Speech Therapy -> Augmentative and Alternative Communication

Augmentative and Alternative Communication

Augmentative and alternative communication encompasses the communication methods used to supplement or replace speech or writing for those with impairments in the production or comprehension of spoken or written language.

Minor focus areas

Skilled interventions

  • AAC Least-to-Most Prompt Hierarchy

    Using a least-to-most prompt hierarchy gives children scaffolded support to become independent and autonomous communicators. Least-to-most prompt hierarchy: 1) pause and wait without pressure, 2) express interest in what the child might say with body language or facial expressions, 3) observe the child and make an “I wonder…” statement (e.g., “I wonder if you are all done”), and 4) model without expectation. Avoid: 1) modeling with the expectation that the child will copy what you said and 2) prompting the child to say something you want them to say. Reference: Finke, E. H., Davis, J. M., Benedict, M., Goga, L., Kelly, J., Palumbo, L., . . . Waters, S. (2017). Effects of a Least-to-Most Prompting Procedure on Multisymbol Message Production in Children With Autism Spectrum Disorder Who Use Augmentative and Alternative Communication. American Journal of Speech-Language Pathology, 26(1), 81-98.

  • Aided Language Input (ALI)

    Aided Language Input is a communication strategy that allows a communication partner to teach symbol meaning and model symbolic communication by pairing speech with graphic symbols or other forms of aided AAC. Aided Language Input (ALI) consists of (1) using aided AAC as we speak and (2) implementing intervention in the context of natural communication interactions. This type of modeling shows where graphic symbols are located and how they can be used to communicate various messages. The approach also involves observing the individual with complex communication needs, attributing meaning to their behaviors, and modeling symbolic alternatives using speech paired with the graphic symbols. Aided Language Input helps students: (1) understand that their behaviors carry meaning; (2) learn how they can use symbols to communicate more conventionally; and (3) develop language by showing how to expand messages by adding additional symbols. 

    Sennot et al. (2016) found that ALI led to meaningful gains across language domains. Specifically, children took more communication turns, gained vocabulary knowledge, increased multi-symbol utterances, and demonstrated knowledge of early morphological markers. Brady et al (2013) found that ALI builds receptive understanding and expressive use of graphic symbols. 

  • Augmentative/Alternative Communication (AAC) Intervention: Education, Training, and Programming

    AAC intervention benefits individuals with developmental disabilities who have significant speech and language impairments by enhancing their communicative competence and facilitating the development of language skills. The SLP provides education, training, and programming of AAC devices and monitors effects on communicative competences, social interactions, language skills, and speech production (Miller, et al 2006).

  • Augmentative and Alternative Communication (AAC) Training

    AAC training involves using tools and strategies to facilitate communication for those with significant speech difficulties. Activities may include using communication boards, speech-generating devices, and picture exchange systems to express needs and ideas effectively.

  • Picture Exchange Communication System (PECS)

    Picture exchange communication system (PECS) is a nonverbal communication system where the patient picks a picture and hands it to the communicative partner who then gives what the picture implies or depicts. SLPs uses this system to teach communication and as a transitional system eventually leading to verbal communication traning (Bondy & Frost, 2001).

Reference links

  • Therapy Co-Treatment Scenarios and Documentation - Harmony Healthcare International (HHI) Blog 1
    www.harmony-healthcare.com     Author: Kris Mastrangelo, OTR/L, LNHA, MBA - PT and OT appear to be a natural pairing because of the treatment crossover in neuromuscular and orthopedic deficit remediation. However, patients also benefit from co-treatments with SLP and OT, for interventions such as self feeding. During these types of therapeutic collaborations, OT can address postural alignment, positioning, adaptive equipment, and the motor sequence of self feeding, while the SLP addresses bolus size, rate of presentation, and any specific strategies identified to reduce the risk of aspiration; such as chin tuck swallow, or multiple swallows per bolus. Examples of appropriate goals in support of co-treatment follow: Patient will demonstrate self feeding skills with setup assistance x 4/5 consecutive sessions x 14 days, while applying swallow safety strategies with minimal verbal cueing. Patient will demonstrate lower body dressing skills with minimum assist while maintaining standing balance in order to complete the task safely in preparation for return to ALF.
  • Augmentative and Alternative Communication 0
    en.wikipedia.org     Author: Wikipedia - Augmentative and alternative communication (AAC) encompasses the communication methods used to supplement or replace speech or writing for those with impairments in the production or comprehension of spoken or written language. AAC is used by those with a wide range of speech and language impairments, including congenital impairments such as cerebral palsy, intellectual impairment and autism, and acquired conditions such as amyotrophic lateral sclerosis and Parkinson's disease. AAC can be a permanent addition to a person's communication or a temporary aid. Stephen Hawking used AAC to communicate through a speech-generating device.
  • Multilingual, Multicultural, Bilingual Resource Link For SLPs 1
    www.asha.org     Author: ASHA - Link includes ASHA resources and information related to evaluation and treatment of clients from linguistically and culturally diverse backgrounds. Link includes ASHA resources to: Accent Modification Bilingual Service Delivery Collaborating With Interpreters, Transliterators, and Translators Cultural Competence Voice and Communication Services for Transgender and Gender Diverse Populations Dynamic Assessment Micro Course Cultural Competence Self Assessment Phonemic Inventories and Cultural and Linguistic Information Across Languages Collaboration With Interpreters: Securing Positive Outcomes Practical Assessment and Treatment Strategies for English Language Learners with Language Impairments Serving Clients From Diverse Backgrounds: Speech-Language Difference vs. Disorder Langu Continuing the Dialogue on Dialect: Positive Steps Toward Less Biased Assessments of Children Who Speak African American Englishage and Identity--Shifting Away from a Deficit Perspective on African American English Información en español
  • Joint Guidelines For Therapy Co-Treatment Under Medicare 1
    www.aota.org     Author: The American Occupational Therapy Association (AOTA) The American Physical Therapy Association (APTA) The American Speech-Language-Hearing Association (ASHA) - Co-treatment may be appropriate when practitioners from different professional disciplines can effectively address their treatment goals while the patient is engaged in a single therapy session. For example, a patient may address cognitive goals for sequencing as part of a speech-language pathology (SLP) treatment session while the physical therapist (PT) is training the patient to use a wheelchair. Or a patient may address ADL goals for increasing independence as part of an occupational therapy (OT) treatment session while the PT addresses balance retraining with the patient to increase independence with mobility. Co-treatment is appropriate when coordination between the two disciplines will benefit the patient, not simply for scheduling convenience. Documentation should clearly indicate the rationale for co-treatment and state the goals that will be addressed through this method of intervention. Co-treatment sessions should be documented as such by each practitioner, stating which goals were addressed and the progress made. Co-treatment should be limited to two disciplines providing interventions during one treatment session.
  • Scope of Occupational Therapy Services For Individuals With Autism Spectrum Disorder Across the Life Course 1
    research.aota.org     Author: Copyright © 2015 By the American Occupational Therapy Association, Inc. The American Journal of Occupational Therapy, 2015, Vol. 69(Supplement_3), 6913410054p1–6913410054p12. - Occupational Therapy practitioners work collaboratively with individuals on the autism spectrum, their families, OTHER PROFESSIONALS, organizations, and community members in multiple contexts to advocate for and provide a range of needed resources and services that support individuals' ability to participate fully in life (Case-Smith & Ambersman, 2008; Kuhaneck, Madonna, Novak, & Pearson, 2015; Tanner Hand, O'Toole, & Lane, 2015; Watling & Hauer, 2015a; Weaver, 2015). According to a study conducted by the Interactive Autism Network (2011), occupational therapy ranks second to speech-language pathology as the most frequently provided service for individuals with autism throughout the United States.
  • Medicare Guidelines For Group Therapy 1
    www.asha.org     Author: The American Speech-Language-Hearing Association (ASHA) - Medicare Benefit Policy Manual, Chapter 15 230-Practice of Physical Therapy, Occupational Therapy, and Speech-Language Pathology A. Group Therapy Services. Contractors pay for outpatient physical therapy services (which includes outpatient speech-language pathology services) and outpatient occupational therapy services provided simultaneously to two or more individuals by a practitioner as group therapy services (97150). The individuals can be, but need not be, performing the same activity. The physician or therapist involved in group therapy services must be in constant attendance, but one-on-one patient contact is not required. The Medicare Benefit Policy Manual does not establish a specific restriction on the use of group therapy, particularly as it pertains to the size of the group. In the absence of such guidance, speech-language pathologists must refer to the LCD developed by their MAC to determine any such restrictions. LCDs may be accessed through the Medicare Coverage Database.
  • The Natural Language Acquisition Guide: Echolalia is All About Gestalt Language Development 0
    www.meaningfulspeech.com     Author: Marge Blanc, M.A. CCC-SLP Illustrated By Jon G. Lyon - 'Echolalic’/gestalt comments, phrases, and others like them are vitally important because they make up the first, crucial stage of language development, real language development, for children and young adults who are ‘echolalic’ — more accurately, gestalt language processors. These gestalt language processors develop language naturally: starting with whole chunks of language: some short, some long — some from media, some from songs, and plenty from the other people in their lives, including you! From now on, you will never see ‘echolalia’ the same way! It is gestalt language processing (GLP), and gestalt language processors use ‘echolalia’ (gestalts) in natural language development!
  • Bilingual (Spanish/English) Evaluation Resources 1
    bilinguistics.com     Author: Bilinguistics - Dozens of speech, language, fluency, and other evaluation resources for bilingual evaluations
  • Leveling Up Regulatory Support Through Community Collaboration 1
    pubs.asha.org     Author: Amy C. Laurenta and Jacquelyn Fede - While behavioral intervention methodologies and societal expectations for masking remain prevalent, in recent years, there has been a greater emphasis placed on understanding the underlying factors contributing to problematic and challenging behaviors. Furthermore, there has been greater recognition of the need to address those underlying factors as the primary areas to target for effective intervention that can actually help autistic individuals navigate their environments in school and as they transition out of school and into the real world (Prizant et al., 2006a). To provide this type of ethical, efficient, and sustainable support, it is imperative for clinicians to understand emotional or energy regulation as a developmental construct and then to understand its relationship to challenging behaviors.
  • OT, SLP & AAC 0
    miota.org     Author: Dilyn Smith MS OTRL; Kelsey Underhill MS CCC-SLP; McKensie Ward MS OTRL - The purpose of this presentation is to discuss what augmentative and/or alternative communication (AAC) is, the OT’s role in supporting clients who use AAC and how to document/write goals related to AAC. In order to maintain best practice and client-centered approach as an OT, it is important to understand how AAC relates to our field. To best serve our clients, we need to advocate for interdisciplinary treatment and collaboration. We will talk from the perspectives of both OT and SLP, using video examples and real life cases, in order to communicate clear treatment examples and facilitate conversation.
  • How An SLP and OT Collaborate Long-Distance - The ASHA Leader BLOG 1
    leader.pubs.asha.org     Author: Stephanie Sigal, MA, CCC-SLP, Michelle Bonang, OTR/L - As speech-language pathologists, we all experience stories of working as an interdisciplinary team. In this story, co-treatment brought us together and keeps us in touch today. Our relationship naturally affected us professionally, but personally as well. This story shares some of my adventures—I’m Stephanie Sigal, an SLP in Manhattan, with my friend and colleague Michelle Bonang, an occupational therapist in Vermont. Together, we teach each other invaluable skills.
  • The Rehab Therapist’s Guide to Co-Treatment Under Medicare - Recommended Co-Treatment Guidelines Based On CMS’s Regulations. 1
    www.webpt.com     Author: Brooke Andrus, Ryan Giebel PT, DPT, OCS, CMTPT/DN - There is one important point to keep in mind, courtesy of joint guidelines for co-treatment created by the American Speech-Language-Hearing Association (ASHA), the American Occupational Therapy Association (AOTA), and the American Physical Therapy Association (APTA): Therapists billing under either Part A or Part B should only provide co-treatment if the purpose for such treatment is to enhance the quality of care the patient receives. Practitioners should never co-treat simply because it is logistically more convenient to do so. If the therapists believe co-treatment is the best way to help the patient progress toward his or her goals, they must clearly document that rationale within their notes. Finally, therapists should not provide therapy in more than two disciplines during a single session Medicare Part A Co-Treatment Rules If, during a single treatment session, a patient receives therapy from two different practitioners working in two different disciplines (e.g., PT and OT), both therapists can bill for the entire treatment session separately. Each treating therapist, however, must ensure the length of time billed as co-treatment is equal in each other’s accounts. Medicare Part B Co-Treatment Rules If two therapists provide treatment—whether that treatment includes the same or different services—to a single patient at the same time, neither therapist can bill separately for the full session.
  • Echolalia and Its Role In Gestalt Language Acquisition 0
    www.asha.org     Author: ASHA / Practice Portal / Clinical Topics / Autism Spectrum Disorder / - This view of gestalt language acquisition and the role of echolalia in individuals with ASD is reflected in assessment procedures (e.g., assessing communicative function of echolalia) and treatment approaches to language intervention (see e.g., Blanc, 2012). Gestalt language acquisitionis a style of language development with predictable stages that begins with production of multi-word “gestalt forms” and ends with production of novel utterances. At first, children produce “chunks” or “gestalt form” (e.g., echolalic utterances), without distinction between individual words and without appreciation for internal syntactic structure. As children understand more about syntax and syntactic rules, they can analyze (break down) these “gestalt forms” and begin to recombine segments and words into spontaneous forms. Eventually, the child is able to formulate creative, spontaneous utterances for communication purposes.

Activity List(s)

Visual Schedule Cards

Assessments

Goal Bank

  • Zander will use personal AAC device to communicate wants and needs with familiar listeners over a 3 month therapy period. 1
  • To increase self-advocacy by the end of a school semester, Byron will request assistance with an object or action using their AAC device. 1
  • Alice will participate in the classroom with the teacher or a peer using their AAC device across a school semester to increase classroom participation and involvement. 0
  • Jody will follow a daily sensory and movement diet with age-appropriate preferred regulatory activities 10 minutes per day, min 4 times per week, with visual and 50% verbal cues, to improve active participation at home and school, 80% of the time. 0

Organizations

Organizations who selected this major focus area as their top area of expertise.

  • melba@rocketcityspeechtherapy.com

    Rocket City Speech Therapy

    Private Practice
    1 employee

    Rocket City Speech Therapy is a pediatric private practice catering to the needs of families with children birth to 5 and children with complex communication needs. Melba Acey is the owner, operator of Rocket City Speech Therapy. With 20 years of experience in a variety of settings, she is passionate about Augmentative and Alternative Communication (AAC) and ensuring the best care for all of her clients.

  • Pals Pediatric Therapy

    PALs Pediatric Therapy

    Private Practice
    6 - 10 employees

    PALs pediatric therapy is a speech language therapy dedicated to serving children on the Mississippi Gulf Coast.

Therapists

Therapists who selected this major focus area as their top area of expertise.

  • Allison King

    Allison King

    Full-time Therapist CCC-SLP

    I specialize in children with articulation and phonological disorders. My favorite population are...

  • Jessica Lenden-Holt

    Jessica Lenden-Holt

    Full-time Therapist Clinical Lead CCC-SLP

    Hi! I'm Jessica Lenden-Holt. I am the Chief Clinical Officer with Sidekick Therapy Partners (mysi...

    • Speechcenter, LLC Speechcenter, LLC
    • Sidekick Therapy Partners Sidekick Therapy Partners
  • Amanda Cox

    Amanda Cox

    Full-time Therapist CCC-SLP

    I specialize in working with children with autism, complex communication disorders, and AAC. I ha...

  • Kelly Dempsey

    Kelly Dempsey

    Full-time Therapist CCC-SLP

    I am a speech-language pathologist and the District Coordinator for Robertson County. I currently...

  • Kelly Manning

    Kelly Manning

    Full-time Therapist CCC-SLP

    I attended Syracuse University for undergrad and University of Tennessee Health Science Center fo...

    • Sidekick Therapy Partners Sidekick Therapy Partners
  • Shannon Briscoe

    Shannon Briscoe

    Full-time Therapist CF-SLP CCC-SLP
  • Samantha Shaffer

    Samantha Shaffer

    Full-time Therapist CF-SLP

    I am a pediatric speech-language pathologist in Knoxville, TN. I love all things pediatric, but l...

  • Shannon Clark

    Shannon Clark

    Full-time Therapist CF-SLP

    I am at CF at Sidekick therapy partners. I have a love for AAC & functional communication wit...

  • Sara Turner

    Sara Turner

    Full-time Therapist CCC-SLP

    Hi! I am Sara Turner and I am a pediatric Speech and Language Pathologist with Sidekick Therapy P...

  • Janette Hreish

    Janette Hreish

    Full-time Therapist CCC-SLP

    Hi there! I am speech pathologist that loves working with students to achieve their speech and la...

    • Sidekick Therapy Partners Sidekick Therapy Partners
  • Dipali Bhakta

    Dipali Bhakta

    Front Desk Full-time Therapist Billing Administration Owner Accounting / Finance Credentialing Developer Administrative Assistant Management Scheduling Clinician Operations Human Resources CCC-SLP

    My name is Dipali Bhakta, I am a speech language therapist born and raised in south MS.I have wor...

    • PALs Pediatric Therapy PALs Pediatric Therapy