Augmentative and Alternative Communication

Individuals with severe speech disorders sometimes cannot communicate verbally and instead rely on another means of communication. These other options are considered augmentative communication if they support verbal speech and language and alternative communication if they take the place of verbal speech and language.

Gestures and body language, formal sign language, writing and a variety of communication aids are often employed as means of augmentative and/or alternative communication.

Gestures and Body Language

Gestures and body language are typically means of augmentative communication in that they are used in tandem with some verbal speech to get a message across. For example, pointing to objects, giving the “thumbs up”, winking, crossing the arms, and shaking or nodding the head are all means of conveying a message without speaking.

Unfortunately, gestures and body language are not universal, nor are they standardised. What is meant by a specific gesture may differ from person to person or culture to culture. Individuals who will be communicating often with someone who relies on gestures or body language to augment their verbal speech should take care to learn what each gesture or action means.

Sign Language

Sign language is a mode of communicating that uses hand signs to convey meaning. Sign language may be used to augment verbal communication, but it is often an alternative means of communication as well. Sometimes sign language is described as “talking with the hands”, and many people refer to being able to “speak” through sign language. Facial expressions, finger spellings, and shoulder movements also comprise methods of communicating via sign language.

Sign language is relatively common throughout the United Kingdom, with British Sign Language (BSL) and Signed Support English (SSE) the most common types used. Regional variations do exist, and Irish Sign Language (ISL) is often learned in Northern Ireland in addition to British Sign Language and/or Signed Support English.

Writing

Writing out messages by hand, or typing them via typewriter or computer, is another method of communicating that can both augment or replace verbal speech. In order for individuals to rely on this type of communication, however, the small muscles of the hands must be strong enough, and coordinated enough, to make writing a viable option.

Communication Aids

A variety of communication aids exist to both augment and replace verbal speech as needed. Communication software, voice amplifiers, switches, and mounting/holding devices can all be used as augmentative and/alternative means of communication. Word/symbol boards are another means of supporting or replacing verbal speech. These boards allow individuals to point to items or words that they wish to communicate. Some software, such as Boardmaker, allows individuals to add to their boards as desired.

Electronic communication aids may also be employed to support or replace verbal speech, such as SuperVoca, an electronic display communication aid, The Liberator, an electronic communication aid which allows synthesised speech, and The TouchTalker, an electronic display communication aid which allows produces synthesised or digitised speech.

Further Information

If augmentative and/or alternative communication is needed, a speech therapist will be involved in devising the best plan for the individual involved. Speech therapists can be accessed by a referral from a GP, Health Visitor or privately. A variety of organisations dedicated to supporting individuals affected by speech difficulties and disorders will also likely be able to offer further information on augmentative and alternative communication.

The British Stammering Association (www.stammering.org), Christopher Place, The Speech, Language and Hearing Centre (www.speech-lang.org.uk) Speakability (www.speakability.org.uk) and Talking Point (www.talkingpoint.org.uk) are a few such organisations in the United Kingdom.