Title: AAC Systems
Course: Communication Room (AAC) > Section: Coomunication Room

This lesson presents the concept of Alternative and Augmentative Communication Systems, with some examples.

AAC Systems

WHAT ARE AUGMENTATIVE AND ALTERNATIVE COMMUNICATION SYSTEMS (AAC)?

Augmentative and Alternative Communication Systems (AACS) are forms of expression other than  spoken language, which  aim to increase (augmentative) and/or compensate (alternative) communication  and language difficulties of many people with disabilities. .Communication and language are essential for every human being, to relate  to  others, to learn, to enjoy and to participate in society and today  , thanks to these systems, they should not  be slowed down because of the  oral language difficulties   . For this reason, all people, whether  children, young people, adults or the elderly, who for any reason have  not  acquired or have lost a sufficient level of speech to communicate satisfactorily, need to use an AACS.

Among the causes that may make the use of an AAC necessary are   cerebral palsy (CP),  intellectual disability,  autism spectrum disorders (ASD),  neurological diseases such as  amyotrophic lateral sclerosis (ALS),  multiple sclerosis (MS) or  Parkinson's, muscular dystrophies, cranio-brain trauma, aphasia or pluridisabilities of  diverse typologies, among many others.

 Augmentative and Alternative Communication (AAC) is not incompatible but complementary to the rehabilitation of natural  speech, and  can also help its success  when possible. It should therefore not hesitate  to  introduce it at  an early age,  as soon as  difficulties in the development of oral  language are observed  ,

WHAT RESOURCES ARE USED?

Augmentative and Alternative Communication includes various systems of symbols, both graphic (photographs, drawings, pictograms, words or letters) and gestures (mimicry, gestures or manual signs) and, in the case of the former,  also requires  the use of support products. The various symbol systems are adapted to the needs of people with very different  ages and motor, cognitive and linguistic abilities.

Communication support  products include technological resources, such as artificial speech communicators or personal computers  and tablets with special programs, which allow different forms of access adapted some for people with very reduced mobility, and  also facilitate the incorporation of the different systems of pictographic and orthographic signs,  as well as different forms of output including  voice output.  They can also  consist of  non-technological resources, such as communication boards and books.

To  access computers, communicators, boards or communication books  there are various strategies and instruments generically called strategies and support products for access, such as pointers, keyboards and adapted or virtual mice  or switches.

SYMBOL SYSTEMS

In previous lines we have divided the symbol systems for AAC into gestures and graphics.  In both cases we find a gradation from very simple systems, which adapt to people with cognitive and linguistic deficits of different consideration, to complex systems  that allow advanced levels  of language signed (based on manual signs) or assisted (based on  graphic signs).

In the case of gestural symbols, this gradation ranges from the use of mimic and gestures of common use  to the use of manual signs, usually in the order corresponding to  the  spoken language; it is what is called  signed or bimodal language. . Sign languages used by non-hearing people  are not considered AACS, as  they are languages that have been  developed and acquired  naturally, as is the  case  with spoken language. The use of manual   signs requires sufficient motor  skills  , as may be the case of people with intellectual disability or ASD.

 Graphic symbols range from very simple systems  based on  drawings or photographs  to progressively more complex systems such  as pictographic systems or traditional spelling (letters  , words and phrases). Thanks to the communication support products and  the  various resources for access, the graphic systems can be used by people with reduced mobility, even in cases of extreme severity. Therefore,  in addition to being used, as in the anterior case, by people with intellectual  disabilities or ASD, they are also used by  people with motor  disabilities (PC, ALS, MS, etc.).

Pictographic systems apply to people who are not  literate because of age or disability.  They have the  ventaja to allow from a very basic  level of communication, which adapts to people with low cognitive levels  or in very early stages, to a very rich  level  of communication and  advanced, although never as complete and flexible as the one that can be  reached with the use of the  written language.

The most used pictographic systems in the various territories of the Spanish state  are the SPC system (Pictographic Communication System) and the ARASAAC system, developed by this own Aragonese Portal of CAA and which is freely available under a Creative Commons license.

COMMUNICATION SUPPORT PRODUCTS

We can divide the support products for communication into basic and technological. Communication boards are basic support products consisting of surfaces of various materials on which graphic symbols for communication are arranged  (photographs, pictograms, letters, words).  and/or phrases) that the person will indicate to communicate. When the symbols are distributed over several pages we speak of communication books.

Among the technological products, we find electronic communicators specially designed for this purpose and laptops or tablets with special programs that make them communicators. Dedicated or emulated electronic communicators on computers are customized with the graphic symbols required by each person. They are characterized by being portable and adapting to the appropriate access forms for each person (keyboards, mice,  switches, etc.). They have an output for messages in the form of digitized or synthesized speech,  as well as, often, other outputs such as screen, paper printed or even environment control functions.  For example, on the website www.utac.cat, you can find different versions of an organized pictographic vocabulary (CACE-UTAC), developed with different communication programs, and prepared to be customized and used directly on computers.   personal (who are thus converted into communicators),  as well as to be printed and built communication books. The versions for Plaphoons with ARASAAC pictograms in Spanish and  Catalan are free and open access. The rest of the versions are also freely accessible but require the corresponding programs and/or trading symbol systems.

STRATEGIES AND SUPPORT PRODUCTS FOR ACCESS

To indicate graphic symbols in communicators, boards and  communication books there are five  fundamental strategies, namely:

The direct selection: consists of signaling or pressing the keys directly, with the finger, with the gaze or with other parts of the body, to indicate the pictograms, words or letters that you want to communicate. Pointers of different types are examples of support products  that can make it easier to  select or access.

The selection with mouse: only for electronic products, it consists of   accessing with a mouse to keyboards or grids with symbols for  on-screen communication. A wide variety of adapted mice can be used, in the  form of a joystick, trackball,  as well as the  facial mouse (controlled with head movements), the mouse controlled with the gaze or the multimouse, consistent on five keys or switches.

The exploration or dependent sweep: only in boards or books, consists of the interlocutor  pointing out, one by one or by groups, rows and columns, the symbols or letters to communicate, until the  assisted speaker indicates with a  gesture that has been  given with the one I wanted to communicate.

Independent scanning or sweeping: only for electronic products, in this case it is the communicator or computer that presents the different options to communicate until the  assisted speaker selects the one that  suits him by pressing a switch.  There are many types of switches that can be activated   with different parts of the body.

The coded selection: in this case each symbol or letter has a code, for example a two- or three-digit number  or a color and a number, so that the  assisted speaker indicates directly  or by sweeping this code to convey the symbol or letter. In this way with a few keys or boxes you can  access a large number of symbols.

Thanks  to the different strategies and support products  for access, no matter how restricted a person's  mobility is  ,  it  is almost always possible to  find a solution so that they can access communication,  as well as other activities, such as  assisted mobility, control of the environment or access to the computer for writing, drawing, playing or communication over the network.

HOW CAN WE FOSTER THE SUCCESS OF THE SAAC INTERVENTION?

AAC support systems and products are only a means or a  necessary condition for the person with a  speech disability to communicate, develop their abilities and participate in the world around them, but they do not result.  never enough. What is really important is the process of education, habilitation and advice that must accompany them.

The intervention process should begin with an evaluation of the capacities, skills, needs and desires of the person,  as well as the characteristics,  supports, demands and restrictions of their environment, in order to define the components that you will have the system or systems that will be most suitable.  Support products and access strategies will have to be carefully selected and, for non-reading AAC users, a good selection of the signed vocabulary will have to be made.  or pictographic that is going to be taught. This evaluation process must not be punctual but continued throughout life.

The habilitation and teaching must be directed both to the person and to his environment, including all the contexts in which he participates or wishes to participate,  as well as all the significant people of these contexts, including professionals and, above all, relatives, colleagues and friends. This teaching should be carried out in educational and therapeutic settings but also in natural environments, in a 24-hour approach that ensures that the person will be immersed in a good environment of language, surrounded by sensitive and competent interlocutors, and involved in interesting and enriching activities.

To promote the success of the intervention with ACS, the most important thing is to ensure that the person with speech disabilities has interesting  things to communicate to others, knows how to do it and has interlocutors who want to listen to him and learn how to understand him. This objective should not be left to chance but achieved through the effort and success of competent professionals, supported by a society increasingly aware and free of prejudices.

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