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Does Augmentative and Alternative Communication Decrease My Child's Verbal Speech?
Author: Isabella Knight M.S. CCC-SLP (Check Out Her Staff Page Here)
What Is Augmentative and Alternative Communication (AAC)?
According to the American Speech-Language-Hearing Association (ASHA), AAC is a tool that is used to improve people's daily lives, specifically to express thoughts, wants and needs, feelings, and ideas. It can be something as simple as hand signs or gestures to picture communication boards or speech-generating devices.
What Is Speech Production?
Speech production or spoken verbalizations means using your mouth, voice, and speech muscles to make sounds, words, or word approximations.
Speech Therapy and AAC
During speech and language therapy, you may notice that your speech-language pathologist (SLP) is using something called augmentative and alternative communication, or AAC. This is "an area of clinical practice that supplements or compensates for impairments in speech-language production" (ASHA, n.d.-a). Your SLP may also recommend carrying this tool or strategy over at home during everyday routines.
AAC can look different depending on your child's needs. It may include using a core board, which is a page with pictures or common words that your child can point to while the SLP models language. It may also include simple hand signs, such as signing "more" or "eat." Your child may even already have a speech-generating device that was purchased by your family or introduced by another therapy professional during sessions.
These gestures, tools, and devices can sometimes feel overwhelming, almost like learning a whole new language. Parents often long to hear their child start using words and sentences, so using something other than spoken language may not feel like it matches your goals at first. When AAC is introduced, it is important that the SLP you are working with explains the purpose behind it and how it connects to your child's goals.
‍ ‍ AAC is not meant to replace your child's voice. Instead, it is used to support your child's overall communication, including their ability to express their wants, needs, thoughts, and ideas in a way others can understand. This is communication competence, which "is essential to the quality of life of individuals with complex communication needs" (Light & McNaughton, 2014).
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A Common Misconception
Sometimes, there are misconceptions or misunderstandings about AAC. Some people worry that AAC will stop a child from producing speech, using their voice, or attempting spoken words. However, "this is not true—research shows that AAC can actually help" (ASHA, n.d.-b).
According to ASHA/NJC (n.d.), AAC "incorporates the individual's full communication abilities and may include any existing speech or vocalizations." This means AAC is not meant to take away a child's voice or replace the ways they are already communicating. Instead, it helps us look at the entire child and all of their strengths. Oftentimes, we build on their strengths to support other areas they may struggle in.
It does not prevent speech development and may even support an increase in spoken verbalizations for some children (Schlosser & Wendt, 2008). In a research review that examined AAC intervention and speech production, Millar et al. (2006) found that "none of the 27 cases demonstrated decreases in speech production as a result of AAC intervention." Other studies have shown that children's vocabulary size grew and that augmented communication "does not hinder, and actually aids, speech production abilities" (Romski et al., 2010).
Because of the evidence showing that AAC can support speech production, "AAC services and supports are now considered by many… as a first line of communication intervention" (Romski et al., 2015).
AAC is not a sign that we are giving up on verbal speech. Instead, it gives your child another way to communicate while we continue supporting their speech, language, and overall communication development.
‍ ‍If AAC has been recommended for your child and you feel unsure or overwhelmed, you are not alone. Playful Paths Speech Therapy can help explain what AAC is, how to use it at home, and how it can support your child's speech and communication goals.
References
American Speech-Language-Hearing Association. (n.d.-a). Augmentative and alternative communication (AAC). ASHA Practice Portal. https://www.asha.org/Practice-Portal/Professional-Issues/Augmentative-and-Alternative-Communication/
American Speech-Language-Hearing Association. (n.d.-b). Augmentative and alternative communication (AAC). https://www.asha.org/public/speech/disorders/aac/
American Speech-Language-Hearing Association & National Joint Committee for the Communication Needs of Persons With Severe Disabilities. (n.d.). Augmentative and alternative communication (AAC). https://www.asha.org/NJC/AAC/
Light, J., & McNaughton, D. (2014). Communicative competence for individuals who require augmentative and alternative communication: A new definition for a new era of communication? Augmentative and Alternative Communication, 30(1), 1–18. https://doi.org/10.3109/07434618.2014.885080
Millar, D. C., Light, J. C., & Schlosser, R. W. (2006). The impact of augmentative and alternative communication intervention on the speech production of individuals with developmental disabilities: A research review. Journal of Speech, Language, and Hearing Research, 49(2), 248–264. https://doi.org/10.1044/1092-4388(2006/021)
Romski, M. A., Sevcik, R. A., Adamson, L. B., Cheslock, M., Smith, A., Barker, R. M., & Bakeman, R. (2010). Randomized comparison of augmented and nonaugmented language interventions for toddlers with developmental delays and their parents. Journal of Speech, Language, and Hearing Research, 53(2), 350–364. https://doi.org/10.1044/1092-4388(2009/08-0156)
Romski, M. A., Sevcik, R. A., Barton-Hulsey, A., & Whitmore, A. S. (2015). Early intervention and AAC: What a difference 30 years makes. Augmentative and Alternative Communication, 31(3), 181–202. https://doi.org/10.3109/07434618.2015.1064163
Schlosser, R. W., & Wendt, O. (2008). Effects of augmentative and alternative communication intervention on speech production in children with autism: A systematic review. American Journal of Speech-Language Pathology, 17(3), 212–230. https://doi.org/10.1044/1058-0360(2008/021)