1. AAC, All Day, Every Day

2. Jane Farrall
Speech Pathologist
AAC Support Services Manager
jane@spectronics.com.au
Twitter: @janefarrall
3. What is AAC?
Augmentative and Alternative Communication (AAC): An area of specialised clinical and educational practice that provides communication options and interventions for people with complex communication needs. The term augmentative in this context means supplemental or additional to speech. Augmentative techniques (e.g. gestures, and facial expressions) are commonly used when communicating and interacting with others.
The use of the term alternative acknowledges that there are some individuals whose speech is sufficiently impaired that they must rely completely on standard and special augmentative techniques, which do not augment speech but are alternatives to speech (Vanderheiden & Yoder, 1996).
(Speech Pathology Australia AAC Position Paper 2004)
4. AAC System
AAC system: An integrated group of components, including the symbols, aids, strategies and techniques used by individuals to enhance communication. The system serves to supplement any gestural, spoken, and/or written communication abilities
(American Speech and Hearing Association, 1991).
5. Unaided and Aided AAC
Unaided AAC: All techniques that do not require any physical aids (e.g. gesture, sign, facial expression).
Aided AAC: Techniques where some type of physical object or device is used (e.g. object symbols, communication boards, books, wallets). Aided AAC is often divided into high technology or low/light technology systems.
(Speech Pathology Australia AAC Position Paper 2004)
6. AAC Myths and Legends
Introducing AAC will stop someone from developing speech
Low tech before High tech
Has a little speech so doesnt need AAC
Too cognitively impaired for AAC
AAC will fix all communication difficulties
Too young for AAC
Doesnt need AAC as they can express basic needs
7. AAC Myths and Legends - Resources
Romski, M.A. & Sevcik, R.A. (2005). Augmentative communication and early intervention: Myths and realities. Infants & Young Children, 18:3, 174-185.
YAACK http://aac.unl.edu/yaack/
DynaVox Implementation Toolkit http://www.dynavoxtech.com/implementation-toolkit/learning-paths/list/?id=7
8. Good Practice Approaches to AAC
Aided Language Displays (ALDs)
Engineering the Environment
Chat Now
PODD
Core Vocabulary
9. Additional AAC options to support good practice
Small Talk
About Me Books
Yes/No ++++
Social Scripts
Partner Focused Questions
Storytelling
10. High Tech AAC
Custom Speech Generating Devices
Mainstream Technology
iPod touch/iPad
Android Phones/Tablets
Laptops
11. Communicative Competence
Light (1989)
Linguistic Competence (mastery of the linguistic code)
Operational Competence (access methods, on/off)
Social Competence
Strategic Competence (make the most of the vocab they have)
12. Aided Language Displays
Prospective users must be provided with frequent examples of interactive, generative use to acquire any semblance of proficiency.
No one would dispute the fact that it would be very difficult to become a fluent speaker of French, if your instructor seldom used French in your presence.
Goossens, Crain and Elder (1988); Goossens (1989)
13. Aided Language Displays
Likewise, it is difficult for a nonspeaker to become a proficient AAC user if other people never model interactive use of their system during all aspects of the day.
14. 15. 16. Aided Language Displays
Aided Language Displays are NOT choice making boards.
Choice making boards supplement ALDs.
E.g. in music time a choice board of songs is followed by boards for singing the songs.
17. It is critical for an individual to not only have symbols, but also to have experience with those symbols in a symbol rich environment / print rich environment. The typically developing child will have been exposed to oral language for approximately 4,380 waking hours by the time he begins speaking at about 18 months of age.
18. If someone is using a different symbol set and only has exposure to it two times a week, for 20-30 minutes each, it will take the alternate symbol user 84 years to have the same experience with his symbols that the typically developing child has with the spoken word in 18 months!!!
19. The typically developing child will demonstrate language competency around 9-12 years of age having been immersed in and practicing oral language for approximately 36,500 waking hours. For 9-12 years that child has been using and receiving corrective feedback while practicing with the spoken word.
20. At twice a week, 20-30 minutes each time, it will take the alternate symbol user 701 years to have the same experience
Jane Korsten (2011) QIAT Listserv 4th April
21. Aided Language Displays
If children are to gain proficiency in using their aided AAC systems, others must begin to use the children's AAC system to communicate with them.
22. Aided Language Displays
By modelling how to use a display to initiate and maintain communication, you show a student how to initiate and maintain not just respond!
23. Aided Language Display Design
24. Aided Language Display Design
25. Aided Language Display Design
If you (as a person proficient in language) cannot use a communication system or display throughout an interaction then how can you provide Aided Language Stimulation?
If you cannot use it, is it designed well?
26. www.boardmakershare.com
27. Engineering the Environment
Displays must be stored in close proximity to where they are needed
Displays must be stored in a way that helps with quick access and set-up
E.g. in dress-up box, on back of bookshelf, on walls, in plastic bucket, inside game box, with props, in eye gaze arrangement
28. CHAT-Now
Developed by Gayle Porter (Cerebral Palsy Education Centre) and Marnie Cameron (Communication Resource Centre)
Childrens Aided Language Tools
Consists of aided language displays for early childhood settings and general interactive board(s)
29. CHAT-Now Book
30. CHAT-Now General Interactive
31. CHAT-Now
A series of ALDs for different activities.
Designed for early childhood but suits many special education settings
Also includes a general interactive board for use throughout the whole day
32. Special School Project
Approx 80% of students in school with CCN
A few have individual systems generally not being used
Lots of visual supports in place all staff carry key caddies and all classrooms use visual schedules, first then boards etc
Commonly used AAC is all adult focused language
33. Key Caddies
34. Special School Project
Baseline observations and videos end of 2010
No spontaneous AAC use by students
35. Term 1 2011
Every student establish yes/no
Begin using CHAT-Now
Introducing general interactive board
Then aided language displays
36. Week 1
Problem solve how to make general interactive display available in every situation
37. Week 2
Model more and finished all week
38. Week 3
Add I like this
39. Week 4
Add I dont like this
40. Week 5
Use whole board
Made up in Tap Speak Choice, AAC App
41. Weeks 6 - 10
Consolidate use of whole board
Ensure all students have yes/no
42. Special School Project
Repeat observations and videos end of term one
10 spontaneous uses of AAC by students observed
Next term introducing ALDs for a range of activities
Term 3 introducing multi-page generic displays
43. CHAT-Now
General interactive multi-level
44. Yes/No
Need to watch the number of yes/no questions we ask AAC users
BUT
Every AAC user needs to develop a good, clear Yes/No response
45. Pragmatics
Pragmatics social use of language
Using language for different purposes, such as greeting, informing, demanding, promising, requesting
Changing language according to the needs of the listener
Following conversational rules
www.asha.org
46. Pragmatics
Need to ensure AAC users have access to and know how to use a range of pragmatic skills
Dewart and Summers Pragmatics Profile (1998)
http://wwwedit.wmin.ac.uk/psychology/pp/
47. PODD
PODD is away oforganising whole word and symbol vocabulary in a communication book or speech generating deviceto provide immersionandmodelling for learning.
48. PODD
The aim of aPODD is to provide vocabulary:
for continuous communication all the time
for a range of messages
across a range of topics
in multiple environments.
49. PODD
PODDs can have different formats, depending on the individual physical, sensoryand communication needs of the person who will use it.
50. PODD
PODDs have been developed over the past 15 years by Gayle Porter, a speech pathologist with the Cerebral Palsy Education Centre (CPEC) in Victoria. EachPODD format has been shaped by the experiences of both children with Complex Communication Needs (CCN), and their communication partners.
51. Core Vocabulary
Using common English words on an AAC display to enable a user to construct their own sentences.
Approach used in lots of high tech systems but not used as much in low tech due to difficulty of arranging vocabulary for access.
52. Core Vocabulary
CORE VOCA
High frequency words
Can be combined to get your message across in lots of different situations
FRINGE VOCAB
Low frequency words
Only useful in one or two situations
Often related to a specific topic
53. Core Vocabulary
54. Core Vocabulary
WordPower 24 in TouchChat, AAC App
55. Pixon
http://www.vantatenhove.com/showfolder.php?id=57
56. Core Vocab to supplement ALDS
From the Disability Services Commission WA
http://www.boardmakershare.com/Activity/969086/Core-Vocabulary-Display
57. Technology
58. High Tech and Light Tech
Both are just tools
Both need good vocabulary design and good modelling to ensure success
High Tech can be less forgiving but can offer more access options
Some students more motivated by high tech and some dont like it!!
Most people need both for different situations
59. Speech Generating Devices
STATIC DISPLAY
DYNAMIC DISPLAY
60. Static Display
May be more durable
Generally cheaper
Often run off AA or AAA batteries
Overlay based - require Boardmaker or other tool
Need to work out system for storing and changing overlays
Need to ensure vocabulary is updated
Harder to maintain in many ways
61. Dynamic Display
May be more durable
Usually rechargeable
Tools for generating pages in device and sometimes in free software too
Can change vocabulary on the spot
Can change pages and levels easily
Generally offer a wider range of access options
62. Access Options
For a user who need alternative access, SGDs can offer:
Large range of access options
Flexibility
Complete control over device and other software
63. Scanning and Eye Gaze
64. High Tech Scanning
65. Low Tech Scanning and Eye Gaze
66.

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