AAC SOLUTIONS: LOW TO HIGH TECH Alicia Dinda M.A., CCC-SLP Ann Bedard M.S., CCC-SLP

Overview  What is Augmentative and Alternative Communication (AAC)?  The American Speech and Hearing Association (ASHA) defines AAC as “all forms of communication (other than oral speech) that are used to express thoughts, needs, wants, and ideas.”  These forms of communication can be used in conjunction with (augmentative) or in place of (alternative) oral speech.

Overview  What is Augmentative and Alternative Communication (AAC)?  AAC can include anything from gestures to dynamic display speech generating devices.  “Ideally, an AAC system includes more than one mode of communication, with the child using whichever is the most efficient given the persons, setting and activity at hand. Very often one of the modes of communication in an AAC program is natural speech.” (University of Nebraska- Lincoln’s AAC Connecting Young Kids [YAACK] website)

Overview  Who?  Anyone who has difficulty communicating using verbal speech alone could benefit from the use of AAC.  AAC users are of all ages and have a variety of conditions including: autism, intellectual disability, cerebral palsy, apraxia of speech, Traumatic Brain Injury, etc.  Some may use AAC for only a short time, and others may depend on it for a lifetime.

Overview  When?  Speech is not meeting communication needs  “A child whose speech is not developing within the realm of what is considered normal, or is not likely to develop normal speech due to a pre-existing condition, is a potential candidate for AAC. Even when it is unclear whether or not a child will eventually develop normal speech, and this is frequently the case, the child may still benefit from an AAC program.” (University of Nebraska-Lincoln’s AAC Connecting Young Kids [YAACK] website)

Overview  Where?  AAC can be used in any setting including school, home, and the community  The individual is encouraged to use their form of AAC across settings and environments. This will help to generalize the skills and use of the system.

Overview  Why?  Speech is not meeting communication needs  Vocabulary is not spontaneous  Speech is scripted but lacks meaning  Difficulty initiating communication with others  Speech is not intelligible to familiar and/or unfamiliar listeners

Myths  AAC will stop language development  This myth is false!!!  Available research indicates that the use of AAC does not decrease speech production, and in some cases increases speech production.  This is true for all children regardless of their disability.  Speech may continue to be a component of a multimodality communication program.  YAACK website: Does AAC Impede Natural Speech?  Dynavox Implementation Toolkit: AAC Myths Revealed

Myths  It’s only for kids who don’t talk  Individuals can benefit from the use of AAC in addition to verbal communication when oral speech is not meeting their communication needs.  AAC can be a tool to support communication and language growth Provides visual information – improves vocabulary and comprehension and capitalizes on visual-spatial learning skills Aids in language retrieval (information taken from But…My Child Can Talk…Why a device? By PRC’s Regional Consultants Margaret Prekins and Catherin Raio 9/1/06)

What is No-Tech?  Any communication system that does not require a power source.  Examples: signing and gestures, communication books, eye gaze boards, picture exchange systems

No-tech continued…  Communication book/board  Display symbols/pictures for variety of communication purposes (ex. Requesting, commenting, greeting, etc.)  Can be used to build language, bridge to technology, back up technology  Single sheet, multiple simultaneous, and multiple sequencial designs

No-tech continued…  Flip n’ Talk  Combines use of communication book and board  The book organizes core and situation-specific vocabulary in a spiral-bound set of 30 vinyl communication strips  Board displays core words and sentence starters  Utilizes add-on software to use Boardmaker to edit symbols displayed on the pages

No-tech continued…  Picture Exchange Communication System (PECS)  Developed by Pyramid Education Consultants  Begins with requesting and then moves to picture discrimination, creating sentences, answering questions, and commenting  ABA based  Training and consultation exclusive to Pyramid Consultants

No-tech continued…  Eye gaze board  a see-through frame with letters or pictures on it

Modifying  All no-tech systems can be modified to meet the student’s needs. Things to consider when creating include:  Size of symbol  Number of symbols presented per page  Symbol vs. photo  Line drawing vs. color symbol

Resources  Boardmaker  Google Images  Quick Pics  Speaking of Speech  Pogo Boards  Picture This software

What is Low/Mid-Tech?  Low Tech: Any communication system that requires a source of power and is very easy to program.  Mid Tech: Any communication system that requires a power source and requires some level of training to adequately program and maintain the device.

Switches  Button Switches  Single message BIGmack Chipper & LITTLEMack  Sequenced messages Big & Little Step-by- Sequencer Step Communicator  Leveled Step-by-Step with Levels

Switches cont.  Variety of sizes/shapes  Add pictures for variety of switches incl. toggle  See communication comparison chart on  Object level communication  Compartment switches  Talking My Way Communication System  iPad/iPod Touch switch apps  TapSpeakTapSpeak Sequencer

Static Display Devices  Go Talk  Quick Talker  AMDI Tech/Speak Series  Boardmaker Activity Pad

Static Display Devices cont.  Progressive Super Talker 7-level Communicators  iPad and Sounding Board iCommunicate iPod Touch apps

ProxTalker  Moveable Picture Communication System  The website states: “The Logan ProxTalker is an assistive communication device that anyone who uses picture exchange to communicate can easily learn. The benefit is increased independence in communication because the ProxTalker actually talks.”

More low/mid tech options  Talking photo album  Communication book with voice added using Livescribe pen

Resources  Enabling Devices.com ( sonChart.pdf) sonChart.pdf  Mayer-Johnson.com/us/assistive-technology  Ablenet  Ablenetinc.com

What is High-Tech?  Any communication system that requires a power source and extensive training to competently program and maintain the device.  Examples: dynamic display devices, speech generating devices

Dynavox  Maestro V+Vmax+  TangoXpressM3

Prenke Romich  Vantage Lite SpringBoard Lite  ECO2

Saltillo  ALT-Chat  ChatPC-Silk

iPad/iPod Touch Applications  Proloquo 2 go  “provides a full-featured communication solution for people who have difficulty speaking. It brings natural sounding text- to-speech voices, up-to-date symbols, powerful automatic conjugations, a default vocabulary of over 7000 items, full expandability and extreme ease of use to the iPhone, iPod touch and iPad.”

iPad/iPod Touch Applications cont.  Touch Chat “Words, phrases and messages are spoken with a built-in voice synthesizer or by playing back a recorded message. Includes: symbol based communication pages, core word sentence building, keyboard with word prediction  Word Power can be purchased for a higher level of core word vocabulary  Can edit on both computer and device when Windows editor is purchased

More dynamic screen options  Computer software  Say it Sam  Speaking Dynamically Pro  The Grid  Proloquo  Pogo Boards-----

More dynamic screen options  Nintendo DS  Tap to Talk “makes communication fun, like another “game” on this cool device. Just tap a picture and TapToTalk speaks. Each picture can lead to another screen of pictures. You’ll learn about TapToTalk Designer, the online subscription service that you use to create your own AAC albums for your child. TapToTalk Designer includes a library of over 2,000 pictures. You can add your own pictures, photos and sounds. You can even record your own voice.

Pros and Cons  Dedicated vs. Commercially available  Funding  Training  Tech-support  Durability  Access

Resources for Use and Implementation  Dynavox grids for keeping track of use   Caroline Musselwhite’s resources  AAC Language Lab.com (in the classroom)  AAC Intervention.com  AACandAutism.com

Closing Thoughts  Finding an appropriate AAC tool or device for a student is only the start.  AAC users do not become proficient without appropriate support, instruction, practice, and encouragement.  Just like a piano alone doesn’t make a pianist, nor does a basketball make an athlete. Likewise, an AAC device alone doesn’t make one a competent, proficient communicator. (Beukelman, 1991).

Discussion & Questions Thank you for coming!