Augmentative and Alternative Communication: Talking at the Touch of a Button

Whether it’s via e-Mail, telephone or one-on-one – for many people communication is a basic need. But what can you do if it’s not possible due to health issues to express yourself with words? Augmentative and Alternative Communication might be the answer.

01/10/2010

Mornings at the kindergarten: all children are sitting in a circle and talk about what they did the day before. They chatter happily. Then it is Paul’s turn. He presses a big yellow button and we can hear his mother’s voice. Now she tells the children what other adventures Paul had the previous afternoon. He is all smiles.

This way or similarly Augmentative and Alternative Communication (AAC) can be applied in everyday life and simplify togetherness. People whose expressive language is difficult to understand or completely missing, can improve and expand their communicative options with the aid of AAC.

To determine your spread yourself
is possible with AAC; © Daniel
Daum/panthermedia.net

Hazelnut spread instead of cheese for breakfast

“Many use the term Augmentative and Alternative Communication synonymously with compensating communication. But that is not fair”, Mareike Köhler of Rehavista GmbH in Bremen points out a common misconception. She stresses that with AAC it is not just about the mere compensation and initiation of missing or hard to understand expressive language. The declared goals are actually also the active participation in life and self-determination. “For children for instance it is very important to say that they don’t want cheese but instead hazelnut spread on their sandwich“, adds Köhler.

Simple technical communication aids can be adapted to just these types of situations. The handy devices come with nine key pads for instance, which are adapted with various symbols and messages for specific situations. In the “breakfast“ situation for instance the symbols for butter, jam, hazelnut spread and cheese are displayed on the keys. If the child presses the symbol for hazelnut spread, it sounds the sentence “I want hazelnut spread on my sandwich please“. In normal cases the mother will follow the request and act accordingly.

If a child pushes the white button,
its mother will rebuild the bricks -
an experience of self sufficiency;
© REHAVISTA GmbH

“For children using Augmentative Communication it is primarily about experiencing themselves as self sufficient and to learn that they can achieve something with spoken sentences“, says graduate remedial special education teacher Meike Stahl. In her counseling capacity at Prentke Romich in Kassel she has witnessed many such epiphanies. The children actively press a key by themselves and something immediately happens as a result. These are the type of experiences people without language impairments make in early childhood while acquiring language through vocalisations.

Ranting and playing are a part of it

Aside from children, other people also benefit from AAC: It can also help people with progressive diseases like ALS, Multiple Sclerosis or Parkinson’s as well as people with acquired speech impairments due to accidents for example to better communicate. Which aid ultimately gets selected varies a lot. “The particular communication aid needs to be individually adapted to the needs and skills of the patient on a case-by-case basis“, says Stahl.

This is why it is so important to already find out during the first counseling interview, which motor-prerequisites the future user brings to the table. “When choosing a communication aid it makes a big difference whether the particular person is able to touch only a few large keys with their finger or many small keys or whether they need a different method, e.g. a system controlled by the eyes”, Mareike Köhler knows from her daily routine as a counselor.

Parents, teachers or carers can record messages on the communication aids. Often the statements are quite short and last about 20 to 30 seconds; © REHAVISTA GmbH

But regardless which device is ultimately picked, the focus should always be that this is not just about expressing simple needs, but particularly about experiencing real communication. This is why the electronic auxiliary devices also contain swear words. Many parents or caregivers are sometimes irritated about this in the beginning. “Yet it is so incredibly important for each child to also experience confrontation sometimes and test boundaries – no matter whether they have a speech impairment or not“, Köhler points out. At this point, the law of cause and effect takes effect: the children "curse" and experience an immediate reaction to it: for example astonishment or laughter. Or they are put into their place and people curse back.

This interactive approach is also of great importance in larger groups like classrooms: with the aid of quite simple devices it is possible for students for example to actively participate in group games or competitions. By touching a single key, a student without expressive language can assume an important role in a competition, because everybody is waiting for his commando: On your marks, get set, go!

Nadine Lormis
REHACARE.de

(Translated by Elena O'Meara)