AACpresentation

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Feb 20, 2024

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Augmentative and Alternative Communication Systems (AACs) and ASD Ansley Gervais

PECS Board – Objectives Click on the image for the page you would like to visit Relevance What is AAC? Types of AAC How to Teach AAC Effectiveness References

Relevance • For over 50 years, AACs have been used to help those with developmental or acquired disabilities communicate more effectively. • Purposes of AAC: • To help children who are non-vocal communicate • To help learn manding procedures (asking for what they want) • Helps develop routines • Provides motivation • Alternative and Augmentative Communication devices are becoming more relevant to ABA, Speech, and OT practices in clinical and home settings to provide a way for a child to communicate. Most common use of AACs are to help children with ASD communicate wants and needs. Fast Fact: In 2016, the National Joint Committee for the Communication Needs of Persons With Severe Disabilities amended the Bill of Rights to provide access to interventions that improve communication (including AAC)

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What is AAC? • Augmentative meaning “in addition” or to aid in speech communication • Alternative meaning “instead of” or to be used in place of speech communication AAC stands for Augmentative and Alternative Communicatio n • Can be for those who have intermittent, unreliable, or insufficient speech • Intermittent: cannot always speak • Unreliable: say things that do not align with intended meaning • Insufficient: cannot fully express everything they mean Presented as an option to caregivers when the child displays minimal verbal skills.

Types of AAC Low-Tech Systems • Require no technology and are often on a piece of paper • Sign Language • Picture Boards (PECs boards) • Letter Boards (spelling out what they want) • Gestures • PECS boards have been highly used in the ABA field to encourage manding (asking for items or tasks) and have been proven helpful (Frolli et al., 2022). Mid-Tech Systems • Require some technology but are often not touch screen and consist of fewer buttons • Big/Little Mack – a line of buttons that are programmed with a word that is spoken when pressed (allows child to make simple choices) • Go Talk Line – 2-32 buttons with a piece of paper slipped behind it and programmed as text to speech • Mid-tech systems are simpler to use and the least expensive option when choosing a device. However, it is limited in how many buttons are available at a time. (Clark, 2023)

Types of AAC (cont.) • Touch-screen devices that show different choices for the user to push (text-to-speech). • Customization is available to input specific reinforcers or terms that fit the client’s personal preferences • Can download assistive touch to allow for the client to not touch any other parts of the screen • AAC apps – downloaded on a smartphone or tablet • Dedicated device – device is only used for child’s communication and prevents distraction with games and other applications on the phone or tablet High-Tech Systems (Clark, 2023)

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How to Teach AAC – Possible Interventions • Modeling • Caregivers, speech therapists, and BCBAs can work together to implement modeling techniques to teach the child how to press the buttons for the desired object. • Ex: Pairing your verbal words with the button on the device to demonstrate to the child that it is a way of asking for items. • Stimulus Pairing • Relating the button that they press to the desired item attached to that button. This allows the child to understand the relation between the buttons and the possible items they can receive. • Ex: The child presses the button for “cookie” and receives a cookie. • Providing Communication Opportunities • Allow for the child to have opportunities to utilize the AAC in situations where they would normally not have to ask for things to encourage use of the device. • Ex: When the child is at snack, give them a few bites and have them ask for “more” using the AAC device. (AAC Devices, 2022)

Effectiveness • One study sought to understand which version of AAC was more effective in a clinical setting: PECs versus Manual Signs. • The study revealed that while PECs are more effective in the clinical setting, an overall need for studies involving AAC are needed to better understand the use of all types of devices for teaching communication (Frolli et al., 2022). • The overall effectiveness of AAC is still being understood and studied currently and each device has its benefits to specific children and their degree of need for the device. • AAC has been effective in many situations, but each child has different needs and different levels of device involvement.

References American Speech-Language-Hearing Association. (n.d.). Augmentative and alternative communication (AAC). American Speech-Language-Hearing Association. https://www.asha.org/public/speech/disorders/aac/ AAC devices - 5 steps for implementing in your child’s routine. (2022, February 22). Sensory Solutions. https://sensorysolutions.org/home/blog/5-steps-for-implementing-aac-devices-in-your-childs-routine/ Clark, C. (2023, March 15). AAC devices for autism: Are communication devices helpful?. Speech And Language Kids. https://www.speechandlanguagekids.com/giving-voice-non-verbal-children-autism-aac-autism/ Company, P. R. (n.d.). Why AAC?. The Center for AAC & Autism. https://www.aacandautism.com/why-aac Donaldson, A. L., corbin, endever, & McCoy, J. (2021). “everyone deserves AAC”: Preliminary study of the experiences of speaking autistic adults who use augmentative and alternative communication. Perspectives of the ASHA Special Interest Groups, 6(2), 315–326. https://doi.org/10.1044/2021_persp-20-00220 Frolli, A., Ciotola, S., Esposito, C., Fraschetti, S., Ricci, M. C., Cerciello, F., & Russo, M. G. (2022, September 26). AAC and autism: Manual signs and PECS, a comparison. Behavioral sciences (Basel, Switzerland). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9598566/ How technology can help. Autism Speaks. (n.d.). https://www.autismspeaks.org/tool-kit-excerpt/how-technology-can- help#:~:text=Likely%20the%20most%20common%20use,at%20all%20levels%20and%20abilities.

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