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The term Augmentative and Alternative Communication (AAC) quite simply means any methods of communicating that can supplement the ordinary methods of speech and handwriting, where these are impaired. Many people with physical, sensory, or cognitive disabilities cannot rely on speech as their main means of communication, so may have to use special techniques and/or technologies. The aim of augmentative communication is to provide support and to enhance the communication, learning, participation, degree of independence and the quality of life generally of such people.

Most people can agree that communication exists firstly to bring about social contact and closeness, and secondly "to get the message across". AAC offers people the possibility of achieving these aims, even when they can't speak, or read or write.

AAC is used in all sorts of settings - wherever people need communication:

• family homes
• in nurseries and pre-school settings
• in schools, colleges
• in Higher Education
• in hospitals and intensive care units
• in Day Centres
• and in residential homes

The term Augmentative and Alternative Communication does not refer to any one specific communication system or method, but to the general function, which may be put into practice in a wide variety of different ways. The overall idea of augmentative communication is to use to the full whatever abilities the communication impaired person does have, in order to bypass and/ or compensate for areas of weakness.

An augmentative communication system means the whole "package" of specific techniques and technologies making up "total communication" for a specific individual. Typically, an individual might use their facial expressions, body postures and gestures, eye-pointing, vocalizations with different pitch and tone, and speech attempts. They might also use a more specialized system such as manual signing, pointing to pictures or symbols, and/or operating a computer with message storage, rate enhancement features and synthetic voice output.

Low Tech Augmentative Communication Systems

"Low tech" communication systems might include:

• tangible symbols (e.g. real objects, miniature objects or parts of objects, on an activity calendar)
• picture / photo boards or books
• symbol communication charts or books, topic boards
• letter, word or phrase boards
• communication cards (e.g.clipped on a key ring on a belt)
• eye-blink, or eye-pointing pointing codes
• ETRAN frames (fix pictures, symbols or letters, or a code to a frame in front of the user, who eye-points to the item they want to communicate.)

Features of a low tech system to look out for are the choice of representational system, (ie what kind of pictures, symbols or codes suit the user best) and the method of selection of items (e.g., pointing, saying "yes" or "no" when a helper points, switch use etc.).

Medium Tech Augmentative Communication Systems

"Medium Tech" systems include devices containing some technological element, like a battery or a switch, but which are very simple.

For example:

• pointer boards (hit a switch to stop the pointer going round, when it's at the object / picture / symbol required.
• switches connected to battery-operated toys or simple environmental control devices such as attention-getting bleepers,cassette recorders, single message tape-loops or other simple message players
• switches connected to a 'Mains Switcher' to allow a user to control things like a television, or lamp
• toys or books that speak when certain areas are pressed.

High Tech Augmentative Communication Systems

"High tech" communication aids consist of electronic equipment requiring a power supply (either mains or battery).

High tech aids are generally either:

• dedicated communication aids designed and used solely for the purpose of replacing or enhancing a person's oral speech.
• computer based communication equipment using software (and sometimes hardware peripherals) that transform an ordinary computer into a system functioning as a communication aid (while still giving access, usually, to all its other functions as well).

Features to look out for in "high tech" communication systems include:

• portability
• range and type of possible input methods (keyboard? overlay keyboard? switch and scan?)
• techniques used to store and retrieve messages
• output (transient or permanent? (what type of screen, if any? digitized voice? synthetic voice? text? hard copy printout? storage on disk?)

"High tech" communication aids vary also in the degree to which they demand of the user more or less sophisticated techniques of visual perception, memory, sequencing skills, language processing, meaning associations, grammar or encoding.