Alternative Communication (AAC) covers a huge range of techniques that support or replace spoken communication. These include gestures, signing, symbols, word boards, communication boards and books, as well as Voice Output Communication Aids (VOCAs).

About AAC

AAC is a range of strategies and tools from simple letter or picture boards to sophisticated computer technologies. AAC helps someone to communicate as effectively as possible, in as many situations as possible.

Insurance

You may need to insure your communication aid against loss, theft or accidental damage.

Getting an assessment

The assessment process varies depending on the person’s age, and where they live. Generally, contacting a local speech and language therapist is the first step.

Children and young people may start the assessment process through school services. They may be referred on to a specialist service that can assess, advise and make recommendations.

Assessment services can give advice about funding. A person must be thoroughly assessed before requesting funding from health or education services. NHS England has a system for providing communication aids. Scotland, Wales and Northern Ireland have their own systems.

Training and keeping up to date

AAC users need support and to learn how to use communication aids. Carers and professionals need training to be able to provide this support.

Suppliers of equipment and services

Equipment and services suppliers comply with our Code of Conduct. They can demonstrate, supply, customise and deliver training about communication aids. Some suppliers offer trials or loans of equipment.

Commissioning and Evidence

Commissioning the right help for people who need AAC can be complex. We need to gather evidence to make the case for the appropriate provision of AAC services and equipment.

Different types of AAC

No-tech

No-tech communication needs no extra equipment – it is sometimes called “unaided communication”. Examples include body language, gestures, pointing, eye pointing, facial expressions, vocalisations and signing.

Low-tech communication systems

Low-tech communication systems do not need power to function. They are sometimes called “aided communication” because they use basic equipment. Examples include: pen and paper to write or draw; alphabet and word boards; communication charts or books with pictures, photos and symbols; particular objects that represent what someone needs to understand or say.

High-tech communication systems

High-tech communication systems use batteries or mains power. Most gadgets or software speak and/or produce text. Some are based on familiar equipment such as mobile devices, tablets and laptops and may have simple buttons or pages that speak when touched. Very sophisticated systems use equipment specially designed to support communication. Hi-tech communication is also sometimes called “aided communication” because it uses equipment.

HAVING A CONVERSATION WITH AN AAC USER

Talking with an AAC user for the first time may feel daunting. It’s common to have worries.

  • “Will I understand them?”
  • “Will they understand me?”
  • “What will I do if it all goes wrong?”

AAC users have made the following suggestions to help you relax and enjoy a conversation with them.

  • THE SITUATION

    • If possible choose a quiet environment with minimal background noise so you can concentrate on the conversation.
    • Face the person you are talking with – we all find it easier to communicate naturally when we can pick up visual clues like body language, gesture and facial expressions.
    • Everyone communicates in a different way, and it’s the same for an AAC user. Start off by asking if they need anything to help them have a successful conversation with you.
  • GETTING STARTED

    Before you start talking, be aware that however brief your conversation you will need more time than you would with a speaking person. Be prepared to give that time.

    • A good start to the conversation boosts everyone’s confidence. Make eye contact and speak directly with the AAC user, not their assistant.
    • If you have never listened to an AAC user before in a conversation, let them know – they will be patient and assist you the best they can.
    • Start with concrete subjects such as the current situation you are both in.
    • When you ask a question please wait for a reply.
    • Keep your own remarks short and simple. It helps the AAC user and gives them a chance to speak.
    • It is tempting to speed things up by finishing off the person’s sentence for them. Avoid this – it’s where misunderstandings often start.
  • DEVELOPING CONVERSATIONS

    • Take the time to make sure you have understood the AAC user correctly by rephrasing their response.
    • Try to introduce only one topic of conversation as a time, as the pace of interaction is slower.
    • Be clear when you are changing the topic; the AAC user may miss subtle facial clues if they are looking at their system.
    • It is much harder for an AAC user to interject into a conversation. They will appreciate it if you make time and invite them to ask questions, rather than expect them to.
    • Asking questions is important in conversation, but be aware that there are different types of questions. It is good to structure a conversation by only asking one question at a time.
    • Ask open questions to get a more detailed response; it’s worth waiting for the answer. Open questions usually begin with “who”, “what”, “where”, “when”, “why”, “how” and “if”.
    • Avoid asking questions that can only be answered by “yes” and “no” – it’s boring for everyone!
  • DEALING WITH MISUNDERSTANDINGS

    Misunderstandings happen all the time in normal conversation. We all use little phrases like “Hang on a minute, did you say…?” AAC users cannot use these easily. It really helps if you watch their face – if they look confused check they have understood. Don’t be afraid to ask “Did you mean …?” or “Could you say that again?”

    If you get really lost, ask the AAC user to clarify:

    • Who are we talking about?
    • What situation are we talking about?
    • When did this situation take place: in the present, past or future?
  • ENDING A CONVERSATION

    • When the flow of conversation is interrupted or slow, it can feel like hard work. This can lead to fatigue and loss of concentration. This is more likely to happen to you than the AAC user; they are used to conversations being this way. It is absolutely fine to say if you need a break, but if you haven’t completed your conversation it is good manners to say you will return to finish it.
    • Some AAC users find using their system tiring – they might need a break themselves before you finish your conversation. If you sense they are getting tired, why not suggest they take a break.
    • Many of us use non-verbal cues to signal it’s time to end a conversation – this might be looking away, fidgeting, etc. Remember the AAC user may not see these cues if they are looking at their system. They are not missing cues; they simply can’t see them. Let them know clearly that you need to move on or have to go. Be courteous and check they have had their say before you do end the conversation.
  • LAST THOUGHTS

    We hope we have given you some thoughts and insights into communicating with AAC users. As with all new ways of communicating, practice makes perfect. The more you engage with AAC users, the better you will become. Remember that AAC users want to talk to you; they understand how you feel and will help you all they can.

Frequently Asked Questions

What reading and spelling skills are needed?

Some people use spelling to create messages, but good reading and spelling skills are not essential. AAC can use powerful systems based on symbols, pictures, photos or objects instead.

What is the best AAC system to use?

There is no “best” AAC system – each has pros and cons. What best suits a person will depend on their abilities, needs and personal preferences. Many people use several AAC tools and choose which to use depending on the situation and who the listener is.

What if someone can’t press keys?

There are plenty of tools available for a person who has difficulty physically using an item of equipment. Accessibility options include a keyguard, a pointer, a switch to control a scanning system or even an eye gaze controller. For more details, see Access methods: switches, keyboards and eye-gaze.

How do people get the AAC system that they need?

There are many options so it is a good idea to get specialist advice in order to identify the most appropriate AAC system or systems. The starting point is usually to contact the local speech and language therapy service. They may be able to help, or may refer on to a specialist AAC service (see our List of AAC Assessment Services).

Have a look at our AAC E-Learning website!

Our free, online resource provides a comprehensive introduction to AAC.

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