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Combination of Aided and Unaided AAC

COMBINING APPROACHES

The choice between aided and unaided, high-tech, and low-tech AAC is one that is highly individualized. Often, aided and unaided strategies are used together to facilitate communication. For example, the use of manual signs and a speech-generating device can be used by the same child simultaneously. Or, a mobile application can teach a child how to sign a specific word. 

 

USING LOW-TECH TO TRANSITION TO HIGH-TECH

There is evidence to suggest that it is easier to transition to a high-tech AAC device after first using low-tech devices.

 

In a study investigating differences between AAC technological complexity, researchers found that children who proficiently used the Picture Exchange Communication System (PECS), a low-tech aided AAC system, successively transitioned to a high-tech Speech Generating Device (SGD) in about five weeks of consistent training (3). 

 

Additionally, after this transition was made, the children seemed to prefer using the SGD in situations where both SGDs and PECS were available. This suggests that using low-tech AAC to help teach the basic principles of AAC communication promoted an easier transition to high-tech AAC, which was eventually preferred (3).

WHERE TO START

There are no set rules as to what device you have to try first. Similarly, there are no rules about what combination of strategies you can use. Some families find it easier to try low-tech AAC first to see if their child is engaged in communicating via picture or communication board. Or, they may try low-tech options before investing in high-tech options. It is recommended to follow the advice of health-care professionals involved in the assessment of your child's communication, especially speech-language pathologists, educators, and physicians. 

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At the end of the day, the goal of AAC is to establish functional communication, which can and often does look different from child to child. If your child prefers one method over the other, roll with it! If they are able to convey what they want, need, and feel, in a way that works for them, then AAC is doing its job, no matter how simple or advanced the strategy is. You as a parent are the expert on your child, and as such are an important member of the team deciding what device suits their needs. Choose the AAC option you think will work best, and do not be afraid to ask for help and support from healthcare professionals (4, 6). 

REFERENCES

  1. Alzrayer, N. M. (2020). Transitioning from a low- to high-tech Augmentative and Alternative Communication (AAC) system: Effects on augmented and vocal requesting. AAC: Augmentative and Alternative Communication, 36(3), 155–165.

  2. Aydin, O., & Diken, I. H. (2020). Studies Comparing Augmentative and Alternative Communication Systems (AAC) Applications for Individuals with Autism Spectrum Disorder: A Systematic Review and Meta-Analysis. Education and Training in Autism and Developmental Disabilities, 55(2), 119–141.

  3. Beck, A. R., Stoner, J. B., Bock, S. J., & Parton, T. (2008). Comparison of PECS and the use of a VOCA: A replication. Education and Training in Developmental Disabilities, 43(2), 198–216.

  4. Beukelman, D. R., & Light, J. C. (2020). Augmentative & alternative communication: Supporting children and adults with complex communication needs (5th ed.). Paul H. Brooks Publishing.

  5. Leonet, O., Orcasitas-Vicandi, M., Langarika-Rocafort, A., Mondragon, N. I., & Etxebarrieta, G. R. (2022). A Systematic Review of Augmentative and Alternative Communication Interventions for Children Aged From 0 to 6 Years. Language, Speech & Hearing Services in Schools, 53(3), 894–920. https://doi.org.10.1044/2022_LSHSS-21-00191

  6. Marshall, J., & Goldbart, J. (2008). 'Communication is everything I think.' Parenting a child who needs Augmentative and Alternative Communication (AAC). International Journal of Language & Communication Disorders, 43(1), 77–98. https://doi.org/10.1080/13682820701267444

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