AAC Options for People with
Speech/Language Difficulties
Following a Stroke
Monique Fourcaudot, SLP
Loralee MacLean, SLP
Toronto Rehab AAC Clinic
March 30, 2010
Overview
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What is AAC and who can benefit?
Range of AAC options
What you can do
Training AAC use
Customization
How to access services in Ontario
Questions
What is AAC?
 AAC = Augmentative & Alternative
Communication
For face to face communication…
 It is the use of facial expressions, gestures,
objects, pictures, symbols, sign language,
written words and/or communication
technology to augment speech, or to provide
an alternative means of communication when
speech is not possible or functional
Who is a candidate for
technology?
 Almost anyone whose
speech/language is non-functional
 Motivated to communicate
 Accepting of alternative methods to
communicate
 Receptive language strong enough
to follow one step commands
Communication post Stroke
 Aphasia
 Non-fluent aphasia
 Fluent aphasia
 Apraxia of Speech
 With or without aphasia
 Dysarthria
 With or without aphasia
 Voice impairment
AAC and Aphasia
 Partner dependent communicators
 Emerging
 Contextual choice
 Transitional
 Independent communicators
 Stored message
 Generative message
 Specific need
Other Considerations….
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Language
Residual speech
Cognition
Vision
Hearing
 client and/or their communication partner
 Physical
 Use of hands & quality of movement
 Ambulation
AAC and Natural Speech
 AAC is not all or none
 AAC can be used as repair if speech
not understood
 AAC use can promote increase in
speech with more successful
communication opportunities
TYPES OF AAC:
No Tech Options
Low Tech AAC Options
High Tech AAC Options
Face-to-Face Communication
No Tech Options
Pen and paper
Write /erase boards
Supported conversation
Gestures, facial expressions, body
language
 Life history books
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Communication Books
Low Tech AAC Options
Voice Amplifiers
 Chattervox
 Spokeman
 Addvox
 Electolarynx
Low Tech AAC Options
Alerting / Signaling Systems
 Switch & Buzzer
 Baby monitors
 Call bells
Low Tech AAC Options
TTY – Text Telephones
 Telephone
communication for
clients with impaired
speech
 Also used by people with
hearing impairments
Low Tech AAC Options
Small hand held spelling device
 iPod touch with speaking apps
 Netbook with speaking software
 Keyboard Communicator KC200
TYPES OF AAC:
High Tech AAC Options
Face-to-Face Communication
Text to Speech Devices
Word Prediction
Abbreviation expansion
 Able to save frequently used
phrases using a 1-2 letter code
 For example: hh=hello, how are you?
Devices with Static Displays
Devices with Dynamic Displays
Word and Pictures
Virtual
Visual Scene
Category
Word-based
Spelling for Scanners
What you can do?
 Identify people who could benefit from AAC
 MCST-A (screening tool for people with Aphasia)
 Prescribe low tech devices – if you are an IA
 Make communication books (important to
customize!!!)
 Refer to AAC Clinics for high tech AAC
options
 Support AAC use in community
 Train clients to use AAC
Training an AAC System
 Operational competency
 on/off, charging, navigating
 Linguistic competency
 Recognizing symbol sets, reading, manipulating
linguistic codes
 Social competency
 pragmatics – initiation, turn taking, etc
 Strategic competency
 limitations of system and how to use adaptive
strategies to repair, using multimodal
communication, etc)
Customization of AAC including
communication books
 Vocabulary collection
 Category based
 Situational based
 Needs to fit client’s abilities and
communication needs
 Real pictures
 Second language
 Number of items/page
Why customize?
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Better outcomes
Relevant to client
Motivating
Compensate for deficits and
maximize strengths
Role of AAC Facilitator
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Setup
Charging
Cueing / Reminders
Training communication partners
Mounting
Device troubleshooting
Shipping and receiving equipment
Other AAC Clinics in Ontario
 More than 26 AAC Clinics in Ontario
 See children / adults
 May have diagnostic or geographic
criteria
 To find an AAC Clinic in your area –
call the Assistive Devices Program
(Communication Aids)
Toronto Rehab AAC Clinic
 Interprofessional team
 SLPs, OT, CDA and Technologist
 We see adults with acquired conditions
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Stable / progressive conditions
Face-to-face communication
Adapted computer access for writing aids
No geographic boundary
How to refer to our AAC Clinic
 Call Toronto Rehab AAC Clinic
 416-597-3028
 Find application on Toronto Rehab
website:
 www.torontorehab.on.ca
Q&A