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Arbutus Speech Therapy AAC

What is AAC? A Guide to Augmentative and Alternative Communication

Do you have a family member who is unable to communicate their needs verbally? If so, you might have heard the term AAC or Augmentative and Alternative Communication. AAC is a combination of systems and strategies that replace or supplement speech. In this guide, we will be discussing some of the most common questions about AAC to help you determine if this is something that might benefit your family:

  • What exactly is AAC, and who is it for?
  • How does an SLP help identify children who might need AAC, and what does an assessment look like?
  • Where can I get an AAC device or application?
  • What kind of funding is available in BC for people looking to buy one?

What is AAC?

AAC, or Augmentative and Alternative Communication, refers to ways of communicating that does not require spoken or sign language. AAC helps people who can’t communicate verbally to express themselves using symbols to convey meaning including objects, real life images (people, places, things), symbolic images, words, and much more.

Typically, AAC is driven by technology, but this is not always the case. In fact, there are some cases where low-tech alternatives are more suitable. More on that later! AAC is all about improving a person’s ability to communicate their needs and desires.

Who needs it?

Does my child need AAC? There are many reasons why a child might benefit from using AAC systems with their communication partners/caregivers: they have been diagnosed with conditions such as Autism Spectrum Disorder (ASD), cerebral palsy , developmental delay etc., they have had a brain injury that has impacted their ability to produce any speech sounds

AAC can help adults too. Do you know someone who has lost their ability to speak due to a medical condition such as ALS (Lou Gehrig’s Disease) or stroke? In this case, they might benefit from an Augmentative and Alternative Communication device since it would allow them another option for communication besides writing. Adults with autism can also benefit from AAC strategies.

What does AAC look like?

As mentioned earlier, AAC devices come in many forms – and not all require technology! There are several different ways of using AAC strategies which include manual signs, picture symbols , gestures, objects and more. Examples of AAC systems that do not need to be “plugged in” are photo albums, communication books or binders, physical objects, buttons, wooden or plastic boards to name a few.

For more advanced users, technology is required. Common AAC systems that require technology include systems communication apps available on computers, tablets, or iPads. Read the next section for more information about popular communication apps.

For early or emergent communicators, AAC systems include yes/no response systems, object choices, paper-based communication boards with pictures, and devices that speak when an item or message is selected (voice-output systems).

While technology is a blessing for those who require alternative means to communicate, it is best to have a paper-based communication system as a backup for days when the iPad is forgotten, out of charge, or damaged.

An AAC device should be as ‘available’ to its user as possible. Without their device, they are essentially without their voice. Many systems, such as paper-based, book-bound, tablet/iPad or purpose-built AAC devices are convenient and portable.

Physical ability and general mobility are also factors in determining which AAC device to use. Depending on an individual’s ability and mobility, an AAC user may have their system secured to their wheelchair (an occupational therapist is also involved in fitting such devices.)

Common Communication Apps

A communication app is software that you can download onto a device that you already own, such as a laptop, tablet, or iPad. Some examples of popular apps include:

Communication apps are made up of pictures and words in a grid. Depending on  the user’s needs and abilities, there may be many (up to 80 or more) selectable images, categories, and grammatical markers on each page, or there could be a few large images. Don’t worry though, the configuration of the grid and the number of images on each page is part of the recommendations provided by the speech-language pathologist.

A screenshot from the TouchChat. AAC apps are highly configurable based on your family member’s needs

Communication apps can cost hundreds of dollars, and that does not include the device that it runs on. This is why having a speech-language pathology AAC assessment is so important as you will have certainty that you are being recommended an app that is right for you before you buy.

Speech-Language Pathologist AAC Assessment

An AAC Assessment falls under the Speech-Language Pathology profession. Assessments can last from 45 minutes to several hours, depending on the individual’s diagnosis and needs.

A speech-language pathologist will begin by determining the individual’s ability to communicate functionally in all areas of their life. The individual as well as their family will be asked to provide important information that will indicate whether an AAC device is required.

Just because your family member can communicate verbally, does not necessarily mean they are not a fit for an AAC evaluation and device. Many AAC users have the ability to speak verbally to some extent, use sign, or have already developed a system of their own to communicate. Regardless, AAC may be able to enhance their ability to have their thoughts and desires understood.

A speech-language pathologist’s AAC assessment will help determine the ideal AAC set-up for your scenario. There are many factors taken into consideration including upper body mobility, eye sight, literacy, cognitive abilities, age, and lifestyle. 

Based on these factors and more, a speech-language pathologist will make specific recommendations as to what, if any, AAC device is required, how and where you can obtain an AAC device, as well as help with access to funding and any other questions you may have.

Costs and Funding for AAC Devices

It is important to know that there are options for many individuals in BC who may require access to alternative and augmentative communication. Depending on your situation, your Arbutus Speech Therapist will know what/if any funding options are available to you. Fortunately, there is funding available in BC for Alternative and Augmentative Communication for a number of different situations.

Below is a list of organizations and suppliers in BC who provide funding for devices:

Communication Assistance for Youth and Adults (CAYA):

CAYA is a province-wide service program that supports adults aged 19 years and older who require an AAC system due to a severe communication disability (i.e. speech that is not functional for daily communication.)

Assistive Technology BC

For people with disabilities, Assistive Technology BC provides assistive technology and related support services to British Columbians with disabilities.

Special Education Branch of the BC Ministry of Education (SET-BC)

SET-BC is a good place to start for BC students with complex needs to participate more actively in their education and in standard curriculums. SET-BC also have a wealth of resources and training to tap into.

Without funding, the cost of a specialized device is typically within the range of $3,000 to $8,000 CAD, depending on the complexity of the device. Devices can be rented or purchased from a number of suppliers in BC such as the resources mentioned below. Tablet-based apps on the other hand tend to be more cost effective, and in many cases are highly effective (see our list of recommended apps above.)

Ready to get started?

AAC is a valuable assistive communication tool that should be considered as part of an effective treatment plan for children and adults with severe speech or language difficulties. If you are based in BC and suspect that AAC might be helpful for you or someone you love, reach out to Arbutus Speech Therapy for a free consultation.

Resources and Providers of Augmentative and Alternative Communication Equipment

Wavefront Centre Communication Devices

Wavefront Centre’s Communication Devices Showroom is located at their Mount Pleasant head office. They have on display a variety of assistive listening and alerting devices for people with hearing loss to optimize communication and safety at home, in the workplace, and in social environments.

Bridges Canada

Bridges is a national, full service, assistive technology company. They deliver support in assistive technology for learning, communication, alternative access, low vision and blindness needs.

Canadian Assistive Technology

Sells and delivers a wide range of accessibility equipment to enable persons with disabilities to be successful in the workplace or engage in their favourite activities at home

National Autism Resources

National Autism Resources is a leader in providing cost effective, research based therapeutic tools that meet the needs of people on the autism spectrum across their lifespan

Technology and Autism

This website has information on assistive technology for autism and how it may be best utilized.

WorkBC Assistive Technology Services

WorkBC Assistive Technology Services provides assistive technology to people with disabilities to help them gain employment.