The Best AAC Options for Adults
Has someone recently recommended AAC to you or someone you care for? Alternative and Augmentative Communication (AAC) can make a real difference for adults facing communication challenges in everyday life. For some, progressive neurological conditions affect the muscles and areas of the brain used to produce speech. For others, lifelong conditions mean that verbal speech is challenging, and introducing AAC means anyone can be equipped to engage in every area of life with confidence.
In this article, we’ll take you through what you need to know about AAC options for adults: what AAC is, the different options available, and how to get started with the support of a local Speech Pathologist.
What is Augmentative and Alternative Communication (AAC)?
AAC is a term used to describe the different methods a person can use to communicate alongside or instead of talking verbally. AAC can support anyone with communication difficulties, whether that’s difficulty producing spoken words, difficulty expressing wants and needs, or significant fatigue from communicating verbally over long periods.
Some adults use AAC throughout their life, while others may need to use AAC after an accident or new diagnosis. People who may benefit from AAC include those with autism or intellectual disability, those with movement difficulties such as cerebral palsy or muscular dystrophy, and those with communication difficulties caused by stroke or other progressive neurological conditions.
It is notable that terminology in this space continues to evolve, and preferences vary between individuals. Recent large-scale surveys of AAC stakeholders, including nonspeaking AAC users, speaking AAC users, family members, and professionals, found real differences in terminology preferences across these groups. While “AAC user” (identity-first language) has emerged as a commonly preferred term over alternatives like “person who uses AAC”, other people prefer terms such as “multimodal communicator”. At Speak and Swallow, we take the lead from each person’s own preference.
Current practice increasingly frames AAC not as a single fixed system a person “uses,” but as one part of a broader, flexible approach called multimodal communication, drawing on multiple methods such as speech, gestures, facial expression, writing, sign, and AAC systems together to convey meaning, in the same way that all humans naturally combine speech with gesture and expression. Rather than choosing one “right” AAC system, most people benefit from access to several communication modes they can move between depending on context, fatigue, and communication partner.
What AAC Options Are Available for Adults?
AAC options generally fall into two categories: unaided and aided.
Unaided AAC uses no external tool – the person’s own body (blinking, gestures, facial expression, sign).
Aided AAC uses an external tool to support communication, and is split into low/light technology and high technology.
Low/Light Technology AAC
There are a lot of different types of low tech AAC, including:
- Writing or drawing in a book or on a whiteboard
- Spelling words by pointing to letters on a spelling board
- Pointing to photos, pictures, or written words in a communication book
High Technology AAC
High-tech AAC is highly personalised, and choosing the right option usually takes time and the support of a team of allied health professionals. Options include:
- An iPad or tablet running specialised AAC software
- A dedicated speech-generating device (SGD) with specialised software and an access method suited to the individual (e.g. eye-gaze, switch access, touch)
- Increasingly in the recent years, AI-assisted features within AAC software – such as predictive/contextual phrase suggestion and more natural-sounding synthesised voices – which are an active area of research aimed at improving access and communication efficiency for people with complex communication needs.
Most people end up using a combination of low-tech and high-tech options across their day – for example, relying on a high-tech SGD with eye-gaze access for most communication, but switching to a laminated low-tech communication page during hydrotherapy, when a device isn’t practical.
Finding the right fit is the most important thing. As you can imagine, it’d be scary to have ‘no voice’, especially in new situations with unfamiliar communication partners.
How to Get Started with AAC
If you’re at the start of your AAC journey, the best first step is to connect with a local Speech Pathologist and allied health team. A Speech Pathologist is the allied health professional who assesses communication and swallowing.
Your Speech Pathologist will begin by getting to know the person – their background, needs, interests, and preferences – before carrying out a thorough assessment of current communication strengths and difficulties. From there, access methods and mounting systems are discussed and trialled, often alongside other allied health professionals such as Occupational Therapists.
After the assessment, your Speech Pathologist will match essential features to a shortlist of device or system options and organise trials, so you and your care team can see how each option fits into everyday life. It may take one trial or several to find the right fit – and the right fit may well be more than one tool used together.
The Best AAC Options for Adults
As you might expect given how personalised this process is, there’s no single “best” option, what works well for one person may not suit another. That’s why working with a dedicated Speech Pathologist is so important in finding what’s right for you.
If you need to go down the high technology route, we are so lucky that we have many amazing AAC suppliers here in Australia: Zyteq, Liberator, Spectronics and Control Bionics – just to name a few! Your treating Speech Pathologist can help you to liaise with suppliers for trials.
Keen to get started with AAC, or interested in finding out if it might be a helpful solution for yourself or someone you care for? Get in touch with the friendly team at Speak and Swallow Speech Therapy and we’d be happy to help you begin your AAC journey.