Augmentative and alternative communication (AAC)
Augmentative and Alternative Communication (AAC) is a key focus area for the speech pathology department of Novita Children's Services. Some children may not develop sufficient speech to communicate well and therefore require some form of AAC Novita speech pathologists work with children, their families and other team members to design the best possible communication system for each child and their family, helping children to reach their full potential.
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What is AAC?
AAC stands for augmentative and alternative communication:
- Augment means to add to or to enhance. For example, we can augment speech by using gestures, eye pointing and body language.
- Alternative means a choice or a substitute. We can use alternative communication to speech by pointing to symbols, signing or by spelling.
- Communication means to send and receive messages with at least one other person.
Therefore AAC is the term used for all communication that is not speech, but is used to enhance or to replace speech. An AAC System means the whole combination of methods used for communication, for example, gestures, eye pointing, vocalizations and pointing to symbols.
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How does AAC help?
AAC systems can help people who cannot speak to:
communicate (our most powerful skill) - "If all of my possessions were taken from me with one exception, I would choose to keep the power of communication, for by it I would regain all the rest" [Webster, Daniel. Politician & orator (1782 1852]- develop language skills
- decrease frustration
- increase socialisation - "To me and others like me, being able to communicate puts us in society. It lets us have a voice. For me, having a Liberator (voice output device) has changed my life completely." [McFadden (1995) - refer to the CALL Centre Education link in the Related External Links list on this page]
- increase participation
- have control over what happens to them.
AAC might be suggested:
- if speech is slow to develop
- as a back-up if speech is difficult to understand
- as a way of communicating most of the time if speech ability is very limited or non-existent
- to help develop understanding of delayed language.
An AAC system may be either a short or a long-term solution to communication difficulties being experienced by a child.
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Does AAC hinder the development of speech?
"Children will use the quickest, most effective, and most accessible way available to them to communicate. Speech beats any other AAC system if it is available to the child. Since AAC includes all communication methods, intervention also addresses improving functional verbal skills. Available research indicates that AAC facilitates spoken language by increasing interaction, language skills, and/or providing a voice output model for speech." (Cynthia J, Cress PhD)
For further information on this topic, see Frequently asked questions.
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Examples of children who may be assisted by AAC
- Peter's story - a 4-year-old child with Cerebral Palsy.
- Renée's story - Renée is 2 years old with a physical disability and problems with her vision.
- Jack's story - Jack is a baby with severe and multiple disabilities.
View the document 
AAC stories (PDF - 44Kb)
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Types of AAC?
AAC covers a large number of ways of communicating. It can include one or more of the following:
- Natural communication methods, such as:
- pointing and gestures
- mime
- facial expressions
- body language.
- Methods that can be taught, such as:
- Signing - this involves the use of a formal set of signs, or signs which are particular to an individual. Signing is useful to help children to understand language. The sign can be seen and held for slightly longer if needed, whereas speech disappears as soon as it is spoken. Signing can also be used as a means of expression with other people who know signs.
Novita provides a number of Makaton (Key Word Signing) workshops each year, These are free for the families of Novita clients. For information and to register view the 
Key Word Signing Workshops 2008 - Information and Application Form (PDF - 95Kb)
- Object symbols - these are objects such as small versions or parts of objects which represent an activity, object or person (for example, a set of keys represents that its time to go in the car)
- Photos, drawings, symbols - these are used like object symbols to represent words in a visual way
- Communication boards and displays - these are sets of photos, drawings, symbols or words that are used by an individual for communication - .
For more details, view/download the document Types of AAC (PDF - 189Kb).
Disclaimer: General information only - you should consult with the relevant professional before using it with a particular child. See further disclaimer details
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Combinations of AAC methods
For all people, the type of communication needed throughout each day varies greatly. For example:
- we talk with a variety of people, such as friends, strangers, superiors, relatives
- we talk in a variety of places, such as:
- a noisy place, such as at the football
- a dirty place, such as in the sandpit
- We talk for a variety of reasons, for example:
- to joke
- to argue
- to talk about an experience
- to discuss.
It is unlikely that any one communication method or system would meet a persons needs in all of these situations. Children who use AAC often need a variety of methods and systems to let them communicate throughout the day and night!
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What's important about AAC?
Parental involvement - successful use of AAC involves support and active involvement of those who are in the child's immediate environment - parents and caregivers are the key to AAC success. (graphic-communication group-child and parent).- Communication partners - there are lots of things that communication partners (those who interact with AAC users) can do which make a real difference to the skills an AAC user develops.
- Opportunities to communicate - in order to develop and practise communication skills, the child (particularly in the early stages of using AAC) may need some extra encouragement to use their AAC system.
- Vocabulary choices - the words and messages chosen for an AAC system are very important - if they are not useful or motivating to the child or listener, they will not be used.
- Ongoing evaluation - an AAC system should be ever-changing, matching the needs of the user as they grow, learn and meet new people - communication needs are always changing, and an AAC system should change to meet (or anticipate) these needs.
- Ease of use - for communication to be successful, it needs to happen as easily as possible for the user and as quickly as possible for the listener - many factors will need to be considered to achieve this goal.
For more information, view the factsheet What's Important About AAC? (PDF - 58Kb)
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AAC prescription
When deciding on the best AAC device for a child or adult, it may be useful to consider the following:
- Giving a person an AAC communication system does not mean they will show an interest in using it - AAC systems are tools, they do not provide the interest or ability to communicate.
- Read up on the information on the Assessment page of this site.
- Check the information in the What's important about AAC? section of this page.
- Prescription of a voice output communication device requires careful consideration and a variety of information and input from others. For more information, check out the following sites in the External sites list at the bottom of this page:
- AAC Connecting Young Kids (YAACK) - look at the 'Issues with Different AAC Devices and Systems' section.
- Washington University AAC page - follow the links for 'Understanding AAC Features'.
Remember that an AAC system should not be recommended without looking at the whole communication picture - the best result is usually obtained when the speech pathologist co-ordinates all the steps involved - the speech pathologist can also work out the most suitable type of AAC system , together with the child, their family and other therapists - these people can also be supported by therapists from the NovitaTech Support Team, if needed.
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AAC training
There are a number of different approaches and methods that may be used in AAC training. These include immersion and modelling.
Teaching, training and practise are very important in determining the success of AAC use.
For more information view the factsheet AAC Training(PDF - 66Kb)
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Camp Yackety Yack
Camp Yackety Yack is a weekend camp for children with complex communication needs and their families that assists families to improve their communication with the child who uses a communication device.
Check out the photos from the last campCamp Yackety Yack 2006 (PDF - large file - 3.6 Mb)
- What kind of cognitive skills do children need before you start AAC?
- How do you know how much a child really understands if they can't talk?
- Why should we introduce AAC if the child doesn't seem to want to communicate about much?
Go to the Cyntha Cress website for answers to these, and other commonly asked questions
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Books and journals referred to on this page
The following books may be found in the Novita Toy & Resource Centre. If you are registered with the Centre, you can borrow them by completing the on-line request form.
- AAC Augmentative and Alternative Communication (Vol. 17, No. 1, March, 2001) Special Issue on AAC and Literacy
- Cooney, A, Cowley, J, & Knox, G (Eds) (1984). Line Drawings for use with the Revised Makaton Vocabulary. Makaton Australia, Newcastle, NSW
- Beukelman, D R & Mirenda, P (1992). Augmentative & Alternative Communication, Management of Severe Communication Disorders in Children and Adults. Paul H Brookes Publishing Co. Inc.
- Bloom, Y (1990) Object Symbols - A Communication Option. Monograph Series - No 1
- Elder, P & Goossens, C (1994). Engineering Training Environments: Strategies for Adolescents and Adults who are Multiply/Severely Developmentally Delayed. Birmingham, AL: Southeast Augmentative Communication Conference Publications Clinician Series
- Goossens, C, Crain, S & Elder, P (1992). Engineering the Preschool Environment for Interactive, Symbolic Communication: 18 Months to 5 Years. Birmingham, AL: Southeast Augmentative Communication Conference Publications Clinician Series
- Jeanes, R, Reynolds, B & Coleman, B (Eds) (1993). Dictionary of Australian Signs (2nd Ed), Victorian School for Deaf Children, Australia
- Johnston, T (1996). AUSLAN Dictionary: Dictionary of the Sign Language of the Deaf Community. Australian Print Group, Australia)
- Lloyd, L, Fuller, D and Arvidson, H (1997). Augmentative and Alternative Communication: A Handbook of Principles and Practices. Allyn and Bacon, Massachusetts
- Millar, S and Larcher, J (1998). Symbols Software. CALL Centre, Edinburgh University, Edinburgh, UK
- Musselwhite, C & St.Louis, K (1988). Communication Programming for Persons with Severe Handicaps (2nd Edition). College-Hill Press, Boston
- Williams, M and Krezman, C (2000). Beneath the Surface: Creative expressions of Augmented Communicators. ISAAC Series, Vol 2, Toronto
- Yoder & Koppenhaver, (1993). Literacy Learning and People with Severe Speech Impairments (Special Issue). Topics in Language Disorders, Vol 13, No. 2
Disclaimer Detail: The information on this website is of a general nature only and does not constitute advice. Novita Children's Services makes no representations as to the accuracy, usefulness, suitability or application of the information to a child's particular circumstances. You should seek professional advice before acting or relying on the information. In using this site, you are agreeing to the Terms and Conditions of Use for the site.