Augmentative Communication

Downey D, Hurtig R: Augmentative and alternative communication. Pediatric Ann 2003;32(7): 467-474.

Communication is vital for daily life and includes much more than speech. Augmentative or alternative communication (AAC) attempts to help individuals with severe expressive communication disorders such as speech, language, or writing impairments. This article reviews three categories of AAC: low-tech systems, mid-tech systems, and high-tech systems. The systems vary from simple gestures, eye gaze boards, and communication notebooks, to highly sophisticated electronic voice-output devices.

Advances in technology have created a wide variety of aids that can allow a person direct access via touch screen, keyboard, head mouse, or light beam. Bodily movement such as hand, arm, or leg movement, eye blinking, or eyebrow movement can activate the system.

A child's speech, motor skill, positioning and overall development need to be evaluated by an interdisciplinary team. They can recommend the most appropriate system, facilitate payment (Medicaid, Medicare, and third-party payment), and teach the child and family how to use and care for the system. There is a Communication Bill of Rights to guide individuals to appropriate ways of communicating.