1. Augmentative and Alternative Communication (AAC)
1.1. Another approach to treatment, with a focus on understanding how the disorder affects individuals daily lives and identifying ways to help them participate more fully society
1.1.1. Communication Partners
1.1.1.1. Parents, friend, spouse, and strangers that in a variety of settings to enhance independence and participation in desired life situations
1.2. The clinical practice of AAC involves a set of procedures and processes through which an individual's expressive and receptive communication skills are maximized for functional and effective commmunication
1.2.1. Multimodal
1.2.1.1. People use a combination of communication modalities to meet their intended communication goals
1.2.1.2. Listening, reading, talking, writing, and sign language are all language-based modalities
1.2.1.3. Communicators also use modalities that are not language-based including gestures, facial expressions, vocalizations, vocal inflection, speaker proximity, posture, and eye gaze
1.2.2. Complex Communication Needs
1.2.2.1. It emphasizes the importance of speech, language, and/or cognitive disorder
1.2.2.2. Replaced previously used terms, such as severe communication disorders or severe communication impairments
1.3. An AAC system utilizes symbols, aids, strategies, and techniques to supplement an individual's current way of communicating
1.3.1. Speech Generating Device (SGD)
1.3.1.1. Used to produce words and phrases as an alternative to speaking in situations where he or she is not understood
2. ACC System
2.1. ACC consists of four different components that are used to enhance communication
2.1.1. Symbol
2.1.1.1. A symbol is something that stands for something else
2.1.1.2. Aided symbol requires a device or accessory that is external to the body to transmit a message
2.1.1.2.1. Example: Typing a message, drawing a picture, or pointing to photographs
2.1.1.3. Unaided symbols require only one's body
2.1.1.3.1. Example: Speaking, gesturing vocalizing, and signing
2.1.1.4. Static symbol do not require movement change to understand their meaning
2.1.1.4.1. Example: A photograph or an illustration
2.1.1.5. Dynamic symbols require movement or change to understand their meaning
2.1.1.5.1. Example: Gestures
2.1.1.6. Iconicity symbol system is the degree to which symbols visually resemble what they refer to
2.1.1.7. Opaque symbol system has little resemblance to what it represents
2.1.2. Aid
2.1.2.1. An aid refers to a type of assistive device that is used to send or receive messages
2.1.2.2. Electronic AAC aids are usually referred to as speech generating devices
2.1.2.3. Nonelectronic AAC aids are described as either no technology or low/light echnology
2.1.3. Strategy
2.1.3.1. Strategy is the way symbols are effectively conveyed
2.1.3.2. AAC strategies are intended to improve message transmission time, support grammatical formulations of messages, and enhance communication rates
2.1.4. Technique
2.1.4.1. Technique refers to the way in which, messages are transmitted
2.1.4.2. There are two types of techniques
2.1.4.2.1. Direct Selection
2.1.4.2.2. Indirect Selection
2.1.5. Selection Set
2.1.5.1. An AAC aid may display symbols on displays in different ways
2.1.5.1.1. Fixed display
2.1.5.1.2. Dynamic Displays
2.1.5.1.3. Hybrid displays
2.1.5.1.4. Visual scene display
3. People with Complex Communication Needs can Benefit from an AAC System
3.1. Communication Competence
3.1.1. Emerging Communication
3.1.1.1. No reliable method of symbolic expression and are limited to nonsymbolic methods of communicating
3.1.1.1.1. Examples: Facial expressions, physical movements, or vocalizations
3.1.2. Context-dependent Communication
3.1.2.1. Reliable symbolic communication but communicate in only a few contexts or with only a few contexts or with only a few partners
3.1.3. Independent Communication
3.1.3.1. Individuals at the point of independent communication are usually literate and interact with both familiar and unfamiliar communication partners in a variety of communication environments
3.2. Increasing Participation in Society
3.2.1. Any barriers to effective communication must be addressed in treatment to allow complete participation in all desired social and communication roles
3.2.1.1. Social Roles
3.2.1.1.1. The roles each person has in society
3.2.1.2. Communication Roles
3.2.1.2.1. The roles of how you communicate with different people
4. Complex Communication Needs
4.1. The purpose of Communication Interactions
4.1.1. Information Transfer
4.1.1.1. When we communication to give and receive information
4.1.2. Needs and Wants
4.1.2.1. When we regulate behaviors of others
4.1.3. Social Closeness
4.1.3.1. Establish and maintain relationships with others
4.1.4. Social Etiquette
4.1.4.1. Being polite and conforming to the social conventions of one's culture
4.2. Causes of Complex Communication Needs
4.2.1. Intellectual Disability
4.2.1.1. Having significant limitations in both intellectual functioning and adaptive behavior
4.2.2. Cerebral Palsy
4.2.2.1. Neuromotor impairment resulting from trauma or damage to the developing child before, during, or soon after birth
4.2.3. Autism Spectrum Disorders
4.2.3.1. Group of developmental disorders characterized by impaired social interaction; difficulty with verbal and nonverbal communication; and unusual, repetitive, or severely limited activities and interests
4.2.4. Childhood Apraxia of Speech
4.2.4.1. Speech disorder characterized by the inability to control the purposeful speech movements and sequences of speech movements
4.2.5. Traumatic Brain Injury
4.2.5.1. Acquired injury to the brain caused by a traumatic event
4.2.6. Stroke
4.2.6.1. When the blood supply to part of the brain is interrupted or when a blood vessel in the brain ruptures
4.2.7. Degenerative Diseases
4.2.7.1. Amyotrophic Lateral Sclerosis (ALS)
4.2.7.1.1. People with ALS may experience a deterioration of speech skills, resulting in unintelligible speech, or may experience poor respiratory functioning, resulting in mechanical ventilation
4.2.7.2. Parkinson's Disease
4.2.7.2.1. Slowly progressive disease of the basal ganglia in the central nervous system
4.2.7.3. Dementia
4.2.7.3.1. Results in significantly impaired intellectual functioning, resulting in disruptions to daily activities and relationships
5. AAC Systems and Complex Communication Needs Identified
5.1. The Assessment Team
5.1.1. Multidisciplinary Team of professionals conducts an AAC assessment
5.1.1.1. Possible team members include individuals with complex communication needs, parents, teachers, speech-language pathologists, physical therapists, occupational therapist, rehabilitation engineers, social workers, psychologists, vocational counselors, nurses, and doctors
5.2. The Assessment Process
5.2.1. Comprehensive AAC assessment
5.2.1.1. The purpose is to identify, measure, and describe factors affecting communication, effects of the communication impairment on the individual's activities and participation, what barriers exist to desired participation, what facilitates successful communication, and what AAC system would enhance communication and participation in life situations
5.2.1.1.1. Opportunity barriers are imposed by other people and prevent an individual's participation in communication activities
5.2.1.1.2. Access barriers prevent participation in communication activities, but they stem from the capabilities, attitudes, and resources of the person using AAC