Augmentative & Alternative






•    benefits of functional communication

  usefulness of visual schedules

  total versus aided communication

THE ISSUE    Augmentative and Alternative Communication (AAC) devices are used to help children who are unable to speak, children who have mobility issues, children with vision or hearing impairments, and children with cognitive limitations to communicate with others using methods other than traditional speech. Communication devices range from very low-tech devices, such as picture communication boards, on which children communicate by pointing to pictures, to very high-tech devices, such as computer voice output devices where children can program a computer to speak for them.

THE REVIEWS    Of the 65 review articles included in this project, only 3 address AAC interventions and none reflect eitology or assessment. These reviews of research examine evidence for the effectiveness of specific augmentative and alternative communication techniques commonly used in therapy such as visual schedules, functional communication training, and communication rejecting.

WHAT THE REVIEWS CONCLUDE    Overall, functional communication training has been shown to increase children’s use of functional signs and to reduce problem behaviours as long as clinicians match the new functional communication goals to existing problem behaviours. Visual schedules have been shown to help children, particularly children with autism, to predict and understand activities, and to reduce problem behaviours.

The research evidence suggests that there is little agreement and limited evidence to determine which communication strategy is  better for children with limited expressive language skills: total or aided. In general however, research suggests that total communication may be the more effective method for children with good fine motor abilities, while aided communication may be the better method for children with poor fine motor difficulties.

Studies on total communication have focused on naming vocabulary, while studies using aided communication have focused on functional communication such as requesting which may be more beneficial for children in terms of social success. Research on teaching communication rejecting to children revealed three empirically validated strategies for clinicians to use in intervention: rejecting when offered non-preferred objects, discrimination rejecting, and rejecting as a communicative repair strategy. This review may be beneficial to clinicians in selecting which evidence-based AAC strategies to use with specific children.

 ©2006 by Canadian Centre for Knowledge Mobilisation. All rights reserved.