Augmentative and Alternative Communication
When a child has a visual impairment and additional disabilities, she may need to use alternative methods to communicate her thoughts and needs. Your child needs to have a variety of methods both to express her thoughts and to understand what others are communicating to her. The term "augmentative and alternative communication" (AAC) is used to refer to alternative communication methods that can support a child's efforts to communicate.
Augmentative and alternative communication methods can be unaided or aided, using objects or devices. Examples of unaided methods of communication include gestures, facial expressions, vocalizations, speech, and sign language (such as American Sign Language). Examples of aided forms of communication include the following:
- using an actual object to convey meaning; for example, your child hands you a cup to let you know she is thirsty
- pointing to symbols, such as pictures or textures on a communication board or in a book
- activating a device; for example, your child presses a switch or button on a recorded speech device, initiating auditory output that says "I'm thirsty."
It is important for your child to have both aided and unaided methods of communication. Learning unaided methods of communication is important because a device or other communication aid may not always be available in every situation in which your child needs to communicate.
Devices used for communication range from simple to sophisticated. There is a wide array of devices on the market, and they are continually changing. Every child's needs are different, and an AAC system is usually designed specifically for an individual child.
If your child is receiving special education services, her educational team will work with her to determine what devices may be most appropriate for her. It is important that one or more professionals who are familiar with communication issues be closely involved in this assessment. Such professionals might include a communication specialist—typically a speech therapist who has specialized in communication for children with significant communication issues—speech therapist, special educator, or occupational therapist.
It is equally important for the teacher of students with visual impairments to contribute to the selection of an AAC system by providing information about how your child uses any vision and other senses to obtain information from the world around her. Your child will need different solutions depending on, for example, the size of the symbols she can see on a device, where in her visual field she needs to have the device positioned in order to see it, or whether she understands braille. If your child has useful vision, she should have a functional vision assessment to determine how she uses her vision before she is evaluated to see what kind of AAC system would best suit her needs.
The following are some broad categories of devices used by some children with visual impairments and additional disabilities:
- Communication board: A communication board can be made out of cardboard, wood, or another solid surface. Typically it has a grid on it with two or more symbols. The symbols can be concrete, such as actual objects or parts of objects; pictorial, such as photographs or drawings; alphabet symbols in print or braille; or words in print or braille. When using a communication board, a child can express herself by pointing to the symbol, picture, letters, or words that convey what she wants to share.
- Communication books: Like a communication board, a communication book has selected symbols that your child can point to in order to convey her message. The book may be arranged so that the first page has broad categories, such as emotions, foods, and people. Once your child picks a category, the person she is talking with turns to a page that offers more specific choices within that category.
- Recorded speech devices: With a recorded speech device, someone (such as you, a teacher, or a sibling) records messages for your child to use. Your child activates the message using a switch or other button. Systems with multiple switches can store 4, 6, 8, or more messages. There are very complex AAC systems that enable the user to convey a wide array of information. For example, if your child has a device with four pre-recorded message slots, you might record four messages for bedtime, such as, "I want a blanket," "Read me another story," "I love you. Good night," and "Sit with me and rub my back." Once she is in bed, your child can press the appropriate switch or button to tell you what she wants.
- Keyboards: Your child may type a message on a keyboard which then reads the message aloud. The symbols on the keyboard might be letters, words, or picture symbols.
It's important to remember that your child needs multiple methods for expressing herself. Ideally, she should not have to rely solely on one method of communication. Providing her with an array of communication options she can use now and in the future will help her grow and develop and participate more fully in daily life.