Augmentative and Alternative Communication

Abstract

Any patient who is unable to use speech to meet all communication needs across partners and contexts, whether temporarily or permanently, is a candidate for augmentative and alternative communication (AAC) systems and strategies. AAC encompasses a range of tools that can be used to support residual speaking ability or as a replacement for speech for those with severe communication challenges. AAC tools span a continuum of low tech (alphabet or communication boards) to high tech (apps for tablets and smartphones, dedicated communication devices). The primary goal of AAC systems and strategies is to support functional communication. AAC can play different roles for a patient, depending on the course of the disease. For those with degenerative conditions, AAC plays an important role in maintaining functional communication abilities as the disease progresses; tools should be adaptable to accommodate loss of abilities. For those expected to improve or recover, AAC may play a short-term role until functional speech intelligibility is established; tools should be adaptable to accommodate improving speech production abilities. Assessment and intervention with a speech language pathologist are critical for success in determining appropriate AAC systems and strategies and for ensuring the patient learns to use AAC systems and strategies for functional communication and social participation.