Augmentative and Alternative Communication

When a child is blind or low vision and additional disabilities, they may need to use alternative methods to communicate their thoughts and needs. Your child needs to have a variety of methods both to express their thoughts and to understand what others are communicating. The term “augmentative and alternative communication” (AAC) refers to alternative communication methods that can support a child’s efforts to communicate.

Augmentative and alternative communication methods can be unaided or aided using objects or devices. Examples of unaided methods of communication include gestures, facial expressions, vocalizations, speech, and sign language (such as American Sign Language). Examples of aided forms of communication include the following:

  • Using an actual object to convey meaning; for example, your child hands you a cup to let you know she is thirsty
  • Pointing to symbols, such as pictures or textures on a communication board or in a book
  • Activating a device; for example, your child presses a switch or button on a recorded speech device, initiating auditory output that says “I’m thirsty.”

It is important for your child to have both aided and unaided methods of communication. Learning unaided methods of communication is important because a device or other communication aid may not always be available in every situation in which your child needs to communicate.

AAC Devices

Devices used for communication range from simple to sophisticated. There is a wide array of devices on the market, and they are continually changing. Every child’s needs are different, and an AAC system is usually designed for an individual child.

If your child receives special education services, the educational team will work with your child to determine the most appropriate devices. It is important that one or more professionals who are familiar with communication issues be closely involved in this assessment. Such professionals might include a communication specialist—typically a speech therapist specializing in communication for children with significant communication issues—speech therapist, special educator, or an occupational therapist.

It is equally important for the teacher of students with visual impairments to contribute to selecting an AAC system by providing information about how your child uses any vision and other senses to obtain information from the environment. Your child will need different solutions depending on, for example, the size of the symbols can be seen on a device, where in the visual field your child needs to have the device positioned to see it, or whether your child understands braille. If your child has useful vision, a functional vision assessment needs to be completed to determine how vision is utilized before being evaluated to see what kind of AAC system would be appropriate.

The following are some broad categories of devices used by some children with blindness and low vision and additional disabilities.

  • Communication board: A communication board can be made of cardboard, wood, or another solid surface. Typically it has a grid on it with two or more symbols. The symbols can be concrete, such as actual objects or parts of objects; pictorial, such as photographs or drawings; alphabet symbols in print or braille; or words in print or braille.
  • Communication books: Like a communication board, a communication book has selected symbols that your child can point to in order to convey her message. The book may be arranged so the first page has broad categories, such as emotions, foods, and people.
  • Recorded speech devices: With a recorded speech device, someone (such as you, a teacher, or a sibling) records messages for your child. Your child activates the message using a switch or other button. Systems with multiple switches can store four, six, eight, or more messages. Very complex AAC systems enable the user to convey a wide array of information.
  • Keyboards: Your child may type a message on a keyboard which then reads the message aloud. The symbols on the keyboard might be letters, words, or picture symbols.

It’s important to remember that your child needs multiple methods for expressing their wants and needs. Ideally, your child should not have to rely solely on one method of communication. Providing your child with an array of communication options they can use now and in the future will help them grow and develop and participate more fully in daily life.

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