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There are no prerequisites to the use of AAC. No one is too disabled to be able to benefit in some way(s) from augmentative communication techniques and technologies. The whole point about AAC is that it offers a new way of doing something - so an inability to do something the old way does not mean that someone should not be allowed to try the new way, it means rather that they should be offered the opportunity to try the new way as soon as possible!

But, naturally, different people will use different type of systems, and at different levels depending on their age and stage and upon the pattern of their strengths and needs. For example, some individuals with complex multiple disabilities may benefit most from use of technology to enhance their attention-getting, mobility and play - and thus interaction - before a "formal" communication system as such is introduced, later, perhaps.

Integrating the use of AAC into education and everyday life

Identifying the most appropriate augmentative communication system and even finding the funding to purchase it, for a user, is often the easy bit. Purchase of a powerful (and expensive) communication aid will not guarantee that it will be used interactively or constructively. Mastery of a particular system does not guarantee that a user will be a competent communicator. Implementing effective use, and integrating use of the system into daily life at home, school, or work can prove to be a difficult and a long term task.

Special consideration needs to be given to the provision of services to follow up AAC assessments and to ensure adequate support through the introduction, teaching and using of AAC, and its integration into daily life. It needs to be remembered too that staff move on, and that children change teachers each year, so that training and support of staff needs continual updating.

Communication is not a specific skill, it's an essential part of being a human being. Communication is not done in isolation - it changes depending on the situation and the communication partners around at the time. If people and situations seem to give out the message that AAC use is "too difficult" or "takes too much time" then it will not be surprising if the user appears unmotivated to use their system. The user needs to feel s/he is working in an environment where their AAC use is encouraged and valued. AAC cannot be "set aside" while the user does school work, or does physio - to be fun and useful and effective it needs to be part of everyday activities, not a "task" done occasionally.

Therefore the responsibility for helping someone to use AAC effectively is not just the job of the speech and language therapist., but of everybody around the user.

Finding advice and information on AAC

Because AAC is very new, not all families, teachers, therapists and social work staff have acquired training in its use. If this is the case, and you think you or your family member or client could benefit from AAC, you could ask for a special assessment for AAC. If you do not know of any specialist centres, contact your local Speech & Language therapy service.

All Speech and Language Therapists have a "duty of care" and professional standards which include the requirement that they "recognize whether or not a specific client might benefit from AAC and whether or not they themselves have the skills and resources to treat the client adequately. Therapists may then seek consultation and refer to appropriate other agencies" (College of Speech and Language Therapists, "Communicating Quality" 1991) . In many area, local Speech & Language therapists have a team member who has special responsibility for AAC, and will be able to offer an assessment or a referral to an appropriate assessment centre.

Funding Augmentative Communication Aids and Services

The situation depends upon where one lives, and the policies and practices in that country / area. Only one thing seems common to all - it is not easy to find funding for AAC! It is not enough, either, just to find money to purchase a piece of technology -remember the 'hidden costs' (which are far higher) of expert training and support on an ongoing and sometimes long term basis.

There may be arguments as to whether an AAC system and supporting services should be paid for by Health, Education or Social Work. In some cases, an ideal solution is to try and arrange joint funding.

Many areas now support a central point (either Health or Education, or jointly funded) of expert assessment and advice (sometimes with access to a central fund for the purchase of equipment.) Equipment purchased will be allocated to the child or adult personally, either permanently, or more sensibly, on a long-term loan basis for as long as they need it. There may be privately run centres.

Sadly, many people still have to wait for many months, if not years, for the statutory services to provide funding for an AAC system - if they ever do - and many end up relying on friends, families, charitable donations and awards, or insurance or compensation payments to fund purchase of their communication systems.

In spite of this problem, there has been, in the past ten years, quite extraordinarily exciting progress in the field of augmentative communication - in the public's awareness of the possibilities; in managers "and administrators" recognition of the issues (still more to be done here!); in professionals" and families" understanding of the issues and knowledge of techniques and possible solutions; in the development of powerful and user-friendly technology; and in the development of the skills, confidence and increasing independence and assertiveness of people who use AAC.