In the past decade, the use of high-tech augmentative and alternative communication (AAC) systems has increased dramatically, primarily due to the availability of tablets. Augmentative and alternative communication is an intervention that is useful for many children with communication disorders. As with any communication intervention, it is best to start as early as possible; and it is very important to seek help from an AAC specialist.
AAC assessment requires knowledge of ever-changing technologies, proficiency in system selection and programming, and clinical expertise in language intervention. Systems range from low-tech (e.g., PECS) to high-tech speech-generating devices (SGDs)—and each system or strategy has benefits.
The choice and implementation of an AAC system should be done on a case-by-case basis, based on each communicator’s specific strengths and needs (1). Identifying the appropriate symbols, mode of selection, symbol display, and teaching strategies require time and knowledge.
When selected and implemented properly, SGDs often offer many advantages over low-tech options including increased social acceptance (2), easier editing, voice output, and unlimited vocabulary possibilities. Recent systematic reviews found SGDs superior to low-tech modes in supporting the development of spoken language (3).
The overall accessibility of tablets is certainly valuable, but the ease of acquisition may also encourage some to select this tool without doing a full and comprehensive evaluation—an unintended, negative consequence. The selection of an inappropriate communication tool, neglect of continuous re-evaluation, and the lack of appropriate teaching strategies often leads to missed opportunities for language development, inability to communicate, and ultimately, device abandonment.
Ultimately, the goal of an AAC assessment is to identify the appropriate tool for each communicator. Ongoing evaluation is necessary to ensure continued success.
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1. Augmentative and Alternative Communication Assessment. (2018). In ASHA online.
2. Lorah, E.R., Tincani, M., Dodge, J. et al. (2013) Evaluating Picture Exchange and the iPad™ as a Speech Generating Device to Teach Communication to Young Children with Autism.Journal of Developmental and Physical Disability (2013) 25: 637. https://doi.org/10.1007/s10882-013-9337-1.
3. Kasari, C., Kaiser, A., Goods, K., Nietfeld, J., Mathy, P., Landa, R., . . . Almirall, D. (2014). Communication interventions for minimally verbal children with autism: A sequential multiple assignment randomized trial. Journal of the American Academy of Child and Adolescent Psychiatry, 53, 635–646.