FAQs

Frequently asked questions about augmentative and alternative communication (AAC) and the benefits it can offer.

These questions have been put together based on our research and we are in the process of answering the questions raised. These issues will be addressed in much of the site content. Any additional questions and potential sources of information that you would like to suggest are very welcome - please contact us.

Some FAQs are generic in nature and some are specific to children or adults. Some questions apply across each section but need different answers. Many answers will be provided with links through to other websites and factsheets, where we have found useful existing resources.

The questions are in no particular order of importance and address the following issues:


Last updated July 2013

FAQs - AAC + Autism Spectrum Disorder (ASD)

About half of people autism do not develop enough speech to meet their needs (Wing & Attwood, 1987), and children with autism may have difficulties both understanding and producing speech. An AAC system offers an alternative format for communication that may help some children manage or overcome their communication difficulties. A good fit between an AAC system and a child with autism can help the child meet her communication needs and increase her communication, independence, interaction with others and quality of life.

A picture symbol system is an aided AAC system that is designed to build up children’s functional language skills.  One commonly used system is the Picture Exchange Communication System (Bondy & Frost, 1995).  Initially, a child is taught to exchange a picture of an item that they want for the actual item.  Children are encouraged to request items spontaneously.  As they progress, children are taught to make sentences, answer questions, produce comments and use adjectives.

Such a system is widely found to be effective for children and adults with autism.  Sometimes, this system can help increase speech in children with autism and their interaction with new people, as well as decrease problematic behaviours.

A symbol system can take a long time for a child to learn and use.  Imagine an adult picking up a completely new instrument and then being expected to play in performances!  Pay particular attention to environments where your child may use the system spontaneously and environments where he may not seem motivated to use it.  Try modelling language using the symbol system and providing plenty of opportunities for your child to communicate his choices and opinions using the system.  If you have the opportunity, be sure to speak with your child’s speech and language therapist or teacher about his communication patterns and preferences and raise any concerns you have about the symbol system.

The National Autistic Society (www.autism.org.uk) provides information for people with autism and their family, carers, colleagues and employers.  The Society provides a wealth of information about education, health, employment and benefits.

Treating Autism (www.treatingautism.co.uk) runs a membership society, local support groups and national conferences.  This Society advocates and lobbies for a biomedical approach to autism.

Ambitious about Autism (www.ambitiousaboutautism.org.uk) runs campaigns about autism and offers training and consultancy to parents, teachers and professionals who work with children with autism.  This organisation maintains Talk about Autism (http://www.talkaboutautism.org.uk), an online community that shares experiences, provides support and discusses autism.

The Autism Research Centre (www.autismresearchcentre.com) operates at the University of Cambridge.  The Centre investigates biomedical causes of autism and provides links to their current research and on going projects.  Volunteers with a diagnosis of autism are invited to participate in research.

Research Autism (www.researchautism.net) provides information about interventions for autism.

Sometimes, using an AAC system can help increase the speech production of a child with autism.  Importantly, using an AAC system does not hinder speech production in children with autism, so introducing an AAC system to a child with autism will not harm potential speech development.

 


Things you might want to look into on this site:


Although this information is believed to be accurate, you are strongly advised to make your own independent enquiries.

Last updated July 2013

tags: 
AAC
tags: 
autism (ASD)

FAQs - AAC + cerebral palsy (CP)

No, not everybody with CP is the same and personality characteristics are as variable as in those without CP.  People with CP can have a variety of different movement characteristics, often described like this:  Children with CP can have either increased muscle tone (hypertonia) or decreased muscle tone (hypotonia).  Muscle stiffness can affect one side of the body (spastic hemiplegia)  or both legs (spastic diplegia).  Other types of CP affect balance and depth perception (ataxic CP) or cause both increased and decreased muscle tone that results in jerky movements (athetoid or dyskinetic CP).  The most severe physical  type of CP is called spastic quadriplegia, and it is characterized by stiffness in all limbs and loose neck muscles, which may make it difficult to hold your head up unaided.

Additionally, some people with CP can have what are called associated conditions such as epilepsy, visual and hearing impairments, a curved spine (scoliosis), communication difficulties, learning difficulties or delayed growth.

Characteristics of some types of CP include difficulties speaking or controlling the parts of the body necessary to produce speech, such as the tongue, lips and vocal chords.  An AAC system can augment the speech skills the person does have or offer an alternative format to speech in order to facilitate language and communication skills. This can be helpful for both children and adults with CP.

The choice of an AAC system depends on the person’s age, current abilities and circumstances.  There is no one-size-fits-all AAC system for CP.  There are a variety of options, though, and if uncertain it is best to seek advice from a speech and language therapist, or through a specialist AAC assessment centre (information about centres are available on this site).

Insights into how this is caused and defined is continually changing due to increases in knowledge about foetal development and neurological change. Currently, cerebral palsy is caused by damage to the brain or brain stem, specifically the parts controlling muscles.  In 5-10% of cases, this damage occurs from asphyxia, a temporary lack of oxygen that can result from a complicated birth.  Sometimes, damage can occur after birth due to infection or head injury.  In the majority of cases, however, this damage occurs before birth due to a lack of blood supply, atypical brain development or prenatal bleeding in the brain.  

A speech and language therapist is the best person to talk to about a person’s speech and communication.  He can teach a child exercises to improve breath control and the articulation of speech sounds as well as introduce manual signs, if appropriate.  A speech and language therapist will also be knowledgeable about various AAC systems that may support communication.

 


Things you might want to look into on this site:


Although this information is believed to be accurate, you are strongly advised to make your own independent enquiries.

Last updated July 2013

tags: 
AAC
tags: 
cerebral palsy (CP)

FAQs - AAC + developmental difficulties

'Learning difficulties' is a very broad term, and everyone with learning difficulties is different. If a child has problems in understanding or using spoken language they might benefit from some form of AAC. This could be the use of signs or symbols, or a communication aid. Which system or systems to use depends on the individual child and the people they are communicating with.

The first point of support to help your child develop their skills should be their speech and language therapist (SLT). If they need AAC then a therapist with specialist knowledge in this field should offer an assessment. If there is no local SLT with these skills then you can ask for an assessment by a regional specialist centre.

When an AAC system or systems have been identified for your child there is an on-going need for teaching, support and review for the user and their carers. Ideally this would be provided by your local SLT team or specialist teachers, possibly with support from regional AAC centres.

There are also groups such as 1Voice which offer support for families and role models for young AAC users, to support their communication development.

'Developmental disability' is an umbrella term that covers lots of different diagnoses and refers to disabilities which mean that a child does not follow the usual developmental course of childhood. It is often present from birth but might not be identified until later in childhood.

Developmental disability is when the overall development of a child differs from the typical in either the rate of achieving milestones or the order in which the milestones are reached. It can affect one or more skill areas including: physical development, learning, speech and communication, social skills.

Some people who have been described as having a developmental disability might 'catch up' over time; others will not do so and might always have a greater or lesser degree of difficulty.

Again it is not possible to give one answer that will apply to everyone diagnosed with developmental disability. There is evidence to show that introducing AAC systems to support their communication will not prevent the development of speech. By giving support to develop skills through AAC individuals then have the option of stopping using the system if they no longer need it. Some people with developmental disabilities will go on to develop successful communication skills; others will need on-going support throughout their lives.

 
Links:

Glossary: Developmental-learning disability

List of UK Assessment Services

A comparison of picture exchange and speech-generating devices: Acquisition, preference, and effects on social interaction

AAC and young children with disabilities - review (summary)

van der Meer L, Sigafoos J, O'Reilly MF, Lancioni GE. Assessing preferences for AAC options in communication interventions for individuals with developmental disabilities: A review of the literature. Research in Developmental Disabilities. 2011;32(5):1422-31.

Mirenda P, Hamm B. Post-School Quality of Life for Individuals with Developmental Disabilities Who Use AAC. AAC: Augmentative and Alternative Communication. 2006;22(2):134-47.

Mirenda P. Sheltered employment and augmentative communication: An oxymoron? AAC: Augmentative and Alternative Communication. 1996;12(3):193-7.

1Voice

Contact a Family

Mencap

Scope

National Autistic Society

The Communication Trust


Although this information is believed to be accurate, you are strongly advised to make your own independent enquiries.

Last updated January 2014

tags: 
AAC
tags: 
learning disability

FAQs - AAC + employment

A Disability Employment Advisor at your local Jobcentre will be able to advise you on opportunities that would be especially good for you.  One scheme is called Work Choice, which can help you get and keep a job if you are disabled (www.gov.uk/work-choice/overview).  Residential training opportunities in England can help disabled adults obtain guidance, experience and qualifications (www.gov.uk/residential-training/overview).

The Government has produced a guide to help disabled people who are looking for work, which is available here: www.gov.uk/looking-for-work-if-disabled/looking-for-a-job.  There is also information for people who are looking to move from benefits to work: www.gov.uk/moving-from-benefits-to-work/overview.

Different opportunities are available in Northern Ireland.  The Condition Management Programme is designed to assist disabled people in obtaining the health care advice they need to return to work (www.nidirect.gov.uk/index/information-and-services/people-with-disabilities/employment-support/work-schemes-and-programmes/condition-management-programme.htm).  Steps to Work offers guidance from an employment advisor, short courses and long-term support to those who are and are not disabled (www.nidirect.gov.uk/index/information-and-services/employment/jobseekers/jobseekers-programmes/stepstowork.htm).  You many also qualify for other work schemes and programmes (www.nidirect.gov.uk/index/information-and-services/people-with-disabilities/employment-support/work-schemes-and-programmes.htm).  The full advice for those living in Northern Ireland is available here: www.nidirect.gov.uk/index/information-and-services/people-with-disabilities/employment-support/finding-employment/help-with-finding-work.html

Citizens Advice has a summary of employment schemes in England, Wales, Scotland and Northern Ireland available here: www.adviceguide.org.uk/england/work_e/work_self-employed_or_looking_for_work_e/government_employment_schemes.htm

The Government provides an online tool that allows you the check if you are receiving all the benefits to which you are entitled.  You can also see how your benefits will be affected if you find work.  You can access it here: www.gov.uk/benefits-adviser

In Northern Ireland, Disability Action can advise on benefits and ensure that you are acting in your own best financial interest.  More information is available here: www.disabilityaction.org/services-and-projects/information-and-advice/benefits-and-helpful-information

There are lots of great resources for people looking to volunteer.  National organisations in the UK provide information on volunteering opportunities in your area and local centres that can help you find a position that’s right for you.  Please also look at the links at the end of this piece too, which may give you some insights and support about how to circumvent potential challenges to volunteering experiences.

If you are in England, see Volunteering England: www.volunteering.org.uk

If you are in Wales, see Volunteering Wales: www.volunteering-wales.net

If you are in Scotland, see Volunteer Scotland: www.volunteerscotland.org.uk

If you are in Northern Ireland, see www.nidirect.gov.uk/volunteering

Access to Work is a government grant scheme for people living in England, Wales and Scotland.  You can apply for support for some the costs of your paid employment associated with physical or mental health or disability.  For example, you may need special equipment or a support worker at your job, or you may have special transportation needs.  With this scheme, you will not have to pay this money back, and it won’t affect any other benefits you receive.

To see if you can apply and make a claim, you will first need to contact an Access to Work centre, in London, Cardiff or Glasgow.  More information is available here: www.gov.uk/access-to-work/overview.  

 


Things you might want to look into on this site:

Things you might want to look into on other sites:


Although this information is believed to be accurate, you are strongly advised to make your own independent enquiries.

Last updated July 2013

tags: 
AAC
tags: 
employment

FAQs - AAC + facilitated communication (FC)

Facilitated communication is form of AAC in which people with communication impairments and disabilities express themselves by pointing at pictures, letters or objects, or by typing.

It involves a communication partner who gives physical or communication supports and encouragement.

It is also called Facilitated Communication Training (FCT) because it aims to develop independent or almost independent communication either through typing or a combination of speaking and typing.

It is a controversial system as some researchers believe that using a facilitator means that the user might not be directing the communication.

It can be used by people with a wide range of conditions including autism, learning disabilities, cerebral palsy and acquired brain injuries who have not been able to use other strategies such as signs, writing or communication aids effectively.

A facilitator is the person who is supporting the FC user to access their communication system. The amount of facilitation needed can vary from just a hand resting on the users shoulder to holding the users hand and enabling their index finger to be isolated. The facilitator should not move or lead the user.

The initial aim is to enable the user to make choices. Some users go on to be able to communicate through typing with very little support, or a combination of typing and speaking.


Links:

Case Story: Heidi's experiences with facilitated communication

Can the facilitated communication method support autistic people, according to facilitators' opinions?

Hidden communicative competence: Case study evidence using eye-tracking and video analysis

Institute on Communication and Inclusion


Although this information is believed to be accurate, you are strongly advised to make your own independent enquiries.

Last updated January 2014

tags: 
AAC
tags: 
therapy

FAQs - AAC + hospitalisation

You can use a communication aid in hospital.  Be aware that the nurses and doctors working in hospital will not be as familiar with the aid as you are.  Try to keep it out where it can be seen and you can access it if you need to.  If someone who knows about your communication aid accompanies you to hospital or visits you there, ask them to tell the nurses about your aid and how it helps you to communicate. You may find some challenges with the positioning and accessing of your aid, and this could be where family or PAs can help. A low-tech page with key words or picture symbols often works particularly well in a strange situation like this.

If you need to communicate with someone who you think may have lost some of their communication skills, there are specific things you can do to help that person understand you.  First, make sure you have the attention of the person with whom you would like to communication.  Make sure the person can see your face clearly.  Check how they can signal ‘yes’ and ‘no’ to you, e.g. eye blinks, head nods, vocalisations, gestures. This will make any following conversation much easier for both of you. Then, use simple words and sentences to communicate your message.  Use gestures to support your message, and then give the person time to understand what you have said.  If you think the person may be able to read, try writing down the message as well.  If you have a picture, graphic or object related to your message handy, show it to the person.  Try to confirm what you think the person has communicated by repeating their message.

For example, if a nurse is pouring some water with her back turned to a patient and says ‘would you like a drink’, the patient is unlikely to be able to see or hear the nurse very well.  A better approach would be if the nurse stood near the patient, got the patient’s attention and then said, clearly, ‘water?’, while miming drinking from a cup of water.

You should find out if the person can understand or produce written words or pictures of items.  This can help in the short-term, but you should always try to see a speech and language therapist, who will be able to provide you with individual guidance.

A speech and language therapist is the best person to advise on communication and speech if those skills have been impaired. You can request a referral through your GP, or if in hospital through any of the hospital staff.

A speech and language therapist may start by getting to know a little bit about you and your family or circumstances.  They will work with you to assess the skills that you have and create a plan of interventions or therapy. From this, they would develop goals for your communication recovery.

 


Things you might want to look into on this site:


Although this information is believed to be accurate, you are strongly advised to make your own independent enquiries.

Last updated July 2013

tags: 
AAC
tags: 
therapy

FAQs - AAC + locked-in syndrome

This medical condition is described in our glossary

Locked-in syndrome is a rare neurological disorder, characterised by complete paralysis of voluntary muscles in all parts of the body except for those that control eye movement. Thinking and reasoning function normally, but there is inability to speak or move.

This syndrome may result from traumatic brain injury or diseases affecting circulation or nerve cells, such as motor neuron(e) disease.

See also brain injury and motor neuron(e) disease (MND).

Useful information available at

If you have good eye control, you may be able to use a low tech e-tran or high tech eye gaze method of AAC, as described on the Communication Matters website.

 


You may be interested in Martin Pistorius' book, Ghost Boy.

Ghost Boy is the compelling story of Martin Pistorius who at the age of 12 fell inexplicably sick. First he lost his voice and stopped eating, within eighteen months he was mute and wheelchair-bound. Martin's parents were told that an unknown degenerative disease had left him with the mind of a baby and with a poor prognosis for survival.

The book eloquently weaves its way as Martin recounts his journey of recovery against all the odds. It is a brave and moving account of his struggle to communicate in a world full of changes. Martin describes himself as ‘a man-child reborn in a world he didn't know’, unable to remember anything before his illness but clearly aware of all around him in his world of silence. Through Martin's story we get a glimpse what it is like to be unable to communicate yet feeling and understanding everything. Martin's emergence from his darkness enables us to celebrate the human spirit and is a wake-up call to cherish our own lives.

"It is a deeply affecting and at times shocking book... The Diving Bell and The Butterfly but with a happy ending."
The Sunday Times, 17 July 2011

"[Pistorius’s] levels of empathy are remarkable, perhaps because he was forced for so many years into the role of watcher and listener, hearing people unburden their problems around him, absorbing their pain without them knowing... [his] communication is strikingly direct, almost fearless in the way he confronts emotional reality."
Catherine Deveney, Scotland on Sunday

"Martin tells the story of his remarkable recovery—and how he eventually came to find love, a home and a job… Now in a deeply moving – and ultimately uplifting - new book, Martin Pistorius tells the amazing story of life as The Ghost Boy." 
The Irish Mail


Although this information is believed to be accurate, you are strongly advised to make your own independent enquiries.

Last updated December 2012

tags: 
AAC
tags: 
locked-in syndrome

FAQs - AAC + Parkinson's Disease (PD)

Parkinson’s disease is an extensively researched condition.  It is a progressive neurological condition that affects dopamine-producing cells in a part of the brain called the substantial nigra. The reduction of dopamine results in movement problems including involuntary shaking, or tremor, muscle stiffness, or rigidity, and very slow movements (bradykinesia).  A person with PD may experience walking with a shuffling gait - hunched over with limited arm movement. Muscle cramps and spasms are not uncommon; and there is a reduction in facial expressions, which can affect how people interpret meaning. Fine finger movements can also be a challenge.  PD is also associated with speech problems, called dysarthria, and swallowing problems, called dysphagia.

In addition, PD raises the risk of developing cognitive impairments and frequently occurs with memory problems.  Depression is common, and it is not just as a reaction to the disease.  The medicines used to manage the disease can cause visual hallucinations, and people with PD may think they see animals and people, especially deceased relatives and pets.  Sometimes these hallucinations can occur even when people are not taking medication. 

Parkinson’s disease is a progressive condition, which means that symptoms will not improve as time passes.  However, advances in treatment options means that people diagnosed with Parkinson’s disease now have a near-normal life expectancy.  Medications that create or act like dopamine or inhibit the breakdown of dopamine are often prescribed.  Professionals such as a physiotherapist, occupational therapist, speech and language therapist and dietician can provide solutions to increase independence and quality of life for people diagnosed with Parkinson’s disease.

As Parkinson’s disease progresses, those with a diagnosis of the disease can experience a reduction in the volume of their voice and the intelligibility of their speech.  They can have difficulty articulating some speech sounds and controlling how fast they speak.  An AAC system can help people with Parkinson’s disease communicate clearly with others.

The best AAC system will depend on a variety of factors including a person’s motor symptoms, cognitive abilities, speech and language skills, attitude and personal preferences.  Many speech and language therapists think that amplifiers, alphabet boards and picture charts can help people with Parkinson’s disease as they begin to experience difficulties with their speech and its volume.  If their speech deteriorates further, a high-tech device with a voice output function may be helpful.

If you would like more information about AAC for a person with Parkinson’s disease, consult the speech and language therapist of that person.

If you would like more information on Parkinson’s disease and support for those with a diagnosis and their carers, Parkinson’s UK operate a useful website (www.parkinsons.org.uk) and helpline - 0808 800 0303.

 


Things you might want to look into on this site:


Although this information is believed to be accurate, you are strongly advised to make your own independent enquiries.

Last updated July 2013

tags: 
AAC
tags: 
Parkinson's

FAQs - AAC + stroke + aphasia

A stroke is a sudden rupture or obstruction in a blood vessel of the brain.  A stroke may also be called a cerebrovascular accident (CVA).  If it is caused by a rupture it is called a haemorrhagic stroke, and if it is caused by an obstruction it is called an ischaemic stroke.  In either case, a stroke deprives the brain of its vital blood supply and causes symptoms such as numbness or weakness on one side of the body, slurred speech, difficulty understanding speech and blurred vision.  A stroke that causes symptoms which last only a short time is called a transient ischaemic attack (TIA).

A stroke can cause speech and language difficulties during the attack and lasting impairments afterwards.  A communication difficulty called aphasia may result from a stroke.  Aphasia is a language impairment that affects the comprehension and production of language.

Other disorders that can occur after a stroke affect the movements required to speak.  Dysarthria creates muscle weakness in areas that are necessary to produce speech sounds, so people with dysarthria often have slurred or weak speech.  Acquired dyspraxia produces loss of knowledge about how to perform skilled, coordinated movements such as those necessary for speech.

Aphasia is an acquired disorder that affects understanding and formulating language.  It results from brain injury, commonly after a stroke but also after incidents such as head injury, TBI (traumatic brain injury) or encephalitis.

Aphasia can be described as fluent aphasia, also called Wernicke’s aphasia, or non-fluent aphasia, also called Broca’s aphasia.  People with fluent aphasia can usually produce different kinds of words, but their speech may not make sense, and they may have difficulty understanding what is said to them.  People with non-fluent aphasia can usually produce speech that makes sense, but they find it difficult to do this in long phrases.  They can usually understand what is said to them.

Though these are two main types of aphasia, many people with aphasia have some difficulty both understanding and producing language.  People with acquired aphasia may also have difficulties with numbers and maths, music or the ability to control their emotions.

Some people with aphasia may find an AAC system helps them to plan and produce what they want to say. This may be picture or word based.



Things you might want to look into on this site:

Things you might want to look into on other sites:

Stroke Association 

Chest Heart & Stroke Scotland


Although this information is believed to be accurate, you are strongly advised to make your own independent enquiries.

Last updated July 2013

tags: 
AAC
tags: 
stroke-CVA

FAQs - AAC + training

This is dependent on your role and which elements of AAC you want to be trained in. The Communication Matters (CM) website contains information for people who are new to AAC and CM produces a number of 'Focus on ...' leaflets which provide a very simple introduction to various aspects of AAC.

For specific training on signing, whether for the deaf community or for other augmented communicators local FE colleges often run part-time or evening courses, or, if you are working with children who sign, it is worth asking your child’s school and/or speech and language therapy department about any courses they might run.

There is limited formal training available in the use of symbols for communication. CALL Scotland run courses on the use of symbols in schools, Talking Mats offer one day training courses around the UK, Makaton reps run training workshops in signs and symbols around the UK, or again, ask your local team about specific training for your needs.

Widgit, Mayer-Johnson (Picture Communication Symbols), provide on-line training in the use of their symbol software.

Elklan run a number of courses for parents, teachers, therapists and practitioners working with children and adults with complex communication needs, and those who use AAC. These courses are externally accredited through apt awards, the accreditation is dependent on completion of a portfolio.

If your interest is in a particular high-tech voice output communication aid (VOCA) and you are working with individual VOCA users the company supplying the system will probably be able to offer some training, at least initially, and many suppliers have or are developing on-line training resources. The therapists and/or specialist teachers working with the VOCA user should be able to offer either formal training or informal support in using their communication.

AAC specialist assessment centres might run training courses for both families/carers and professionals. Some companies run free information days or workshops that give an overview of their products.

The costs for these training opportunities vary and generally would have to be paid by the person attending.

If a particular strategy or system has been recommended by your local speech and language therapy or education team then they should be able to offer you group or individual training and support in the use of these.

CM offers a range of training events including road shows and conferences. Communication Matters Roadshows are a useful way to get an overview of what is available and to talk to suppliers. The annual Communication Matters conference is an event where people who use AAC, family members, carers and professionals meet to exchange information and ideas both formally and informally. There are many different presentations, a number of which are aimed specifically at people who use AAC, as well as an exhibition at which many AAC suppliers are available to demonstrate their systems. In addition CM runs occasional study days on more specific topics e.g. literacy, eye-gaze.

Take advice from professionals working with you and your family.

Speech and language therapists, AAC specialists in education, AAC specialist centres, communication aid suppliers, people who use AAC and their families and carers.

Newly qualified professionals have a generalist training in their chosen discipline. People who specialise in AAC usually develop their knowledge through additional training, both formal and informal, whilst working. Not all local areas currently have specialists in AAC.

Post qualification courses in AAC are available at Dundee and Manchester Metropolitan Universities and the ACE Centre.

Recent training related initiatives

The new NHS England commissioning of specialised AAC services aims to develop local teams, supported by regional hubs, to be able to support the needs of the majority of AAC users in their areas, in England only.

NHS Education for Scotland has developed IPAACKS which "describes the core values required of those who work with people who use AAC or people who may benefit from AAC. In addition, IPAACKS presents the AAC specific knowledge and skills that workers should aspire to achieve in relation to the role they play in supporting individuals who use AAC" and provides a framework for workers to develop their knowledge and skills so that they can better support people who use AAC. The package is available on line and would be applicable to health, education and social care staff working with people who use AAC throughout the UK.

The AACScotland website contains many ideas, resources and links about AAC. They have also developed a series of five online learning modules aimed at people who are new to AAC.


The information given above is as accurate and comprehensive as possible at the time of writing.

tags: 
AAC
tags: 
training

FAQs - AAC assessment and clinical decision making

There are a number of specialist centres throughout the UK that offer specialist AAC assessments (see service delivery and policy section of the website). These centres offer a personalised and detailed assessment of need. Access to these centres varies according to their funding source; however, all offer specific information on how to complete a referral for assessment. Contact each centre directly for the most up to date referral processes and procedures.

This may vary according to geographical location. Specialist assessment centres tend to have a team of professionals who collaborate on the assessment. These include speech and language therapists, teachers, occupational therapists and clinical scientists/assistive technologists. Depending on your particular needs these professionals play a greater or lesser role in the assessment.

Locally, you may find a speech and language therapist completes an initial assessment of your communication needs. This personal may have the relevant AAC knowledge and may alternatively recommend that you be referred to a specialist centre for further consideration.

 A care pathway exists within the NHS and is a plan for a patient’s clinical experience.  It documents the interventions and care that a patient has received and the milestones that a patient has or will achieve.  It is based on multidisciplinary working and is further explained by the Royal College of Nursing here: www.rcn.org.uk/development/practice/perioperative_fasting/good_practice/service_improvement_tools/care_pathways

This section presents some historical information that may be helpful. Please note that the terminology and policy documentation being used across the different parts of the UK is changing. Statements of special educational needs are issued by local councils in England and Wales and outline what a child’s needs are in school and how they will be met.  They are legally binding documents that are issued if a child’s needs cannot be met within school.   A statement will detail extra resources like money, staff time or special equipment that a child might require, as well list non-educational needs.  Statements are reviewed every year and include a transition plan that helps plan for a child’s future after Year 9.

As a parent, you can disagree with the statement and request an appeal.  You can find out more about this process at: www.gov.uk/children-with-special-educational-needs/statements.  The Department of Education has information about statements here: www.education.gov.uk/popularquestions/a005396/sen-statement

There is no direct equivalent to a statement of special educational needs in Scotland.  Prior to 2005, an educational ‘record of needs’ served a similar function to a statement.  The most recent legislation, however, discontinued the use of these records.  Some literature produced in anticipation of the change in legislation is available from the Scottish Executive here: www.scotland.gov.uk/Resource/Doc/47021/0023972.pdf, and here: http://www.scotland.gov.uk/Resource/Doc/47251/0023736.pdf

The current legislation includes an element called a ‘co-ordinated support plan’, which can be issued by an education authority for children and young people with complex and multiple factors that affect their education.  The goal of this plan is to co-ordinate support from the variety of different agencies that a child might need to access, including education, health and social services.  Fewer children will qualify for a co-ordinated support plan than had a record of needs.  A variety of other plans for pupils exist, including individualised educational programmes and personal learning plans, but a co-ordinated support plan is the only legally-binding document. 

The Scottish charity Enquire has lots of helpful information on this topic and others.  It can be accessed online at enquire.org.uk and operates a helpline on 0845 123 2303.  It has produced information on co-ordinated support plans here: enquire.org.uk/20100622/wp-content/uploads/2010/11/co-ordinated-support-plans.pdf

‘Additional learning needs’ is the term that is used in Scotland to refer to all learning support needs and is used instead of the older term ‘special educational needs’.  Additional learning needs encompasses the needs of all children, including, for example, disabled children, children in care, refugees, gifted children, children with English as an additional language, bullied children, bereaved children and children who are parents.

The first point of contact for speech and language therapy is your GP.  Due to changes in the health system, the Royal College of Speech and Language Therapists recommends you use this option in England and Wales. 

You can also ask a district nurse, health visitor, nursery staff member or teacher for a referral.  If you would like to make a referral yourself, you can contact your local primary care trust and ask for the phone number of the local NHS speech and language therapy service (www.rcslt.org/speech_and_language_therapy/how_to_find_an_slt/howtofind).

If you would like to access private services, you can search for therapists near you on the Association of Speech and Language Therapists in Independent Practice: www.helpwithtalking.com 

This is a debatable point but in summary, it is the process that professionals, in consultation with clients and families, go through to arrive at a set of recommendations that would best support individual communication needs. In the context of this website, we would be specifically considering recommendations in relation to augmentative and alternative communication needs. This area also includes decision about a range of technologies that support communication, e.g. mounting systems, access systems, and intervention support structures.

 


Things you might want to look into on this site:


Although this information is believed to be accurate, you are strongly advised to make your own independent enquiries.

Last updated July 2013

tags: 
AAC
tags: 
assessment

FAQs - general paediatric AAC

AAC can be beneficial for children who find communication difficult because they have little or no clear speech. If a child has problems in understanding or using spoken language they might benefit from some form of AAC. This could be the use of signs or symbols, or a communication aid.

AAC covers a wide range of strategies and systems which can benefit people with many different conditions that affect their ability to communicate using spoken language either temporarily or in the long term. This can be as a result of a congenital problem, such as cerebral palsy, or an acquired condition, for example a head injury.

Some people use AAC to express themselves, others use it to help them understand what is said to them.

Your child's speech and language therapist (SLT) should be able to advise you about whether your child would benefit from AAC, or to refer you to a local specialist therapist or regional specialist centre for a detailed assessment.

Communication Matters runs regular roadshows around the UK at which you can see communication aids and meet with suppliers. They also produce a series of 'Focus on...' leaflets that offer an introduction to various aspects of AAC.

AAC is usually divided into 'aided' and 'unaided' systems. Unaided systems do not require any additional equipment and include systems such as signing, eye pointing, facial expression and gesture.

Aided systems can be further divided into low and high tech.

Low tech systems, such as picture, symbol, word or alphabet boards and books do not need power to work. They can also include the use of everyday objects and objects of reference which are sometimes used to give people with complex learning needs clues about what is about to happen.

High tech systems require a power supply to work. They can range from devices which can play a single recorded message to much more complex systems requiring the user to select a sequence of pictures, symbols or letters to produce spoken output.

Most people who use AAC use a combination of aided and unaided systems.

No single AAC system is right for everyone. Which system or systems to use depends on the individual child and the people with whom they are communicating.

The choice of an AAC system depends on many different factors, age, current abilities and circumstances.

There are a wide variety of options and therefore it is best to seek advice from a speech and language therapist, or through a specialist AAC assessment centre to identify the best option for an individual. If a high tech system is identified as being appropriate it might be possible to arrange a short term loan or rental of a device, either through an assessment centre or directly through the supplier to get a better idea of whether the system will work for your child and family.

Your speech and language therapist might be able to put you in touch with other AAC users or their families in your local area.

The group 1Voice runs family fun days and weekends with role models who use AAC and opportunities for AAC users and their families to meet together.

Contact a Family might also know of contacts in your local area.

If the need for a communication aid is identified in your child's statement of special educational need in England and Wales then the local authority is obliged to fund it, though the relatively high cost of devices means that this is often difficult. Currently health authorities are sometimes able to offer support for funding, but this is not common.

Many people resort to seeking charitable funding to provide high tech communication aids.

There are some charities that might be able to offer support with fund raising. These include the Sequal Trust and the Aidis Trust.

Many communication aid suppliers offer useful funding information on their websites.


Links:


Things you might want to look into on this site:

Parenting a child who needs AAC

Funding a communication aid for my son

Emily's story about making new friends


Although this information is believed to be accurate, you are strongly advised to make your own independent enquiries.

Last updated May 2014

tags: 
AAC
tags: 
children

FAQs - service delivery + policy

Two key pieces of legislation affect disabled people in the UK.  First, the UK has agreed to the UN Convention on the Rights of Disabled People.  This document explicitly states that disabled people have the same rights as others, including, among others, the right to be free from discrimination, the right to education, employment, health and justice.  Information about the convention can be found here: www.un.org/disabilities

Second, the Equality Act 2010 provides the UK’s framework on discrimination protection.  Under this piece of legislation, a disability is defined as an impairment that causes ‘substantial’ and ‘long-term’ negative effects on the ability to perform daily activities.  The entire Act can be found here: www.legislation.gov.uk/ukpga/2010/15/contents  Government guidance can be found here: www.gov.uk/equality-act-2010-guidance

In terms of AAC services and provision there are two reviews underway in England/Wales and Scotland.  Key reports can be found on the Communication Matters Website: www.communicationmatters.org.uk

There are many services that can help individuals find AAC systems that work best for them.  Communication Matters has compiled a list of services available throughout the UK here: www.communicationmatters.org.uk/contacts-assessment-services-all

Through the service reviews and modelling of services currently in progress across England, Wales and Scotland, the following may be reconfigured within a new national framework over the coming months.  The information that follows was accurate, to the best of our knowledge at the time of publishing.

Some charities aim to help people who may benefit from AAC.  These include the ACE Centre in Oxford and Oldham; Hannah’s Trust in the South West; and the Percy Hedley Foundation in Newcastle.

CALL Scotland, at the University of Edinburgh, helps people with disabilities in Scotland and their supporters make the most of new technology.  It specialises in helping pupils access the curriculum in educational settings.  CENMAC has similar aims for helping children in Greater London.  CandLE in Cumbria is another independent organisation that can assist with AAC assessment.

Some services address disability more broadly and can provide assessments for physical limitations as well as communication impairment.  These include AbilityNet in Warwick; Assistive Technology Consultancy Services in Winchester; Compass at the Royal Hospital for Neuro-disability in London; and Sensations CTS in Nottingham.

Local specialist AAC services are available through the NHS in Ayrshire and Arran, Barnsley, Belfast, Birmingham, Bristol, Cardiff, Central London, East Kent and Swale, Glasgow, Kent, London Great Ormond Street Hospital (children’s service), Newcastle, North Bristol (children’s service), Oxford, Sheffield, Southwark and Sussex (children’s service).  Councils that provide advice on AAC include Aberdeen (children’s service), Edinburgh, Fife and Norfolk (children’s service). 

Most of these services would like to work with everyone involved with the individual who will be using AAC, including family members, therapists, educators and support workers.  

The websites of all the services listed above detail each organisation’s referral procedure.  Some can only be accessed by referral of a speech and language therapist, other medical professional or education professional, but others accept self-referrals. 

Services offered through the NHS are free at point of service.  Some independent consultants and private companies will charge a fee for their service.  Charitable bodies may offer a combination, with some advice being free and more bespoke services incurring a cost.  Funding may be available through your school or local authority.

  


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Although this information is believed to be accurate, you are strongly advised to make your own independent enquiries.

Last updated July 2013

tags: 
AAC
tags: 
reports and legislation