This document discusses augmentative and alternative communication (AAC), including why it is important, who uses it, and different forms it can take. AAC is used to supplement or replace speech and writing for those with communication impairments. It involves using symbols, which can include pictures, objects, signs, or spelling, to represent concepts, actions, and language. The meaning of symbols may depend on culture and familiarity. The goal of AAC is to enable people to communicate effectively and participate in daily interactions and activities.

1. Symbols for
Communication and
Literacy
Module 1
Unit 1

2. In this activity you will:
• Explore what we mean by AAC
• Consider why we use AAC
• Think about who uses AAC
• Consider different forms of AAC
• Learn about Symbols
• Think about language and culture in using symbols

3. Why is language and communication so important?
Communication and language skills allow a person to…
• Initiate, maintain, and terminate conversations
• Establish/maintain relationships
• Give information
• Ask/Answer questions
• Describe events
• Solve problems
• Direct others
• Express feelings
• Tell Stories
• Learn
• Function with greater independence
Can you imagine your life where you were unable to do any of these?

4. What is the impact if we cannot communicate?
People who cannot communicate experience a loss
of control over their own lives
Inability to communicate has an impact on every
aspect of life and is likely to affect mental health,
behaviour as well as any opportunity to learn new
skills through interacting with others

5. How do we communicate?
We all use multiple ways to communicate and are
often divided into verbal and non verbal forms.
Verbal forms would include speech and non verbal
forms of communication would include gesture,
facial expression, intonation, written words and the
use of symbols or images to convery meaning

6. What prevents us being able to communicate?
Communication can be limited for a variety of reasons.
These can include reasons related to the individual who
may be unable to articulate words, structure sentences
or process speech as a result of a wide range of
disabilities.
But they can also relate to the communication partner
who does not understand or recognise the
communication form that a person is using
An obvious example of this is where a deaf person is
using sign language but can only be understood where an
interpreter is available

7. Who uses AAC?
Many people with disabilities benefit from using AAC. These might include those
with
• An intellectual disability
• Cerebral palsy
• Autism
• Apraxia of speech
• Traumatic Brain Injury
• People who have had a Stroke
• Acquired Physical Disabilities such as ALS, Multiple Sclerosis, or Parkinson’s
Disease
• Aphasia
Some people are born with a condition which severely limits their communication,
other acquire a disability with the same impact.
The key difference is those that acquire a disability may have already developed
advanced communication skills before becoming disabled.

8. ASHA define AAC as:
Involving attempts to study and when necessary compensate for
temporary or permanent impairments, activity limitations, and
participation restrictions of persons with severe disorders of speech-
language production and/or comprehension, including spoken and written
modes of communication. (ASHA, 2005)
For the purposes of our learning we can interpret this as meaning that
AAC tries to make up for the loss of communication either verbal or
written, so that a person can participate more fully in daily activities
whether for a short time or long term.
AAC may not always be a permanent need, there are many examples of
AAC usage in hospitals where a patient has used AAC during the early
phases of recovery following trauma or illness.
Can you think of examples where you have seen or have used AAC with
people with different needs?

9. So AAC includes
All forms of communication that enhance or
supplement speech and writing
(ASHA Knowledge and Skills for AAC Service Delivery, 2001)
Take a moment to think about all the different forms of communication
we might use
We will return to this later in our course

10. AAC involves
Supplementing or replacing natural speech and
writing with
• aided symbols such as picture communication
symbols, line drawings, Blissymbols, and physical
objects
• Unaided symbols such as manual signs, gestures,
and finger spelling
In many cases effective communication includes a
combination of aided and unaided approaches and
formal and informal ways to communicate.
The use of symbols to communicate a need may be
enhanced by recognising other cues such as facial
expression and sounds which communicate urgency

11. Types of AAC that we might use?
How many of these forms of AAC are you familiar with?
• Signing
• Gestures
• Pointing to symbols with a finger or eyes
• Sharing symbol cards between people
• Using a speech generating device or voice output
communication aid
• Interpreting non verbal cues
• Touching or selecting physical objects to convey a message
Can you think of others?

12. Regardless of the type or form of AAC used,
AAC always involves the use of symbols to
represent concepts and might include
• single meaning pictures,
• alphabet-based methods, and
• semantic compaction
Which represent the intended communication
of a person

13. But always remember that:
• All communication has a non verbal element
• Before formalising Communication think about
establishing consistency of non verbal
communication
• Ensure there are consistent actions that are
purposeful
• Don’t ignore the input of family – skilled in
interpreting these tiny indicators

14. Establishing Communication
Observe
Interpret
ImitateModel
Initiate
Before starting to introduce
a formal or structured
approach to communication
we should interact with the
person with a disability to
establish prerequisites to
AAC
Such interactions can involve
five steps as shown in the
diagram here

15. Not to find a technology solution to the
communication difficulty but instead to enable the
individual to efficiently and effectively engage in a
variety of interactions.
We can build upon this by introducing a
structured approach to communication. But
remembering that the ultimate goal of
introducing an AAC system is….

16. Before starting with a system or
device – remember….
“The MESSAGE, not the medium is what matters for
people who cannot use their own voices.”
• (McDonald, 1994)

17. Introducing AAC Devices and systems
A quick summary
AAC devices and system are used by people who do not
speak, are difficult to understand, or have language
retrieval issues
AAC devices are used by people of all ages with a variety
of disabilities there is no single device or system that is
suitable for everyone
AAC devices allow a person to send a message through
printed words, voice output, pictures, or any
combination
AAC devices come in a range of styles, and can be low
cost or very expensive

18. Many AAC devices and systems use
symbols to support communication
To help us work with AAC devices and symbols it is
useful to understand a little more about symbols
themselves

19. AAC Symbols can take various forms
Symbol for communication
can include
Objects
Photographs
Or realistic pictures that
could be Color or Black and
White

20. AAC Symbols can include
Line Drawings which
might be in Color or
Black and White.
Experience suggests
that different people
prefer different styles
But may also include
using an alphabet and
spelling to communicate
or alongside other
symbols

21. Picture Symbols
Here are some examples of some picture symbols
What do they mean to you?

22. Picture Symbols
Sometimes meaning is ambiguous and might be
influenced by culture, age or experience
To adults this symbol might mean danger
To children this symbol might mean pirates
As a result of films and TV, pirates are “fun” not “dangerous”

23. Picture Communication Symbols
(PCS)
Symbols often involve us moving from a specific concept “this cat” to a
generalisation “cat”
The communication partner may need to help decide if a child is talking about cats
generally or a specific cat such as a pet.

24. Nouns
Nouns are some of the first symbols we use in communication
They represent objects including people
But even these are subject to interpretation based on context and familarity
How many of the symbols above are unambiguous?
Which ones are you unsure of?

25. Verbs
Similarly what do you think each of these symbols represent
They all verbs and represent actions

26. Verbs
Did you get them all correct ?
Eat Look Run Pray Play

27. Adjectives and Adverbs
As language becomes more abstract
So symbols become increasingly open to interpretation
What do you think these mean?

28. Adjectives and Adverbs
How did you do ?

29. Language and Culture
The interpretation of symbols is also influenced by
our language and culture
Our experience and familiarity with an image will
influence what we believe it means and is trying to
communicate

30. Language and Culture
Arabic Symbols - Tawasol
How many of the symbols in Maryam’s message do you think are “universal” and
how many are influenced by the community and country within which she lives?

31. Culture and AAC – Some key issues to consider
• Cultural influence creates or increases familiarity with a
symbol that represents a concept
• Culture is complex and subtle
• Often we don’t recognise how culture is embedded in a
design until we look at alternatives
• For this reason we emphasise the value of a symbol set
created from within the community in which they will be
used
Compare these two sets of symbols for Arabic speakers
The first uses symbols “borrowed from the west”
The second uses symbols created by Arabic speakers in the
Gulf region

34. Summary
AAC takes many forms and supports a wide variety of
needs
AAC involves communicating meaning using symbols
to address barriers to language
Familiarity impacts upon successful use of symbols
Familiarity is influenced by language and culture
Our purpose is not to simply choose a technology
but to enable communication and interaction

35. Key points to remember
• People who cannot communicate experience a loss
of control over their own lives
• We all use multiple ways to communicate and are
often divided into verbal and non verbal forms.
• Many people with disabilities benefit from using
AAC
• AAC includes all forms of communication that
enhance or supplement speech and writing
• The message, not the medium is what matters for
people who cannot use their own voices