What is augmented and alternative communication?
Augmented communication is mainly used for children who are partially verbal and augmented communication are systems and devices put in place to supplement natural speech. For example, the use of a small portable amplifier to increase speech volume. Alternative communication on the other hand is utilised for children who are non-verbal, wherein systems and devices replace natural speech (NAS, 2017).
The common worry that ties in with the use of augmented and alternative communications (AACs) is when and who should use them, and if it impairs social speech for those partially verbal (Iacomo, Trembath & Erickson, 2016). This brings the focus back to the segregation of augmented and alternative communication. Children who are partially verbal should not be using alternative forms of communication as it can discourage them from speaking when they have the ability to do so, especially in the early stages of growth where it may still be possible to improve speech with early intervention strategies like speech therapy and behaviour therapy. When natural speech is compromised and it affects daily communication needs, AACs should be implemented. Factors to take into consideration before the use of AACs would be the level of communication skills of the people in the child’s environment, rate of communication and the level of communication complexity (NAS, 2017).
Who is at a higher risk of communication impairment?
It was discovered that the majority of people who were born with communication needs are people with autism spectrum disorder (Perry, et al., 2004). Children with autism are at higher risk of a slower development of speech and expression. On top of that, lower functioning children with autism may struggle with expressing their needs and wants, hence the emphasis on the need of AACs (Rogers, 2003). Lack of speech is an obvious symptom but still an essential skill for interaction with family and peers in children with autism, and children who are verbal have more opportunities for social interactions as well as a greater chance in participating in mainstream settings like in school and the community (Howlin, 2005).
With the introduction of AACs into the industry, the percentage of non-verbal and partially verbal children with poor long term outcomes have decreased from 40% to 20%-30% (Rogers, 2003). Therefore with AACs, it can pave a new platform of communication for children struggling with communication to be better integrated into society (Wali & Sanfilippo, 2020).
What are assistive devices and how can it be implemented?
Examples of assistive devices are device applications, sophisticated, speech generating devices (SDG). These devices and device applications work similarly, in the sense that children work with the vocabulary given in the applications and can acquire new words and language with increased familiarity of use. These devices also aid auditory processing of spoken language. An example of a device application would be a tablet with various nouns, verbs and vocabulary for children to structure sentences to be read out by the device.
Other assistive devices are also available for children who struggle with expression through the use of tablets and applications. Children who struggle with their fine and gross motor skills may require devices that can assist a great aspect of communication including tracking of eye gaze, head tracking, joystick control and single and multiple switch controls.
Communication is essential especially for children with autism. If they fail to develop speech skills and have no alternative forms of communication, they are at higher risk of developing problem behaviours, experience limited academic learning, a lack of job prospects and a higher risk of mental health issues. They may feel isolated and frustrated due to the lack of ability to understand what is being communicated to them and vice versa.
The effectiveness of AACs overwhelmingly relates to teaching functional communication with a focus on requests. Aided with AACs, children are able to express their basic needs and wants, which will reduce unnecessary hiccups in their growing stages and aid their learning with added opportunities.
Written by: Joleen
Antao, et al. (2018). PubMed Central. Instruments for augmentative and alternative communication for children with autism spectrum disorder: a systematic review. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6238819/
Iacano, Trembath and Erickson. (2016). PubMed Central. The role of augmetative and alternative communication fo children with autism: current status an future trends. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5036660/
Ibrahim, et al. (2018). Igenta Connect. A review on using asssitve technology to enhance social skills competence among children with autism spectrum disorder (ASD). Retrieved from https://www.ingentaconnect.com/contentone/asp/asl/2018/00000024/00000006/art00092
Loftlandf. (2018). India University Bloomington. Should all nonverbal young children with autism immediately have AAC taught to them?. The Reporter 22(12). Retrieved from
Wali and Sanfilippo (2020). HAL. A review of the state-of-the-art of assistive technology for people with ASD in the workplace and everyday life. Retrieved from https://hal.inria.fr/hal-02510161/document