AAC: Interview with LTC’s Sarah Hanson, MS, CCC-SLP

AAC: Interview with LTC's Sarah Hanson, MS, CCC-SLP                                         Author: Krista Flack, MS OTR/L

1. What is AAC?

AAC stands for Augmentative/Alternative Communication.  It is utilized when natural speech is not intact.  It is used across all ages from children who have delayed speech or a diagnosis that impedes natural speech development, to the geriatric population for a man who has suffered from a stroke and no longer has functional speech.


 2.      Is AAC different than low-tech options, like PECS? 

AAC is an umbrella term for all augmentative/alternative communication.  Sign language, PECS, low-tech devices, and high-tech devices fall under that umbrella.  Anything that facilitates communication when the speech mechanism is not in tact is AAC. An AAC device is an electronic or mechanical tool that facilitates language.  AAC is a term that then falls into an even broader category termed assistive technology (AT) which encompasses wheelchairs, ramps, etc. 


3. What are the prerequisite skills needed to be successful with an AAC device?

In my short 10 years of practicing speech and language pathology, I have come across only 2 prerequisites for using an AAC device. The first is the patient must be breathing and the second is the patient must be awake.  In all seriousness, there are no cognitive prerequisites to use an AAC device.  It is up to the speech and language pathologist and the team of professionals to determine WHICH device will benefit the child the most and implement. 

4. My child has significant behavioral issues/cognitive delays/motor delays; does that preclude him from trying a device?

Absolutely not, in fact, it makes him a great candidate! 

Generally speaking, "behavioral issues", usually stem from the inability to communicate-pair that with processing delays (communication partners sound like Charlie Brown's mother) and we've got some HUGE communication breakdowns.  For these kiddos, the "behaviors" that they exhibit are the only way, up to this point, that they have been able to control their environment and feel safe.

For children who are pre-verbal, there is no way to tell the significance of a cognitive delay, if any.  When working with children with AAC, it is imperative that a high cognitive level is assumed and competence is expected by the team of professionals and family members. 

Motor delays do not stop AAC users either.  The patient must have a controlled motor movement. An isolated finger pointing to the screen or low-tech overlay is the best motor movement for effective communication. However; there are many other access options including eye-gaze, blinking, head movements, foot movements, air puffs, etc.  If there is a reliable motor plan, AAC can be utilized.  Generally, OT's and PT's will assist the team in choosing the best access method for a child using AAC

5. If my child uses an AAC device, will it limit his progress towards verbal speech?

NO, NO, NO!!!   AAC enhances speech production.  Study after study has shown that the majority of pre-verbal, limited verbal, or children who are highly unintelligible (even after intense phonological treatment) become more vocal with the use of an AAC system.  It can act as a bridge to verbal speech.  Natural speech is always the goal!!!

6. How do I get an AAC device for my child?

It takes a team of professionals to determine which type of AAC device will be most beneficial for a child.  The professionals may include a speech and language pathologist, an occupational therapist, a physical therapist, ABA therapists, the child's teacher, and parents. The process can be lengthy, but do not let it discourage you.  Speak with your speech and language pathologist and they will head up and guide you through the process. 

7. I have an AAC device.  What now?

It is imperative that a team of professionals work together WITH the family.  Parents, family members, and caregivers should attend as many therapy sessions as possible and follow a home program in order to learn the device themselves.  Devices can be overwhelming and daunting.  It is up to parents to learn the device right along with their child in order for the child to accept the device and use across all environments.  It may take months and years for a child using AAC to become proficient.  Don't give up!!!!

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