Augmentative and Alternative Communication (AAC)
Augmentative and Alternative Communication (AAC) involves the use of various communication devices, tools, and strategies to help those who cannot fully rely on their speech to communicate effectively.
At FOCUS Therapy, our highly-qualified Fort Myers speech therapists provide AAC evaluations for children to determine:
- Whether AAC is appropriate based on their current communication skills.
- Which form of AAC device will be the most practical and provide the greatest benefit for the child.
- An individualized plan of care to help each child become the most functional communicator they can be - today, tomorrow, and beyond.
"The end goal is always for the child to use their voice independently," explains David Gibb, FOCUS Speech-Language Pathologist and Assistive Technology Specialist. "Alternative and augmentative communication simply allows us to meet kids where they are now."
These devices utilize and build upon the child's existing communication abilities, including speech, vocalizations, manual signs, gestures, etc.
"AAC empowers children with disabilities and delays by helping them overcome the limits of their current verbal output," Gibb explained. "From there, we help them make the most of these tools so that gradually, they'll become functional communicators who rely on AAC less and less - and hopefully, one day, not at all."
Who Can Benefit from Augmentative and Alternative Communication?
The American Speech-Language Hearing Association (ASHA) estimates some 2 million people with significant expressive language impairment (difficulty expressing themselves to others) use AAC devices.
AAC is not limited to those with any one condition or diagnosis. That said, it is most typically recommended for children with:
- Autism spectrum disorder
- Significant speech & language delays
- Down syndrome
- Cerebral palsy
- Muscular dystrophy
- Apraxia of speech
- Phonological disorders
- Hearing impairment
- Intellectual disability
- Traumatic brain injury
Questions parents can ask if they're considering AAC for their child:
- Do my child's language skills meet what is developmentally appropriate for their age?
- Can my child effectively communicate their basic wants and needs?
- Can I understand what my child is saying?
If you answered "No," to these questions, your child might be a good candidate for an AAC device and/or speech therapy.
Forms of AAC Devices
AAC devices come in many forms. Many factors are carefully considered by our Fort Myers speech therapists when determining which will work best for each individual.
Forms of AAC include:
- No-tech: Relies on gestures, signing, pulling, vocalizations
- Low-tech: Voice output devices (switches), static communication boards, etc.
- High-tech: Speech-generating devices
Experienced speech therapists like Gibb, who is certified in MELD, LAMP and has completed numerous AAC trainings, will consider the following when pairing a child with AAC:
- Can they isolate one finger?
- Do they need larger buttons?
- How is their shoulder strength?
- What is their hand and arm range of motion?
- Do they demonstrate joint attention?
- Do they have functional vision/hearing?
- Can they read or do they need pictures and/or audio cues?
- Do they have communication intent?
In a multidisciplinary clinic like FOCUS Therapy, our speech therapists get the benefit of insight from other skilled professionals like physical therapists, occupational therapists, and board-certified behavior analysts. Sometimes recommendations for AAC actually originate from these other therapists, though we may still require physician referral for insurance to cover the evaluation.
Will My Insurance Cover an AAC Device for My Child?
Insurance coverage for AAC devices depends on the individual policy. FOCUS Therapy has a 100% insurance approval rate from Medicaid for AAC devices.
Our Speech Therapy Department works closely with AAC device manufacturer representatives, and understand exactly what information insurers need to approve a request for coverage.
Out-of-pocket costs for some AAC devices can be as much as $5,000+. If insurance won't cover it and you can't afford one out-of-pocket, we *might* have alternative suggestions, such as AAC programming or subscription apps that can be downloaded on a dedicated iPad, etc. The availability and appropriateness of these alternatives will depend substantially on the needs and abilities of each individual.
How Long Will My Child Need an AAC Device?
The duration of AAC device use depends on the individual.
Patients with an AAC device have a separate plan of care related specifically to the use of that device. Progress is constantly monitored, and reevaluations are conducted every 6 months.
"What we're aiming for is functional communication," Gibb said. "If they're functionally communicating verbally, we'll start phasing out their use of AAC. It's all about what is most effective for them right now."
Once your child has an AAC device, we can provide training to parents, teachers, day care program providers, etc. - anyone regularly caring for and/or communicating with your child. This ensures they're getting the most from the device, and they'll start generalizing the skills they're learning much faster.