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Introduction
Severe speech and /or language impairments problems is a common phenomena in individuals with developmental disabilities (Schlosser & Sigafoos, 2006) hence the requisite for an intervention for the development of alternative and augmentative forms of communication. This form of communication is an area of educational and clinical practice which offers a set of approaches and strategies to replace or supplement natural speech or/and handwriting. The two forms of approaches involved are aided or unaided devices. While aided approaches involves an external device or aid such as a speech generating device (SGD) or communication board, unaided approaches on the other hand encompass an individuals own body for communication such as the use of gestures or manual signs.
Conversely, once the decision to use AAC has been seen as a viable option for consideration for an individual, stakeholders and practitioners need to pick from a myriad of symbols or sets, intervention strategies and assistive communication devices. Hence, the question facing a practitioner is what devices, symbols and strategies to pick over others. The answer to this critical question normally involves comparison in some sorts. To exemplify this, one may need to make a decision between (a)traditional orthography and a graphic mode, (b)a graphic mode and a gestural mode,(c)direct selection and picture exchange, (d) between scanning method A and B, (e) activity based instruction and direct instruction, and (f) non- electronic communication boards and SGDs.
According to the American Speech-Language and hearing association, augmentative and alternative communication, or AAC has been defined as an area of research, clinical and educational practice. This area attempts to study and/or compensate for permanent or temporary impairments, limitations, activities and participation restrictions of persons with severe disorders of production of speech language and/or comprehension, inclusive of written or spoken communication modes (Association, 2005). AAC strategies further assistance to individuals with communication disabilities so that they can participate fully in social roles such as learning, interpersonal interaction, community activities, education volunteerism, care management, employment and so on.
Furthermore, the American Speech-Language-Hearing Association (ASHA) is of the position that everybody has a right to communicate to the fullest extent possible because it is the essence of life. Hence, no person should be denied the right of communication irrespective of the severity and/or type of linguistic, communication, cognitive, social, sensory, motor, perceptual or/and other forms of disability that they may present.
The provision of Augmentative and Alternative Communication services is within the practice and scope of Speech-language pathologists. Their responsibilities encompass:
- Recognize and hold paramount interests and needs of persons who may benefit from augmentative and alternative communication, and help them to communicate in ways and areas they may desire.
- Acquisition and maintenance of requisite knowledge and skills which are necessary for provision of quality and professional services.
- The implementation of a multimodal approach for enhancing communication that is effective and culturally and linguistically appropriate.
- Integration of knowledge and perspectives of team members, but especially of those with AAC needs, their significant others or families, to develop meaningful goals and objectives.
- Assessment, intervention and evaluation of outcomes and progress associated with augmentative and alternative communication interventions by use of principles such as evidence-based practice.
- Assist individuals' uses of augmentative and alternative communication for promotion and maintenance of quality life.
- Support with and use for persons who already or can benefit from augmentative and alternative communication, or their families to tackle communication needs and guarantee their rights to full communication entrance (Association, 2005).
Individuals with severe communication problems require the use of augmentative or assistive communication devices. According to the Individuals with Disability Education Act(IDEA), the term assistive technology refers to any piece of equipment, item or product system whether modified, acquired commercially or out of the shelf or customized, and which is used for maintenance, increase and improvement of the functional capabilities of an individual with a disability.
Augmentative or Alternative communication systems encompass use of personalized devices or methods that substitute an individuals ability for communication (Beukelman & Mirenda, 1992, p. 24). There exist different forms or methods of augmentative or assistive communication and most persons with communication problems use a combination of devices or systems, dependant on the communication situation.
Firstly, are unaided augmentative or alternative systems and these are those that do not require the use of additional pieces of equipment. They include gestures and facial expressions, manual signing, eye gaze, pantomime or pointing. Aided systems involve the use of external devices inclusive of a variety of methods, which range from high technology to low technology. Devices involved in aided systems generally display symbols that an individual chooses for conveying messages to listeners (p. 26).
According to Beukelman and Miranda (1992), there are three vital areas for consideration in the Augmentative or alternative communication process. These are methods of symbols representation, methods for symbols selection, and methods for transmission of messages (p. 28).
Augmentative and alternative communication systems use various collections of sets and symbols to represent meaning in communication. These may be through objects, line drawings, photographs, colored symbols, detailed pictures, gestures, geometric shapes, manual signs, words or letters. Additionally, an individuals physical skills, chronological age, visual and cognitive skills should be put into consideration when picking which symbol system to use. In the same way, the vocabulary selected for augmentative and alternative communication systems should enable the user a chance for conveying many intentions and interactions. Core vocabulary should be used in many situations and be availed in different situations and functions to: Introduce conversations and topics, initiate interactions, maintain topics, stop interactions, share information and make requests (p. 34).
According to Beukelman and Miranda (1992), speech pathologists should employ two methods for augmentative and/or alternative communication in selecting symbols. These include: (1) the direct selection of desired symbols from the available symbols, which may be aided using switches, mechanical pointers, prosthesis, light beams, or unaided through the use of eye gaze, blinking, pointing, body movements, or symbol removal (p. 44). (2) Persons who have limited mobility can use a scan selection method to speed the selection process. Here, diverse choices are provided in sequence that includes block representations, one at a time or row column presentation.
Both methods may employ a form of input device for example a mouse, switch or adaptive keyboard in assisting individuals to make a selection. Other devices or methods make use of pages or levels to distinguish different vocabulary choices. Hence, an individual may use high technology where the page or level is changed electronically, or low technology when moving from page to page to switch from a level to the next.
There are different methods and ways for conveying messages in augmentative and alternative communication processes in which users can transmit messages through auditory or visual output. Nonetheless, with the use of manual gestures or signs or boards for communication, listeners have to watch individuals in order to interpret a message. About electronic devices, many aid in provision of voice devices that may be recorded or computer generated or displays, which are written (Beukelman & Mirenda, 1992, p. 52). Augmentative and alternative communication aids are divided into three categories. These include:
Firstly, dedicated devices that serves purposes of communication solely while the second are simple systems, which encompass low-tech aids and technology for example gestural systems and communication boards, and lastly multipurpose systems that function for a diverse range of activities and not limited to communication. Multipurpose systems are designed for various services such as educational, recreational and vocational purposes (60).
Additionally, augmentative and alternative communication devices range in complexity. These may range from complex devices that use sequential icons for representation of different topics, or a symbol at a time availed to a user.
Both communication boards and books are inexpensive and therefore can be altered to meet diverse situations and users needs. Users can point to or they can remove symbols as a way of expressing messages. Furthermore, they are portable and are easily transportable from one area to the next, hence easy to use and they are durable. (Schlosser & Sigafoos, 2006).
Users can access communication symbols using a variety of ways such as the use of single boards, rings, small or large notebooks, aprons or caregiver vests. Availing multiple limited context displays for communication enhances user participation. For example, small displays may be placed in specific locations like the walls, car dashboard, and pages in a story for user communication in any location they prefer or like. Moreover, for special events, mini boards can be made and stored for use in the next season. Individuals with limited mobility can use pictures that should be placed on a transparent acrylic board which aid in displaying or indicating messages for them through eye gazes.
Clinicians ought to address two issues whilst planning for persons who use augmentative or alternative communication. The first involves selecting and custom designing augmentative and alternative communication systems. This is for providing the individual with equipment and tools for effective communication, that is, either receptively or expressively. Secondly, they have to teach operational, linguistic strategic and social skills that are a requisite for the individual for effective communication (p. 104).
Augmentative and alternative systems ought to be customized and selected for a proper fit to the individual with communication problems. A process should be followed by clinicians and families during the selection so that a perfect fit is derived. This process involves a review of the individual's skills and needs and identification of the requirements of the system. (Light, Roberts, Dimarco, & Nina, 1998). Afterwards, augmentative and alternative systems that meet the former requirements should be selected with the evaluation of their effectiveness, appropriateness, efficiency, and individual or user preference through a trial basis. Characteristically, augmentative and alternative involvements are multimodal, and make use of the user's full communication capabilities including gestures, natural speech, signs, and computer based technology and communication books.
By tradition, augmentative and alternative communication for individuals with sever communication problems such as autistics centered on the using unaided modes of communication for example signs and gestures, since most autistics exhibit sufficient motor skills for production of signs. Additionally, such modes bore advantages such s durability, portability and accessibility. Even with research demonstrating autistic individuals can learn how to use unaided AAC systems successfully for communication (Light, Roberts, Dimarco, & Nina, 1998), many autistics experience difficulties in generation of spontaneous communication, communication with partners or family members who have limited knowledge on signs, and in combining signs for complex communication.
Therefore, the recent shift in exploration of aided communication modes for individuals with communication incompetency. The disadvantages to aided communication modes include lack of durability or portability but still, they provide distinctive advantages for autistic individuals. Some of its advantages include their incorporation of visual symbols in their usage; they are easily intelligible to many partners and make use of visual spatial processing, strengths demonstrated by many people with autism.
The misconception that research into the augmentative and/or alternative communication modes and devices, plus the provision of such equipment as seen fit by clinicians is enough to ameliorate the condition of individual with communication incompetency is false. According to Light et al (2006), such individuals must be taught the use of a wide range of skills that encompass the linguistic, social, operational and strategic domains. These skills aid in the effective communications and daily interactions with others.
Firstly, educators have to teach the linguistic domain to individuals with communication incompetencies. These encompasses the expressive and receptive skills in the language(s) spoken by the social community or individual's family, in addition to the receptive and expressive dexterity in the language code of the augmentative and alternative communication systems.
The second domain, which is the operational domain, involves teaching of skills in the operations of aided or unaided AAC systems and their technical production. These sills may include the correct skills for producing proper hand shapes for correct signs, or the use of a head stick in the selections of items on the alphabet board.
Thirdly is the social domain, which according to Light et al (2006) encompasses the sociorelational and sociolinguistic skills that are necessary in the facilitation of communication skills with other people.
The last teaching skill that educators of augmentative and alternative communication strategies need to stress is the strategic domain. This domain covers compensatory strategies that are required by individuals with severe communication competencies so that they can overcome functional limitations required in the other skill domains.
Nonetheless, goals in teaching these domains should be meaningful, functional and achievable. The skills need to be taught in contexts that are relevant in order to respond to natural cues experienced in their daily activities. Individuals with communication competencies should be slowed a chance to practice these skills with relevant partners. Guided practice should also be incorporated to ensure success of the instruction. Moreover, when such individuals use the learnt skills efficiently, natural consequences should be provided. Formative and summative evaluations need to be incorporated for evaluation of the outcomes and progress.
AAC facilitators require an intervention to provide for communication and support for individuals who use augmentative and alternative communication. The intervention ensures that they get required support for effective communication within this domain. The key issues redress in the communication with these facilitators is (1) the use of appropriate interaction strategies and (2) the maintenance, operations, and ongoing developments of an individual's AAC systems.
Instructions for facilitators are there to eliminate any barriers that may occur during communication. These strategies may include obtaining the individuals consent prior to asking questions or provision of instruction. Second, the use of simple sentence structures in questions or giving directions, third, writing or tying on power book to supplement input in spoken language, and lastly, giving individuals at least fifteen or twenty seconds to process information or questions asked (Light, Roberts, Dimarco, & Nina, 1998).
When specific AAC systems are introduced in order to facilitate in communication of individuals with communication incompetence, it is paramount that not only such users are comfortable with them, but also the facilitators. Due to this, facilitators are required to be knowledgeable of access techniques and AAC symbols, positioning requirements, ongoing development in vocabulary, daily maintenance including cleaning, and knowledge in the operations of the AAC devices, plus the procedures for trouble shooting. Additionally, the teachers and parents need tutoring on methods of vocabulary selection and add this to the individual's dictionary for personal communication and ways of operating, maintenance, programming and troubleshooting procedures with the power book.
Augmentative and alternative communication devices come at a cost to families or users. Simple devices such as boards and books are usually quite affordable while complicated devices, especially the electronic ones may come at costly prices to individuals. Hence, clinicians and families usually seek the help and intervention of the government or public amenities to supplement these costs.
According to (Hambrecht & Rice), there exist many government supported centers or programs that are fully equipped with devices for assisting augmentative communication, and which can be loaned out to clinicians or families (p. 88). Such government centers carry out research on the best methods for individual communication problems and provide the best devices and advice. Furthermore, most insurance companies cover these costs after determination that it is the best device for its users. Due to the costly prices of some devices, especially the electronic ones, clinicians ensure they equip themselves with requisite knowledge of the resources that are available to the community or state, and be informed of insurance company requirements in the case of reimbursement claims by the users. Clinicians should also know modifications in equipment for correct prescription to the clients needs.
Conclusion
Many individuals with severe communication complications, for example those with autism and fragile syndrome, usually have trouble in understanding language that is spoken. As such, augmentative and/or alternative communication is a chance for significant opportunity for the development and augmentation of expression and comprehension that may be temporary or permanent. However, in order to realize the benefits of AAC, careful assessment is required in order to determine the individuals' needs and get optimum support from the instructors. Essentially, aided or unaided devices should be incorporated to assist individuals with communication problems. Unaided devices were more conventionally used for their obvious conveniences such as their durability and portability. However, individuals with severe communication complications require the use of aided devices and this have their advantages as well. Although some communication devices are expensive, strategies by governmental and non-governmental institutions have aided in the provision of such equipment. Adequate training of the facilitators is required with the support of parents as well. With the correct research, goodwill, instruction and provision of AAC devices, individuals with communication problems can effectively learn how to express themselves appropriately.
References
Association, A. S. (2005). Roles and Responsibilities of Speech-Language Pathologists With Respect to Augmentative and Alternative Communication.
Beukelman, D. R., & Mirenda, P. (1992). Augmentative and Alternative Communication:Management of severe Disorders in Children and Adults. Baltimore: Paul H Brookes Publishing Co.
Hambrecht, G., & Rice, T. (2010). Clinical Observation: A Guide for Students Speech, Language and Hearing. Sudbury, MA: Jones and Burtlett Learning.
Light, J. C., Roberts, B., Dimarco, R., & Nina, G. (1998). Augmentative and Alternative Communication to Support Receptive and Expressive Comunication for People With Autism. Journal of Communication Disorders , 153-180.
Schlosser, R. W., & Sigafoos, J. (2006). Augmentative and Alternative Communication Interventions for Persons with Development Disabilities: Narrative Review of Comparative Single-Subject Experimental Studies. Research in Developmental Disabilities , 1-29.
Severe speech and /or language impairments problems is a common phenomena in individuals with developmental disabilities (Schlosser & Sigafoos, 2006) hence the requisite for an intervention for the development of alternative and augmentative forms of communication. This form of communication is an area of educational and clinical practice which offers a set of approaches and strategies to replace or supplement natural speech or/and handwriting. The two forms of approaches involved are aided or unaided devices. While aided approaches involves an external device or aid such as a speech generating device (SGD) or communication board, unaided approaches on the other hand encompass an individuals own body for communication such as the use of gestures or manual signs.
Conversely, once the decision to use AAC has been seen as a viable option for consideration for an individual, stakeholders and practitioners need to pick from a myriad of symbols or sets, intervention strategies and assistive communication devices. Hence, the question facing a practitioner is what devices, symbols and strategies to pick over others. The answer to this critical question normally involves comparison in some sorts. To exemplify this, one may need to make a decision between (a)traditional orthography and a graphic mode, (b)a graphic mode and a gestural mode,(c)direct selection and picture exchange, (d) between scanning method A and B, (e) activity based instruction and direct instruction, and (f) non- electronic communication boards and SGDs.Augmentative and Alternative Communication for Disabled Individuals
According to the American Speech-Language and hearing association, augmentative and alternative communication, or AAC has been defined as an area of research, clinical and educational practice. This area attempts to study and/or compensate for permanent or temporary impairments, limitations, activities and participation restrictions of persons with severe disorders of production of speech language and/or comprehension, inclusive of written or spoken communication modes (Association, 2005). AAC strategies further assistance to individuals with communication disabilities so that they can participate fully in social roles such as learning, interpersonal interaction, community activities, education volunteerism, care management, employment and so on.
Furthermore, the American Speech-Language-Hearing Association (ASHA) is of the position that everybody has a right to communicate to the fullest extent possible because it is the essence of life. Hence, no person should be denied the right of communication irrespective of the severity and/or type of linguistic, communication, cognitive, social, sensory, motor, perceptual or/and other forms of disability that they may present.
Responsibilities of speech-language pathologists
The provision of Augmentative and Alternative Communication services is within the practice and scope of Speech-language pathologists. Their responsibilities encompass:
- Recognize and hold paramount interests and needs of persons who may benefit from augmentative and alternative communication, and help them to communicate in ways and areas they may desire.
- Acquisition and maintenance of requisite knowledge and skills which are necessary for provision of quality and professional services.
- The implementation of a multimodal approach for enhancing communication that is effective and culturally and linguistically appropriate.
- Integration of knowledge and perspectives of team members, but especially of those with AAC needs, their significant others or families, to develop meaningful goals and objectives.
- Assessment, intervention and evaluation of outcomes and progress associated with augmentative and alternative communication interventions by use of principles such as evidence-based practice.
- Assist individuals' uses of augmentative and alternative communication for promotion and maintenance of quality life.
- Support with and use for persons who already or can benefit from augmentative and alternative communication, or their families to tackle communication needs and guarantee their rights to full communication entrance (Association, 2005).
Augmentative/ Assistive Communication Devices
Individuals with severe communication problems require the use of augmentative or assistive communication devices. According to the Individuals with Disability Education Act(IDEA), the term assistive technology refers to any piece of equipment, item or product system whether modified, acquired commercially or out of the shelf or customized, and which is used for maintenance, increase and improvement of the functional capabilities of an individual with a disability.
Augmentative or Alternative communication systems encompass use of personalized devices or methods that substitute an individuals ability for communication (Beukelman & Mirenda, 1992, p. 24). There exist different forms or methods of augmentative or assistive communication and most persons with communication problems use a combination of devices or systems, dependant on the communication situation.
Firstly, are unaided augmentative or alternative systems and these are those that do not require the use of additional pieces of equipment. They include gestures and facial expressions, manual signing, eye gaze, pantomime or pointing. Aided systems involve the use of external devices inclusive of a variety of methods, which range from high technology to low technology. Devices involved in aided systems generally display symbols that an individual chooses for conveying messages to listeners (p. 26).
According to Beukelman and Miranda (1992), there are three vital areas for consideration in the Augmentative or alternative communication process. These are methods of symbols representation, methods for symbols selection, and methods for transmission of messages (p. 28).
Symbols Representation Methods
Augmentative and alternative communication systems use various collections of sets and symbols to represent meaning in communication. These may be through objects, line drawings, photographs, colored symbols, detailed pictures, gestures, geometric shapes, manual signs, words or letters. Additionally, an individuals physical skills, chronological age, visual and cognitive skills should be put into consideration when picking which symbol system to use. In the same way, the vocabulary selected for augmentative and alternative communication systems should enable the user a chance for conveying many intentions and interactions. Core vocabulary should be used in many situations and be availed in different situations and functions to: Introduce conversations and topics, initiate interactions, maintain topics, stop interactions, share information and make requests (p. 34).
Methods for Selecting Symbols
According to Beukelman and Miranda (1992), speech pathologists should employ two methods for augmentative and/or alternative communication in selecting symbols. These include: (1) the direct selection of desired symbols from the available symbols, which may be aided using switches, mechanical pointers, prosthesis, light beams, or unaided through the use of eye gaze, blinking, pointing, body movements, or symbol removal (p. 44). (2) Persons who have limited mobility can use a scan selection method to speed the selection process. Here, diverse choices are provided in sequence that includes block representations, one at a time or row column presentation.
Both methods may employ a form of input device for example a mouse, switch or adaptive keyboard in assisting individuals to make a selection. Other devices or methods make use of pages or levels to distinguish different vocabulary choices. Hence, an individual may use high technology where the page or level is changed electronically, or low technology when moving from page to page to switch from a level to the next.
Methods of Transmitting the Messages
There are different methods and ways for conveying messages in augmentative and alternative communication processes in which users can transmit messages through auditory or visual output. Nonetheless, with the use of manual gestures or signs or boards for communication, listeners have to watch individuals in order to interpret a message. About electronic devices, many aid in provision of voice devices that may be recorded or computer generated or displays, which are written (Beukelman & Mirenda, 1992, p. 52). Augmentative and alternative communication aids are divided into three categories. These include:
Firstly, dedicated devices that serves purposes of communication solely while the second are simple systems, which encompass low-tech aids and technology for example gestural systems and communication boards, and lastly multipurpose systems that function for a diverse range of activities and not limited to communication. Multipurpose systems are designed for various services such as educational, recreational and vocational purposes (60).
Additionally, augmentative and alternative communication devices range in complexity. These may range from complex devices that use sequential icons for representation of different topics, or a symbol at a time availed to a user.
Communication Boards and Books
Both communication boards and books are inexpensive and therefore can be altered to meet diverse situations and users needs. Users can point to or they can remove symbols as a way of expressing messages. Furthermore, they are portable and are easily transportable from one area to the next, hence easy to use and they are durable. (Schlosser & Sigafoos, 2006).
Users can access communication symbols using a variety of ways such as the use of single boards, rings, small or large notebooks, aprons or caregiver vests. Availing multiple limited context displays for communication enhances user participation. For example, small displays may be placed in specific locations like the walls, car dashboard, and pages in a story for user communication in any location they prefer or like. Moreover, for special events, mini boards can be made and stored for use in the next season. Individuals with limited mobility can use pictures that should be placed on a transparent acrylic board which aid in displaying or indicating messages for them through eye gazes.
Selection and Customizing Appropriate AAC Systems
Clinicians ought to address two issues whilst planning for persons who use augmentative or alternative communication. The first involves selecting and custom designing augmentative and alternative communication systems. This is for providing the individual with equipment and tools for effective communication, that is, either receptively or expressively. Secondly, they have to teach operational, linguistic strategic and social skills that are a requisite for the individual for effective communication (p. 104).
Augmentative and alternative systems ought to be customized and selected for a proper fit to the individual with communication problems. A process should be followed by clinicians and families during the selection so that a perfect fit is derived. This process involves a review of the individual's skills and needs and identification of the requirements of the system. (Light, Roberts, Dimarco, & Nina, 1998). Afterwards, augmentative and alternative systems that meet the former requirements should be selected with the evaluation of their effectiveness, appropriateness, efficiency, and individual or user preference through a trial basis. Characteristically, augmentative and alternative involvements are multimodal, and make use of the user's full communication capabilities including gestures, natural speech, signs, and computer based technology and communication books.
By tradition, augmentative and alternative communication for individuals with sever communication problems such as autistics centered on the using unaided modes of communication for example signs and gestures, since most autistics exhibit sufficient motor skills for production of signs. Additionally, such modes bore advantages such s durability, portability and accessibility. Even with research demonstrating autistic individuals can learn how to use unaided AAC systems successfully for communication (Light, Roberts, Dimarco, & Nina, 1998), many autistics experience difficulties in generation of spontaneous communication, communication with partners or family members who have limited knowledge on signs, and in combining signs for complex communication.
Therefore, the recent shift in exploration of aided communication modes for individuals with communication incompetency. The disadvantages to aided communication modes include lack of durability or portability but still, they provide distinctive advantages for autistic individuals. Some of its advantages include their incorporation of visual symbols in their usage; they are easily intelligible to many partners and make use of visual spatial processing, strengths demonstrated by many people with autism.
Teaching Skills for Communication Competence enhancement
The misconception that research into the augmentative and/or alternative communication modes and devices, plus the provision of such equipment as seen fit by clinicians is enough to ameliorate the condition of individual with communication incompetency is false. According to Light et al (2006), such individuals must be taught the use of a wide range of skills that encompass the linguistic, social, operational and strategic domains. These skills aid in the effective communications and daily interactions with others.
Firstly, educators have to teach the linguistic domain to individuals with communication incompetencies. These encompasses the expressive and receptive skills in the language(s) spoken by the social community or individual's family, in addition to the receptive and expressive dexterity in the language code of the augmentative and alternative communication systems.
The second domain, which is the operational domain, involves teaching of skills in the operations of aided or unaided AAC systems and their technical production. These sills may include the correct skills for producing proper hand shapes for correct signs, or the use of a head stick in the selections of items on the alphabet board.
Thirdly is the social domain, which according to Light et al (2006) encompasses the sociorelational and sociolinguistic skills that are necessary in the facilitation of communication skills with other people.
The last teaching skill that educators of augmentative and alternative communication strategies need to stress is the strategic domain. This domain covers compensatory strategies that are required by individuals with severe communication competencies so that they can overcome functional limitations required in the other skill domains.
Nonetheless, goals in teaching these domains should be meaningful, functional and achievable. The skills need to be taught in contexts that are relevant in order to respond to natural cues experienced in their daily activities. Individuals with communication competencies should be slowed a chance to practice these skills with relevant partners. Guided practice should also be incorporated to ensure success of the instruction. Moreover, when such individuals use the learnt skills efficiently, natural consequences should be provided. Formative and summative evaluations need to be incorporated for evaluation of the outcomes and progress.
Intervention with Facilitators
AAC facilitators require an intervention to provide for communication and support for individuals who use augmentative and alternative communication. The intervention ensures that they get required support for effective communication within this domain. The key issues redress in the communication with these facilitators is (1) the use of appropriate interaction strategies and (2) the maintenance, operations, and ongoing developments of an individual's AAC systems.
Interaction Strategies for Communication Support
Instructions for facilitators are there to eliminate any barriers that may occur during communication. These strategies may include obtaining the individuals consent prior to asking questions or provision of instruction. Second, the use of simple sentence structures in questions or giving directions, third, writing or tying on power book to supplement input in spoken language, and lastly, giving individuals at least fifteen or twenty seconds to process information or questions asked (Light, Roberts, Dimarco, & Nina, 1998).
Development, Operations and Maintenance of AAC Systems
When specific AAC systems are introduced in order to facilitate in communication of individuals with communication incompetence, it is paramount that not only such users are comfortable with them, but also the facilitators. Due to this, facilitators are required to be knowledgeable of access techniques and AAC symbols, positioning requirements, ongoing development in vocabulary, daily maintenance including cleaning, and knowledge in the operations of the AAC devices, plus the procedures for trouble shooting. Additionally, the teachers and parents need tutoring on methods of vocabulary selection and add this to the individual's dictionary for personal communication and ways of operating, maintenance, programming and troubleshooting procedures with the power book.
Government Interventions and issues in provision of AAC devices
Augmentative and alternative communication devices come at a cost to families or users. Simple devices such as boards and books are usually quite affordable while complicated devices, especially the electronic ones may come at costly prices to individuals. Hence, clinicians and families usually seek the help and intervention of the government or public amenities to supplement these costs.
According to (Hambrecht & Rice), there exist many government supported centers or programs that are fully equipped with devices for assisting augmentative communication, and which can be loaned out to clinicians or families (p. 88). Such government centers carry out research on the best methods for individual communication problems and provide the best devices and advice. Furthermore, most insurance companies cover these costs after determination that it is the best device for its users. Due to the costly prices of some devices, especially the electronic ones, clinicians ensure they equip themselves with requisite knowledge of the resources that are available to the community or state, and be informed of insurance company requirements in the case of reimbursement claims by the users. Clinicians should also know modifications in equipment for correct prescription to the clients needs.
Conclusion
Many individuals with severe communication complications, for example those with autism and fragile syndrome, usually have trouble in understanding language that is spoken. As such, augmentative and/or alternative communication is a chance for significant opportunity for the development and augmentation of expression and comprehension that may be temporary or permanent. However, in order to realize the benefits of AAC, careful assessment is required in order to determine the individuals' needs and get optimum support from the instructors. Essentially, aided or unaided devices should be incorporated to assist individuals with communication problems. Unaided devices were more conventionally used for their obvious conveniences such as their durability and portability. However, individuals with severe communication complications require the use of aided devices and this have their advantages as well. Although some communication devices are expensive, strategies by governmental and non-governmental institutions have aided in the provision of such equipment. Adequate training of the facilitators is required with the support of parents as well. With the correct research, goodwill, instruction and provision of AAC devices, individuals with communication problems can effectively learn how to express themselves appropriately.
References
Association, A. S. (2005). Roles and Responsibilities of Speech-Language Pathologists With Respect to Augmentative and Alternative Communication.
Beukelman, D. R., & Mirenda, P. (1992). Augmentative and Alternative Communication:Management of severe Disorders in Children and Adults. Baltimore: Paul H Brookes Publishing Co.
Hambrecht, G., & Rice, T. (2010). Clinical Observation: A Guide for Students Speech, Language and Hearing. Sudbury, MA: Jones and Burtlett Learning.
Light, J. C., Roberts, B., Dimarco, R., & Nina, G. (1998). Augmentative and Alternative Communication to Support Receptive and Expressive Comunication for People With Autism. Journal of Communication Disorders , 153-180.
Schlosser, R. W., & Sigafoos, J. (2006). Augmentative and Alternative Communication Interventions for Persons with Development Disabilities: Narrative Review of Comparative Single-Subject Experimental Studies. Research in Developmental Disabilities , 1-29.