Communication Facts: Special Populations: Augmentative and
Alternative Communication - 2008 Edition
An augmentative and alternative communication (AAC) system is
an integrated group of components, including the symbols, aids,
strategies, and techniques used by individuals with severe speech
and language disabilities to enhance communication. The system
serves to supplement any gestural, spoken, and/or written
communication abilities (1). Augmentative and alternative modes
of communication have assumed an increasingly important role in
meeting the communicative needs of individuals with severe
General Demographics of Users
- Persons with severe and profound disabilities may be
especially vulnerable to separation from the mainstream of
society. Technologies such as AAC systems can help minimize
this separation from other people (3).
- Published prevalence estimates of the number of people with
severe speech impairments vary widely, depending on the
country, age group, and type(s) of disability surveyed
- Several studies suggest that 8 to 12 people per 1,000
experience severe communication impairments that require AAC
- Two types of individuals may benefit from the use of AAC
systems: those with long-term communication impairments (e.g.,
dysarthria, aphasia, apraxia) and those with more temporary
conditions (e.g., tracheostomy placement, intubation) (8).
- The etiologies for permanent impairment occur in all
socioeconomic, racial, ethnic, and age groups. The etiologies
resulting in significant communication impairment can be
congenital or acquired (8).
Children as Users of AAC
- A significant delay in communication development affects
all aspects of a child's development. Children with
established disabilities and severe communication impairments
may not develop spoken language (9).
- Most individuals who use AAC are first exposed to language
through the spoken language of their families and, later, of
the broader social community. Despite the trend toward early
intervention, many individuals with significant communication
impairments are not introduced to AAC until they are 3 or 4
years old or even older. As a result, the spoken language of
the family and the community may be their only language during
the critical early years of development (7).
- According to one study, several reasons may be attributed
to the neglect of adolescents who have not received any
systematic intervention to develop AAC. These reasons include
continued emphasis on developing cognitive prerequisites before
starting direct instruction to teach functional communication,
and a lack of AAC awareness and expertise among some clinicians
- Current literature suggests a lack of empirically validated
strategies for teaching reading skills to children who use AAC
- In 2006, 50% of speech-language pathologists in schools
indicated that they served individuals who are nonverbal and/or
required AAC (12).
Adults as Users of AAC
- Researchers in the field of AAC have demonstrated that many
people with acquired communication disorders may benefit from
the use of AAC technologies to improve communication
effectiveness and enhance participation in life activities.
However, some adults with acquired disorders may reject AAC
options despite the opportunities they offer for improved
quality of life (13).
- Data on the use of AAC is not collected in any national
census activity. To date, national searches to identify
individuals who use AAC and are employed have identified only
small numbers (14).
- Recent advances in technology should be expanding
employment opportunities for people with disabilities,
including those who use AAC. However, this hasn't been the
case. A survey of AAC professionals suggests that only 14% of
the 5,333 AAC users known to these respondents were employed in
some way (14).
- Schools can and must play an important role in preparing
the future worker with the human capital or "hard
skills" needed for employment. Individuals who use AAC and
their employers believe that schools must do more to prepare
individuals who use AAC for the workplace (14).
- American Speech-Language-Hearing Association. (2002).
Augmentative and alternative communication: knowledge and
skills for service delivery.
ASHA Supplement 22, 97-106.
- Johnston, S.S., Reichle, J., & Evans, J. (2004,
February). Supporting augmentative and alternative
communication use by beginning communicators with severe
American Journal of Speech Language Pathology, 13
- Hourcade, J., Pilotte, T.E., West, E., & Parette, P.
(2004, Winter). A history of augmentative and alternative
communication with severe and profound disabilities.
Focus on Autism and Other Developmental Disabilities,
- Beukelman, D.R., & Mirenda, P. (2005).
Augmentative and alternative communication: Supporting
children and adults with complex communication needs
(3rd ed.). Baltimore: Paul H. Brookes Publishing Co.
- Matas, J., Mathy-Laikko, P., Beukelman, D., &
Legresley, K. (1985). Identifying the non-speaking population:
A demographic study.
Augmentative and Alternative Communication, 1,
- Beukelman, D.R., & Ansel, B. (1995). Research
priorities in augmentative and alternative communication.
Augmentative and Alternative Communication, 11,
- Light, J.C., Beukelman, D.R., & Reichle, J. (2003).
Communicative competence for individuals who use AAC: From
research to effective practice.
Baltimore: Paul H. Brookes Publishing Co.
- Downey, D., & Hurtig, R. (2003, July). Augmentative and
Pediatric Annals, 32
- Sevcik, R.A., Romski, M.A., & Adamson, L.B. (2004).
Research directions in augmentative and alternative
communication in preschool children.
Disability and Rehabilitation, 26
- Sigafoos, J. et. al. Transferring AAC intervention to the
Disability and Rehabilitation, 26
- Fallon, K.A., Light, J., McNaughton, D., Drager, K., &
Hammer, C. (2004, December). The effects of direct instruction
on the single-word reading skills of children who require
augmentative and alternative communication.
Journal of Speech Language Hearing Research, 47
- American Speech-Language-Hearing Association (2006).
2006 Schools Survey Report: Caseload Characteristics. Rockville, MD: ASHA.
- Lasker, J.P., & Bedrosian, J.L. (2001, September).
Promoting acceptance of augmentative and alternative
communication by adults with acquired communication disorders.
Augmentative and Alternative Communication, 17,
- McNaughton, D., & Nelson Bryen, D. (2002, Summer).
Enhancing participation in employment through AAC technologies.
Assistive Technologies, 14
Compiled by Andrea Castrogiovanni * American
Speech-Language-Hearing Association * 2200 Research Boulevard,
Rockville, MD 20850 *