SAC Position Paper on the Role of Speech-Language Pathologists With Respect to Augmentative and Alternative Communication (AAC)

Speech-Language & Audiology Canada. (2015).

Ottawa (Canada): Speech-Language & Audiology Canada, 1-10.

This guideline from Speech-Language and Audiology Canada provides recommendations on augmentative and alternative communication (AAC) tools and strategies for supporting receptive and expressive communication in individuals with communication disorders.

Speech-Language & Audiology Canada

Speech-language pathologists who work with adults who use AAC should: <ul> <li>work with individuals and their communication partners to educate and support new communication methods;</li> <li>implement AAC systems that are minimally disruptive to an individual's natural environment and routines;</li> <li>involve the individuals in decision making to the greatest extent possible;</li> <li>anticipate and plan for future changes in physical, cognitive, or other areas of functioning, particularly in those adults who have progressive diagnoses such as ALS, Parkinson's disease, primary progressive aphasia; and</li> <li>consider temporary AAC systems for adults who have short-term communication needs.</li> </ul>

When working with individuals who use or would benefit from AAC supports, a speech-language pathologist should: <ul> <li>"adopt a client-centered approach that recognizes the client and, where appropriate, family/caregiver as critical members of the care team" (p. 3),</li> <li>recognize there are no minimum prerequisite skills required for introducing AAC tools or strategies;</li> <li>consider the individual's full range of communication needs, abilities, and functions;</li> <li>address the individual's real world communication needs for both in-person and distance (e.g., telephone, email) communication exchanges;</li> <li>include AAC systems that allow for meaningful participation across environments;</li> <li>offer multimodal AAC systems as needed;</li> <li>include low-tech AAC supports for comprehension and expression as backup;</li> <li>select and trial equipment that fits the individual's needs; and</li> <li>consider all four areas of communication competence: operational, linguistic, social, and strategic.</li> </ul>

Speech-language pathologists who work with children who use AAC should: <ul> <li>introduce AAC early;</li> <li>ensure the AAC system meets the individual child's communication needs while also facilitating further linguistic development;</li> <li>model proficient use of an AAC system;</li> <li>work with a child's family, teacher(s), and other professionals to ensure the AAC system meets other language, learning, and development goals;</li> <li>incorporate communication and social language used by the child's peers to inform vocabulary and implementation planning;</li> <li>consider core vocabulary to include developmental, environmental, and functional words; and</li> <li>provide education and support on AAC use to the child's communication partners.</li> </ul>

Speech-language pathologists who work with individuals who use AAC and who have some literacy skills should support the individual's literacy by: <ul> <li>providing systems that include access to spelling;</li> <li>advocating and facilitating literacy development;</li> <li>considering the use of compensatory supports during early literacy development; and</li> <li>ensuring goals related to language and literacy development are available and implemented within the individual's AAC system.</li> </ul>

Speech-language pathologists who work with individuals who use AAC should have basic knowledge related to: <ul> <li>AAC tools and strategies for comprehension;</li> <li>AAC tools and strategies for supporting expressive communication;</li> <li>unaided communication strategies to support comprehension and expression;</li> <li>partner communication strategies; and</li> <li>modeling strategies for improving comprehension and expression.</li> </ul>