Speech & Language

Augmentative and Alternative Communication (AAC) for Unclear Speech

AAC stands for alternative and augmentative communication. Alternative communication means using a different method instead of speech whereas augmentative communication means using an addition to spoken language which makes their message clearer. This might be a repair board, a powered device (for example iPad or other tablet) with communication software, or a communication book. 

For some, augmentative communication aids will be a short term tool while they work on developing the clarity of their speech. For others, augmentative communication will be an important tool for them long term. It will help them to communicate clearly with others and to develop their independence skills.  

What Difficulties May Look Like:

  • Their speech might be difficult for others to understand
  • May rely on familiar adults to translate what they mean to others
  • May find it difficult to share their wants, needs and opinions with others, including familiar adults

Impact Of Difficulties:

  • May lead to increased levels of frustration and associated behaviours
  • May be passive communicators
  • May have a reduced willingness to communicate or make communication attempts if they feel they cannot get their message across

Will Using AAC Discourage Their Talking?

No, AAC will not stop a child from talking. Talking will always be the quicker and easier for way for a child or young person to communicate and therefore this is very likely to remain their preference.

Consistent AAC use will encourage the development and use of verbal speech by reducing frustration, building language skills and facilitating greater independence in communication. 

Universal Strategies

Choosing Vocabulary

  • When using AAC to repair, focus on communicating key words rather than building full sentences. Let the user say as much as they can with their speech then use their AAC to communicate key words to add context and clues for the listener. For example they might say ‘we went to the..’ verbally and then use their AAC to communicate the place.
  • Prioritise key content words when using the AAC. For example doing words, names, places and describing words. Don’t worry about small grammatical words such as ‘is’ or ‘the’ unless they are essential to help the listener understand.
  • Add vocabulary that is important to the pupil but is difficult for others to understand them saying. This could include family names, friends’ names, pets, favourite TV shows, YouTube channels or music, gaming related vocabulary, clubs and activities they attend and favourite places such as holiday destinations, restaurants, or favourite days out.
  • Make sure there is specific conversation repair vocabulary available and show the child or young person where to find this such as ‘no’, ‘wait’, ‘not that’, and ‘can I show you on my AAC’. Make these words and phrases easy and quick to find. 

Creating Opportunities to Practise Using AAC

  • You may find that familiar adults such as classroom staff and family members can understand the child or young person's speech, but that they are difficult to understand for less familiar people. In this case you will have to set up opportunities for them to practise using their AAC.
  • Start with activities in school such as taking a message to another class or the office and build up to using the AAC when you want to support with activities such as ordering in a café or buying a bus ticket.
  • Initially when practising using powered AAC (an iPad) with new people you might need to help the child or young person write out a message in advance. This may be a time it’s appropriate to use a full sentence. 

Making Use of Literacy

  • If the pupil can spell and type, make sure you model and encourage them to use their AAC this way.
  • Prompt them to tell you the first sound in the word they are trying to say using their AAC or signing.
  • Free text-to-speech software, such as TD Talk, can be added onto any devices that they own, such as tablets or mobile phones. 

Environment

  • Ensure that the pupil’s AAC is available to access all the time at school. It should be kept out and in front of them in the classroom and should be taken out on any trips to other rooms around school as needed. Encourage them to take ownership of their AAC.
  • Consider how to talk to the pupil’s peer group about their AAC. Ensure that all forms of communication including spoken language and AAC are celebrated in your classroom. 

Role of Communication Partner

  • Act quick – if you think the message is urgent, try to work out their meaning quickly rather than supporting them through repair strategies.
  • Pause – when chatting to the pupil make sure you are leaving pauses to give them time to use their AAC as needed.
  • Be honest – if you haven’t understood, say so. For example, say “I didn’t quite catch that”. It is better than pretending and getting it wrong. We want them to know that we value what they want to communicate.
  • Provide feedback – giving specific feedback about what could help you to better understand them will develop their awareness of why breakdowns occur and how to repair them.
  • Check – repeat back what you have understood.
  • Ask questions – use closed (yes/no) questions to provide context to what they are saying, for example “Is it about a place?”, “Is it about a thing?”, “It is about a person?”. Start general and make your questions more specific. You can also use who/what/where/when questions.
  • Model their AAC – many AAC systems contain quick repair phrases, such as “It starts with a…” or “I don’t understand”. Model how to use these phrases to the child so they can use them. When you have worked out what they want to communicate, show them how to say it with their AAC. For children who use their AAC to support their speech, it is important that the use of their AAC is not only modelled when communication breakdown has already happened, as they are more likely to be frustrated. This is why it is important to always model AAC.

Targeted Interventions

Who Can Help?

You can access Speech and Language support by calling Just One Number on 0300 300 0123. Our opening hours are 8am-6pm Monday-Friday (excluding bank holidays).

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