1. Complementary roles of AAC and speech

2. AAC and Speech AAC is useful for anyone who is unable to use speech to meet all communication needs – Across all partners – Across all contexts / settings AAC is also useful to address barriers to language learning

3. AAC and Speech AAC and speech are NOT mutually exclusive. – Most people have some ability to vocalize or speak – FUNCTIONALITY is the key concept

4. Roles of AAC Augment existing speech Serve as a primary output mode for communication Serve as both an input and output mode for communication Foster the development of language.

5. Relationship between AAC and speech: 4 categories No need for AAC AAC as a back-up strategy AAC as an equal partner with speech AAC as a primary mode of communication

6. 1. No need for AAC Able to meet all communication needs across partners and contexts using speech alone. – Speech, language, and communication skills may or may not be “normal” – Person is able to use speech to participate at an appropriate level in his or her life without any compensatory communication strategies.

7. 2. AAC as a back-up strategy Able to meet most communication needs across partners and settings using speech alone – mildly reduced intelligibility that sometimes results in difficulty in adverse communication situations. – AAC to supplement speech or as a back-up when partners have difficulty – Speech is the primary mode of communication; AAC is a secondary, supporting mode

8. What does a child who needs AAC as a back-up strategy look like? Talks reasonably well, but below age level expectations Mild intelligibility problems Language may be “normal” or impaired Communication breakdowns may occur in adverse environments Participation is limited in adverse environments Role of AAC: – support language development – supplement speech – resolve breakdown situations – backup strategy

9. 3. AAC as an equal partner with speech Able to meet some communication needs across partners and contexts using speech alone – moderately reduced intelligibility – speech may be functional with familiar communication partners or in quiet situations – AAC used to enhance speech intelligibility; often used simultaneously with speech – AAC and speech are both primary modes of communication, depending on the partner and the setting.

10. What does a child who needs AAC as a partner with speech look like? Talks in single words or multiword utterances Moderate to severe intelligibility problems – Different partners may be more or less skilled at understanding the child Language may be “normal” or impaired Functional communication limited to familiar partners and settings Participation limited without significant scaffolding Role of AAC: – Support language development – Support speech development – Supplement speech – Enhance functional communication and participation

11. 4. AAC as a primary mode of communication Able to meet few or no communication needs across all partners and contexts using speech alone. – May produce a few idiosyncratic words or vocalizations that very familiar communication partners can interpret – may use facial expressions, gestures, and vocal intonation for communication – Comprehensive AAC systems needed for nearly all communication interaction to enable social and educational participation.

12. What does a child who needs AAC as a primary mode of communication look like? Unintelligible speech Language may be “normal” or impaired Very limited functional communication abilities Very limited participation Role of AAC: – Provide expressive communication modality – Enhance functional and independent communication – Enhance participation