Augmentative and Alternative Communication Systems: A Comprehensive Look
Augmentative and Alternative Communication Systems
Pictograms and Ideograms (PIC) vs. Symbol Communication System (SPC)
Both SPC and PIC are communication systems designed for individuals with communication difficulties. The primary difference lies in the symbol arrangement. PIC utilizes white symbols on a black background, potentially aiding interpretation for those with specific sensory or perceptual deficits.
Target Population:
- Individuals with partial or total absence of oral language
- Individuals with intellectual disabilities
- People with aphasia
- People with autism
PIC is not widely used in Spain. Due to its simplicity, it gained acceptance and even displaced the Bliss system. However, PIC is limited, as it does not facilitate phrase construction and has a restricted symbol set.
Premack System
This system uses durable symbols, each representing a word, that users can physically manipulate.
System Advantages:
- Utilizes both visual and tactile channels.
- Enhances memorization skills.
- Easy to learn due to multi-channel engagement (visual, tactile, auditory).
Drawbacks: The Premack system functions more as a tool for generalization and abstraction than a comprehensive augmentative communication system.
Technical Assistance for Accessing Symbolic Communication Systems
Unaided Techniques
Suitable for individuals without motor difficulties and with good hand-gesture execution and intellectual skills. These techniques are limited to manual sign language and similar systems. Individuals with severe cerebral palsy or multiple disabilities may not be able to use these techniques due to lack of motor control.
Basic Elementary Supports
These are easily manufactured and inexpensive, using simple materials like cardboard and plastic. Examples include communication boards in various formats (leaflets, brochures, notebooks). Their versatility allows use in homes, schools, activity centers, and hospitals.
Simple Electronic Aids
These aids translate an individual’s movements into easily interpretable signals, promoting spontaneous and rapid communication. They objectify messages, reducing ambiguity. Examples include printers, video graphics, voice synthesizers, and specialized software for phone and internet communication. Advanced options include mouse emulators like “Mouse Face” and specialized switches (chin, forehead, etc.).
Communicators
Basic Function: Enable computer access for individuals with mobility issues by replacing the mouse and keyboard. Symbol selection can be done by pressing, directly pushing a cell, or through scanning.
Additional Features:
a) Icon Prediction: When an icon is chosen, related icons are highlighted, indicating stored messages associated with them.
b) Predictive Selection: Only boxes derived from the prediction of selected icons are available, reducing errors and increasing selection speed.
Concept Boards or Keyboards
These are practical alternatives to conventional alphanumeric keyboards. They offer easier timing of functions and cell pacing. The larger key size facilitates access for individuals with precision difficulties.
Software for Communicators
- Winbag: Enables sound emission.
- Winspeak: A user-friendly program adaptable to individual needs, suitable for those using graphic communication systems.
Selection of Technical Resources Based on User Skills
The selection process must consider the user’s motor skills, intellectual level, and sensory capabilities.
- Degree of Reduced Mobility: Wheelchair users can utilize larger equipment or panels, while those using crutches require less sophisticated, more portable systems.
- Symbol Choice: This depends on the user’s motor skills, including pointing accuracy, speed of action, and reaction.
- Ability to Perform Repetitive Movements: Consistent speed and efficiency in actions like double-clicking or pressing buttons after specific intervals enable the use of advanced technological devices, electronic communicators, and laptops.
Individuals Likely to Use Augmentative and Alternative Communication (AAC)
Candidates for AAC systems are those who need alternative communication methods to speech. This includes:
- Individuals who develop communication processes normally but cannot speak (e.g., deaf individuals with normal cognitive and physical abilities).
- Individuals with severe communication disorders but who can potentially use oral code (e.g., autistic individuals with good vocal mimicry).
- Individuals with alterations in both communication and oral language production (e.g., individuals with severe intellectual disabilities and autistic children with low cognitive development).
Classification of AAC Systems
A) Augmentative Communication Systems: Supplement spoken language when it is insufficient for effective communication. Examples include cued speech and supportive gestures.
B) Alternative Communication Systems: Replace spoken language when it is absent or not understandable. Examples include sign language, graphic symbols, and writing.
- Dependent: Require assistance from another person to interpret messages, often using communication boards with symbols, letters, or words.
- Independent: Produced entirely by the individual, potentially using technical aids like specialized typewriters, computers, or voice communicators.
I) Unaided Communication: The user creates and develops communication modes without external tools. Examples include sign language and the bimodal system.
II) Aided Communication: Requires external technical resources beyond the user’s body to indicate communicative acts. Signs or symbols are selected using communication boards, computer programs, etc. Examples include pictograms, computer-based programs, and alphabet-based boards.
Graphic Communication Systems Without Voice
These systems provide resources and strategies for individuals unable to produce meaningful voice messages, enabling social interaction and improving quality of life.
Main Objectives:
a) Replace the absence of spoken communication (alternative system).
b) Expand communication channels for those acquiring language or needing to communicate with their environment (augmentative system).
Individuals Likely to Use Non-Voice Graphic Systems
- Physical Disability: Caused by traumatic brain injury, cerebral palsy, neurological and neuromuscular degenerative pathologies, craniofacial malformations.
- Intellectual Disability: Caused by autism, severe developmental disorders, cognitive disability, specific language impairment, multiple disabilities.
- Specific Neurological Speech Disorders: Slurring of speech and communication.
Types of Symbols and Modes
Non-vocal graphic systems primarily consist of pictorial symbols (Foster and drawings) and non-pictographic symbols (without similarity relationships).
Communication Boards and Books
These tools allow individuals using non-voice graphic communication to interact with others. They contain a personalized vocabulary repertoire for transmitting messages. They can be made of light wood, clear acrylic, cardboard, or card stock, and may include additional cards for faster message production. Any gesture repertoire, universal or specific, should be included. Boards and books are economically inexpensive compared to electronic communicators with sign and voice software.
Features:
- Can be made of light wood, clear acrylic, cardboard, or laminated card stock.
- May have additional cards to facilitate message production.
- Should include any gesture repertoire, universal or targeted.
- Inexpensive compared to more sophisticated tools.