AAC Devices for Autism | A Game-Changer for Communication

AAC stands for Augmentative and Alternative Communication. AAC devices are tools that help people with speech and language impairments communicate more effectively. They allow non-speaking individuals to use technology to “speak” using text, symbols, or synthesized speech.

There are many types of AAC devices:

Speech-generating devices: These produce digitized or synthesized speech when the user selects words, letters, pictures, or symbols on a screen. Examples include dedicated devices like Tobii Dynavox or software on a tablet like Proloquo2Go.

Text-to-speech apps: These convert typed text into speech using a synthesized voice. The text can be typed on a tablet device or smartphone app.
Symbol-based aids: These use images, symbols, and icons that represent words and phrases. The user points to or touches the symbols to construct sentences. Symbol-based aids can be low-tech communication boards or high-tech voice output devices.
Eye tracking technology: This allows individuals to control a speech device using only their eyes. It utilizes cameras to track eye movements on a screen.

AAC devices allow individuals with autism or other conditions to communicate basic wants and needs, share their thoughts and feelings, participate in conversations, and improve social connections. They can help reduce unwanted behaviors that often arise from frustration over the inability to communicate.

Benefits of AAC Devices for Autism

AAC devices provide a range of benefits for individuals with autism by improving communication and reducing frustration. One of the most significant benefits is enhanced communication and self-expression. AAC devices give those with limited or no verbal speech the ability to communicate their wants, needs, thoughts, and feelings. By providing a voice, AAC devices empower individuals to express themselves, make choices, and exert more control over their lives.

AAC devices also help reduce problematic behaviors that often stem from an inability to communicate. When children with autism cannot verbally express their frustration, they may act out with tantrums, aggression, or self-injury. AAC devices allow them to communicate the source of their distress, leading to fewer negative behaviors. Improved communication through AAC helps children regulate emotions and interact more appropriately.

Additionally, AAC devices promote independence in children with autism. When they can independently communicate, they become less reliant on caregivers to anticipate their needs. AAC fosters self-advocacy skills and decision-making. With an AAC device, children can communicate personal care needs, make choices, participate in activities, and develop autonomy.

Finally, AAC devices facilitate social interaction for children with autism. By giving them a way to initiate communication and reciprocate in conversations, AAC devices allow for greater social engagement with peers, family, teachers, and others. The ability to communicate socially helps improve quality of life.

Types of AAC Devices for Autism

There are several types of AAC devices available to support individuals with autism. The main categories include:

Dedicated Speech-Generating Devices

These are hardware systems designed specifically for AAC. They come pre-programmed with synthetic speech capabilities, as well as software for programming vocabulary and messages. Popular dedicated devices include those made by Tobii Dynavox and PRC-Saltillo.

Tablets with Communication Apps

Mainstream tablets like iPads can be used for AAC with the addition of specialized communication apps. Apps like Proloquo2Go and TouchChat HD provide text-to-speech and symbol-based interfaces. Tablets offer portability and flexibility.

Symbol-Based Aids

These use images, symbols, and icons to represent words and phrases. Individuals communicate by pointing to or gazing at symbols. Some systems are low-tech using boards and books, while others are high-tech software on devices. Symbol-based aids are very visual.

Eye Gaze Technology

Eye tracking technology can allow people to communicate just using their eyes. Special cameras track eye movements, allowing individuals to type, text-to-speech, or control communication software hands-free. This offers independence for those lacking motor skills.

Choosing the Right AAC Device

Choosing the most appropriate AAC device for an individual with autism is crucial for success. There are several key factors to consider when selecting a device:

Age – The age of the user is important, as different devices are designed for different developmental stages. For young children, simple picture-exchange apps may be most appropriate, while older individuals may benefit from more advanced devices with text and speech capabilities.

Cognitive Skills – An individual’s cognitive and language abilities determine which device features will be most usable. Simple navigation, visual supports, and consistency are key for those with limited cognitive skills. More complex language generators and predictive text suit those with stronger skills.

Motor Skills – Physical abilities affect how a person will access their device. Touch screens work for those with good fine motor control, while switch scanning or eye tracking may help those with limited mobility. Assessing positioning, grasp, and range of motion is important.

Individual Needs & Preferences – Consider an individual’s specific communication goals and challenges. Also identify interests, motivations and personality, as device customization can increase engagement. Prioritize ease of use and comfort.

Involve Experts – Collaborate with speech-language pathologists, assistive technology specialists, educators and therapists to thoroughly evaluate skills and challenges. Their input ensures the device matches the individual’s strengths and needs.

The best AAC devices allow seamless communication and interaction. Keep the individual at the center when choosing a device that empowers their voice. Assessment and customization are key for optimal results.

Teaching AAC Device Use

Successfully implementing an AAC device requires dedication and effort from the individual with autism as well as their communication partners. It is crucial to provide ample training, practice, and support to help the individual become comfortable using their device.

Provide Training and Practice

Work closely with a speech-language pathologist or AAC specialist to create a structured training plan. This may involve direct instruction, modeling, role playing, and hands-on practice.
Break training down into manageable steps based on the individual’s skills. For example, start with just navigating to vocabulary pages before moving to sentence construction.
Schedule regular practice sessions to reinforce device use. Repetition helps build muscle memory and confidence.

Create opportunities to practice communication skills throughout the day. For example, have the individual make requests using their device during play time or meal times.

Make AAC Part of Daily Routines

Integrate the AAC device into the individual’s regular daily activities. This normalizes device use.
Identify key routines where communication occurs, like greeting others, requesting items, expressing feelings, etc. Have the device accessible during these times.

Model using the AAC device yourself during daily interactions with the individual. This demonstrates how it can be naturally incorporated.
Create a communication-friendly environment with visual supports. Post vocabulary pages on the walls or as visual reminders during activities.

Encourage Communication Partners

Educate family members, teachers, therapists and peers on how to engage with the individual using the AAC device.

Role play common interactions to show communication partners how to prompt, respond to, and have conversations using the device.
Advise partners to pause and give the individual time to formulate messages using their device, resisting the urge to speak for them.
Celebrate successes and model patience during mistakes. Maintaining a supportive environment is key.

Consider involving peers in practice sessions. Peer models can motivate device use.

With ample training, practice and support from communication partners, AAC devices can become invaluable tools for expression and interaction. Consistency is critical in making these devices a natural part of an individual’s daily life.

AAC Devices and Speech Development

One common concern from parents and professionals is that AAC devices may hinder or delay natural speech development in children with autism. However, research has shown that AAC devices do not impede speech when used appropriately. In fact, they can actually encourage speech development.

AAC devices provide a means of functional communication while giving the child’s brain time to develop speech and language skills. The devices allow children to communicate their wants and needs, reducing frustration that could lead to problematic behaviors. This creates more opportunities for social interaction and language exposure.

Several studies have indicated that early intervention with AAC devices supports the development of speech in children with autism. One study found that two-thirds of minimally verbal children using AAC devices gained independent speech ability within two years. The key is providing AAC as a complement to speech therapy, not as a replacement.

Experts recommend promoting multimodal communication by modeling the use of speech, sign language, and AAC devices. This demonstrates flexibility across different forms of expression. The goal is for the child to develop speech while having AAC as a backup if needed.

Ongoing speech therapy and language interventions are still essential. But AAC devices give children with autism a way to communicate during the process. With the right support, these devices can play an integral role in building speech and language.

Funding and Insurance Coverage

Navigating insurance options for AAC devices can be challenging but is an important step in obtaining this beneficial technology for individuals with autism. Health insurance plans have varying policies regarding coverage of AAC devices, with some plans declining coverage entirely. Others may cover only certain devices or apply limits on the funding amount.

When exploring insurance options, it’s important to contact the plan to learn about their specific AAC device coverage and any requirements for prior authorization. Providing documentation from speech-language pathologists and medical professionals on the individual’s need for AAC can help in making a strong case for coverage. Having a clear understanding of the plan’s policies allows families to advocate and appeal any denials.

Beyond insurance, there are various resources that offer financial assistance for AAC devices. Nonprofit organizations like UnitedHealthcare Children’s Foundation and Assistive Technology Fund often provide grants to help cover costs. Some AAC device manufacturers, like PRC-Saltillo, also have funding assistance programs in place. Crowdfunding campaigns are another popular option families pursue.

Advocacy efforts continue to call for expanded insurance coverage and policies that ensure AAC technology is accessible for all who need it. Groups like the American Speech-Language-Hearing Association (ASHA) lobby for state and federal laws requiring AAC device coverage. Families can support this advocacy by sharing their personal stories and experiences of needing AAC funding with local and national lawmakers to help affect change.

Integrating AAC Devices in Education

Augmentative and alternative communication (AAC) devices can be highly beneficial for students with autism in school settings. However, careful planning and collaboration is required to ensure successful classroom inclusion.

When introducing an AAC device in school, it’s important for parents to partner closely with the student’s special education team and Individualized Education Program (IEP) team. The IEP team, which includes parents, teachers, therapists, and school administrators, determines the services and accommodations the student needs to be successful academically.

The student’s speech-language pathologist can provide invaluable guidance on how to integrate the AAC device into the classroom. They can train teachers and aides on supporting the student’s use of the device and model effective communication strategies.

It’s key that all members of the IEP team understand how the AAC device works and the student’s capabilities with the device. With training and support, teachers can learn how to:

Set up the classroom to facilitate AAC device use
Modify assignments and activities as needed
Encourage communication through the device with peers

Troubleshoot any technical issues

Teachers play a crucial role in advocating for the student’s device use at school. They can reinforce communication through the AAC device during lessons, transitions between activities, and social interactions.

For group activities, teachers can assign peer buddies to model device use and engage the student using the AAC device. Teachers can also foster a supportive classroom culture where all students view the AAC device positively.

With proper IEP accommodations, AAC devices give students with autism a means to participate in classroom discussions, demonstrate their learning, develop relationships, and gain confidence in their communication abilities. A collaborative effort between families, educators, and therapists leads to the most successful integration of AAC devices in schools.

Examples of AAC Devices for Autism

Nine examples of AAC devices that are commonly used to support communication for individuals with autism. These range from low-tech to high-tech solutions:

PECS (Picture Exchange Communication System): A form of AAC that uses picture symbols to teach communication skills. The user hands a picture to a communicative partner in exchange for the corresponding item or to express a need or desire.^[1]

Speech-Generating Devices (SGDs): Portable electronic devices that produce digitized or synthesized speech, such as DynaVox or Tobii systems, which facilitate expressive communication for non-verbal individuals.^[2]
AAC Apps: Various applications that can be used on tablets or smartphones, like Proloquo2Go and TouchChat, that allow users to tap symbols or type out messages to generate speech.^[2]
GoTalk: Handheld devices pre-loaded with speech output capabilities that come in varying levels of complexity, from simple one-message devices to those with multiple levels and options.

LAMP Words for Life: An app focused on providing a consistent and comprehensive language system, primarily through the use of a pre-loaded speech-generating device.
Pragmatic Organization Dynamic Display (PODD): A book or device which houses an array of symbols and pages that the user navigates through to construct sentences and express themselves.^[2]
Tech/Talk: A multi-level AAC device that allows recorded speech to be played back by the user by pressing buttons with symbols or pictures on them

QuickTalker: A range of multi-message communicators with a static grid layout that allows for easy communication through the press of a button corresponding to a need, desire, or expression.
Zyteq: Electronic devices and speech generating apps that offer a variety of tools and systems for communication for people with complex communication needs.^[2]

When considering AAC for an individual with autism, one should seek assessment from an AAC specialist or speech-language pathologist to find the most suitable system for their communication needs.

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AAC manufacturers are finding ways to make devices more accessible, flexible, and customizable to each user’s needs. Features like word prediction, text-to-speech, and customizable vocabularies enhance usability. More devices now integrate with smart home and Internet of Things ecosystems, increasing accessibility. Configurable mounts and stands allow users to position devices for optimal interaction.

Enhanced Communication and Quality of Life

With ongoing improvements in AAC technologies, individuals with autism can enjoy richer communication and increased independence. AAC devices empower users to express themselves, develop relationships, participate in classrooms, enter the workforce, and gain confidence. As the tools improve, so too will social connections, learning opportunities, and overall quality of life for individuals with autism.