1. SHARON SOWDER SPEECH LANGUAGE PATHOLOGIST
THE ABC'S OF AAC
SHARON SOWDER
SPEECH LANGUAGE PATHOLOGIST

2. THE HUMAN VOICE IS THE ORGAN OF THE SOUL. --HENRY WADSWORTH LONGFELLOW

3. ABOUT AAC
AAC includes all the ways we share our ideas and feelings without talking.
Facial expressions
Gestures
Writing a note
Sign Language
WHO BENEFITS FROM AAC?
Nonverbal
Non-Communicative/Minimally Verbal
Language Delay
Speech Delay
Assistance for communication and literacy

4. AAC AND ASSISTIVE TECHNOLOGY
AUGMENTATIVE COMMUNICATION
ALTERNATIVE COMMUNICATION
ASSISTIVE TECHNOLOGY
Used in place of speech that is absent or nonexistent
Technology needed for all skill areas.
AAC may be used to address Assistive Technology for communication
Used to supplement existing speech

5. TYPES OF AAC UNAIDED SYSTEMS Gestures Body Language Facial Expressions
Sign Language
AIDED SYSTEMS
Two types of aided systems: Basic and High Tech
Basic includes pen and paper, pointing to letters, words, pictures
High Tech includes touching letters or pictures on a computer screen that speaks

6. COMMON SYMBOLS GESTURES SIGN LANGUAGE FINGERSPELLING Hand Shapes
Shaking your head
Shrugging your shoulders
Can share simple ideas but can’t have lengthy conversations
Hand Shapes
Face and Body Movements
Sign Language is a true language with rules and grammar
Hands and finger shapes
Can be used to spell proper names or words without signs

7. LANGUAGE REPRESENTATION METHODS
SINGLE MEANING PICTURES
ALPHABET SYSTEMS
PICTURES WITH MORE THAN ONE MEANING
Each picture means one thing
A 3-year old child would need more than 1000 pictures
Need to be able to read and spell
Some systems have word prediction
Semantic Compaction
One picture can mean more than one thing
Frog + rainbow = green
Frog + arrow = jump

8. CORE VOCABULARY FRINGE VOCABULARY
AAC VOCABULARY
CORE VOCABULARY
A few hundred words used for most of our vocabulary
FRINGE VOCABULARY
Words used for our communication not in our Core Vocabulary

9. COMMON AAC LANGUAGE TERMS CORE with symbols and words (I + like + you = I like you) Partial Phrase with symbols and words (I like + you = I like you) Phrase with a symbol/picture (I like you) Visual Scene: an interactive picture that can mean many things Photo: means just one thing Symbols: drawing of something

10. SELECTION TECHNIQUES DIRECT SELECTION SCANNING ENCODING
Pointing with some part of your body (eyes, toes, fingers, head stick, mouth stick) or switches
Fastest way to make choices
One choice at a time
Point to or stop on picture you want
Must have intact cognitive skills
Codes instead of pictures or words
Codes are made of letters, numbers, shapes

11. AUGMENTATIVE COMMUNICATION AND EARLY INTERVENTION MYTHS AND REALITIES
MaryAnn Romski, PhD, CCC-SLP and Rose A. Sevcik, PhD
The use of augmentative and alternative communication (AAC) services and supports with infants and young children has been limited, owing to a number of myths about the appropriateness of AAC use with this population. This article will provide an overview of some of the myths that have hampered the inclusion of AAC into early intervention service delivery and refutes them. It will then examine some of the realities that must be considered when delivering AAC services and supports to young children.

12. MYTHS
MYTH 1: AAC is a “last resort” in speech-language intervention MYTH 2: AAC hinders or stops further speech development MYTH 3: Children must have a certain set of skills to be able to benefit from AAC MYTH 4: Speech-generating AAC devices are only for children with intact cognition MYTH 5: Children have to be a certain age to be able to benefit from AAC MYTH 6: There is a representational hierarchy of symbols from objects to written words (traditional orthography)

13. AAC EVALUATION
PRIMARY COMPONENT: Child must be able to demonstrate understanding of cause and effect
“What is it that we expect the student to be able to do within the educational program that he/she isn’t able to do because of his/her disability?”

14. AAC EVALUATION
COMMUNICATION HANDWRITING LISTENING MATH MOBILITY READING RECREATION SEATING/POSITIONING SELF-CARE SPELLING WRITTEN EXPRESSION

15. AAC EVALUATION TEAM Student School Nurse Family
Other Medical Personnel
Classroom Teacher
Low Vision Specialist
Instructional Assistant
Vocational Counselor/Case Manager
School Psychologist
School Administrators/Special Education Supervisors
Speech Language Pathologist
School Technology Consultant
Occupational Therapist
Assistive Technology Specialist
Physical Therapist
Assistive Technology Providers
Orientation and Mobility Specialist
Rehabilitation Engineer
Audiologist
Family Physician

16. Student Environment Tasks Tools Framework (SETT)
The Gold Standard for Assessments created by Joy Zabala (

17. Student Environment Tasks Tools Framework (SETT)
The Student
• What does the student need to do?
• What are the student’s current abilities?
• What are the student’s special needs?

18. Student Environment Tasks Tools Framework (SETT)
The Environments
• What is the instructional setting?
• What is the physical arrangement?
• What materials and equipment are currently available?
• What supports are available?
• What are the attitudes and expectations?
• What are the concerns?

19. Student Environment Tasks Tools Framework (SETT)
The Tasks
• What tasks occur that enable student progress toward mastery of IEP goals?
• What are the tasks that allow the student to actively participate in daily life?
• What is everyone else doing?
• What are the critical elements of the activity/task?

20. Student Environment Tasks Tools Framework (SETT)
The Tools
• What system of no-tech, low-tech, and high-tech tools should be considered to support the student in performing the tasks identified in these environments?
• What strategies might be used to increase student performance?
• How might these tools be tried out with the student in the customary environments in which they will be used?

21. COMMON ERRORS
1. Procedures for conducting AT assessment are not defined, or are not customized to meet the student’s needs. 2. A team approach to assessment is not utilized. 3. Individuals participating in an assessment do not have the skills necessary to conduct the assessment, and do not seek additional help. 4. Team members do not have adequate time to conduct assessment processes, including necessary trials with AT. 5. Communication between team members is not clear. 6. The student is not involved in the assessment process. 7. When the assessment is conducted by any team other than the student’s IEP team, the needs of the student or expectations for the assessment are not communicated. (The QIAT Consortium, 2012, pp. 3-4)

22. WHAT ARE FUNDED DEVICES?
MEDICAID AND/OR PRIVATE INSURANCE
For communication only
They are shipped locked but you can purchase a “key” to unlock them
They are called “durable medical equipment” (DME)

23. WHAT IS OFF THE SHELF? Anything you can buy and/or create yourself
iPads and Apps (300+ applications)
Windows and Applications
Universal Applications
Select a device as you would a 401K

24. DO IPADS MAKE GOOD COMMUNICATION DEVICES?
Good way to try things and explore communication
iPads are cheaper than dedicated devices and do the same thing
Can use guided access to restrict use
Avoid using iPad for reinforcing activities like games and videos
They break
Can be purchased through waivers, schools, private pay

25. EXAMPLES OF DEVICES AND AAPS/PROGRAMS Saltillo (TouchChat) Prentke Romig (LAMP) Tobiidynavox (Compass) Forbes AAC (Proslate) Proloquo2 GoTalkNow Let Me Talk Sounding Board (social express) Sprocket Switches Enabling Devices

26. ADDITIONAL RESOURCES
Development of a Handbook for Speech Language Pathologists MISSOURI SPEECH LANGUAGE HEARING ASSOCIATION (MSHA), DESE, AND MOCASE

27. ADDITIONAL RESOURCES MEDICAID APPROVED EVALUATION SITES
KANSAS CITY AREA
The Rehabilitation Institute, Kansas City ( )
MID MISSOURI AREA
Ozarks Medical Center, West Plains ( )
Theracare Outpatient Services, LLC, Springfield ( )
Mizzou Therapy Services, Columbia ( )
ST. LOUIS AREA
Fontbonne University, St. Louis (
The Learning Center, Florissant (
The Rehabilitation Institute of St. Louis, St. Louis (
St. Louis Children’s Hospital, St. Louis ( )
Easter Seals Midwest, St. Louis ( )

28. LOANER DEVICES AND SUPPORT SERVICES
ADDITIONAL RESOURCES
LOANER DEVICES AND SUPPORT SERVICES
Missouri Assistive Technology ( ( )