AUGMENTATIVE AND ALTERNATIVE COMMUNICATION FOR PEOPLE WITH INTELLECTUAL DISABILITY

People with intellectual disability have the right to communicate in the most appropriate means necessary in order to have some control of their life. About half of these individuals do not develop enough speech and language to meet their daily needs. Therefore augmentative and alternative communication strategies are needed to enhance learning, increase social interaction, and provide functional communication skills.

1. AUGMENTATIVE AND ALTERNATIVE
COMMUNICATION FOR PEOPLE WITH
INTELLECTUAL DISABILITY
Dr. Shazia Tahira
Child Mental Health Practitioner

2. AUGMENTATIVEANDALTERNATIVE
COMMUNICATION

3. AUGMENTATIVE AND ALTERNATIVE COMMUNICATION
Augmentative Communication Alternative Communication
Adding something to speech or
language (e.g. sign language,
pictures, a letter board) to
makethe message clearer.
An alternative to speech or
language and only means of
communication when there is
absence of speech or language
and the person is not able to
speak.
Augmentative and Alternative Communication(AAC) means thecommunication
methods used for those with impairments inthe production or comprehension of
speech or languagetosupplement, augment or add to speech or language or in
cases ofabsence of speech or language, to replace as an alternative tospeechor
language.

4. TYPES OF AUGMENTATIVE AND ALTERNATIVE COMMUNICATION
>Unaided AAC-Augmentative and Alternative Communication (AAC)that does not require a
physical aid or tool.
>Aided AAC-Augmentative and Alternative Communication (AAC)that uses tools or materials.
-Low-Tech AAC Aidsare those that do not need batteriesor electricityand is
usually a paper-based tool.
-High-Tech AAC Aidsare thosethat require batteries or electricityand include
dedicateddevices developed solely for AAC, or non-dedicated devices such
asmobile devices with an AACapp.

5. Unaided AAC
(without any tool)
Low-Tech AAC Aids
(tool without battery or electricity)
High-Tech AAC Aids
(tool with battery or electricity)
Facial
expressions
Symbol Boards/
Communication Boards
Speech-Generating Devices or
Communication Devices
Body language Choice Cards AAC Apps on Mobile Devices and
Computer
Gestures Communication Books Tablet Books
Sign language Alphabet Charts Keyboards

6. INTELLECTUAL DISABILITY

7. INTELLECTUAL DISABILITY
Intellectual Disability, also known as General Learning Disabilityand previously known
asMentalRetardationisageneralizedneurodevelopmentaldisordercharacterizedby
>ImpairmentinIntellectual Functioning-intelligence quotientunder 70
>Impairment in Adaptive Functioning-deficits in two
ormoreadaptivebehaviors thataffecteveryday, general living. These
adaptive behaviors mayinclude daily living skills,communicationskills,
social skills etc.

8. Level of Intellectual
Disability
IQ Range Adaptive Functioning
Mild 50–69 Can live independently withIntermittent supportduring
transitions or periods of uncertainty.
Moderate 36–49Independent living may be achieved with limited support
in daily situations.
Severe 20–35 Requires daily assistance with self-care activities and
safety supervision.
Profound <20 Requires 24-hour care for everyaspect of daily routines.

9. VARYING COMMUNICATION ABILITIES
ININTELLECTUAL DISABILITY

10. VARYING COMMUNICATION ABILITIES IN INTELLECTUAL DISABILITY
People with Mild Intellectual Disabilityare most likely to communicate with speech.
Peoplewith Moderate Intellectual Disabilitymay also communicate with speech, but to a
limited degree, such as using incomplete sentences.
People with Severe Intellectual Disabilitymay demonstrate limited communication skills and
are more likely to communicate with informal communication such as gesturing (facial
expressions, eye contact) and by using body movements (shaking hands, pointing, pushing
things away).
Peoplewith Profound Intellectual Disabilityoften lack intentional communication. Instead,
they rely on othersto interpret their facial expressions and behaviorsas indicative of their
wants and needs.

11. Level of Intellectual
Disability
Communication
Mild Communicate with Speech
Moderate Communicate with Speech to a Limited Degree
using Incomplete Sentences
Severe Communicate with Gestures & Vocalizations
Profound Lack Intentional Communication, Rely on Others to
Interpret Their Behaviors

12. AUGMENTATIVE ANDALTERNATIVE
COMMUNICATION IN INTELLECTUALDISABILITY

13. AUGMENTATIVE AND ALTERNATIVE COMMUNICATION IN INTELLECTUAL DISABILITY
People with intellectual disability have the right to communicate in the most appropriate
means necessary in order to have some control of their life.Communication is an important
contributing factor for the quality of life ofpeople withintellectual disability.About half of
these individuals do not develop enough speech andlanguage to meet their daily needs.
Thereforeaugmentative and alternative communication strategiesare neededto enhance
learning, increase social interaction, and provide functional communication skills. Some
people use more than one type of AAC strategy to communicateand many people show a
preference for using one type of AAC thatvaries across individuals.

14. COMMONLY USED AAC FOR PEOPLE WITH INTELLECTUAL DISABILITY
Unaided AAC Aided Low-Tech AAC Aided High-Tech AAC
Gestures & VocalizationsCommunication Boards
and Books
Speech-Generating
Devices
Key Word Signing Picture Exchange
Communication Systems
Smartphone and Tablet
Devices withAAC Apps

15. GESTURES& VOCALIZATIONS

16. GESTURES& VOCALIZATIONS
In people with severe or profound intellectual disability, as they have
mostlylimited communication skills, Unaided AAC may consists of efforts
to promote gestures(facial expression, eye contact body language, body
movements)and vocal behaviorsthat may convey information about
general feelings, or to indicate needs and wants.

17. KEY WORD SIGNING

18. KEY WORD SIGNING
Key word signing is a form ofunaided augmentative and
alternative communication(AAC) that usesmanual signingfor the
words that carry the most important informationas an additional
mode of communication along withnaturalspeechwith the
intention of strengthening the message
For example, if someone said, "Go wash your hands" the key words
that would be signed would be "wash" and "hand".A number of
signs are taught to enable those with intellectual disabilities to
communicate their wants and needs or to formulate messages for
other purposesdependingon their relevance to an individual’s daily
routine.

19. COMMUNICATION BOARDS AND BOOKS

20. COMMUNICATION BOARDS AND BOOKS
Communication boards and books are low-tech AAC aids. Through pictures, symbols
andalphabetsin communication boards and books, people with intellectual disability
can communicate specific messages.

21. PICTURE EXCHANGECOMMUNICATION SYSTEMS

22. PICTURE EXCHANGE COMMUNICATION SYSTEMS
Picture Exchange Communication Systems (PECS) is a form
of low-tech aided augmentative and alternative
communication (AAC) frequently used by individuals with
intellectual disability when speech development is delayed
or does not develop. People using PECS are taught to
approach another person and give them a picture of a
desired item in exchange for that item. By doing so, the
person is able to initiate communication. A child or adult
can use PECS to communicate a request, a thought, or
anything that can reasonably be displayed or symbolized on
a picture card.

23. SPEECH-GENERATING DEVICES

24. SPEECH-GENERATING DEVICES
Speech-generating devices(SGDs), also known asvoice output communication
aids(VOCAs), are high-tech dedicatedaugmentative and alternative
communication(AAC) devicesused to supplement or replace speech or writing for
individuals with severespeech impairments, enabling them to verbally communicate.
There are several input and display methods for users of varying abilities to make use of
SGDs.Speech-generating devices can produce electronic voice output by usingdigitized
recordingsof natural speech or throughspeech synthesis which may carry less
emotional information but can permit the user to speak novel messages. The content,
organization, and updating of the vocabulary on an SGD is influenced by the user's
needs and the contexts that the device will be used in. SGD output is typically much
slower than speech, althoughrate enhancement strategiescan increase the user's rate
of output, resulting in enhanced efficiency of communication.

25. SMARTPHONEANDTABLETDEVICES
WITHAACAPPS

26. SMARTPHONE AND TABLETDEVICES WITH AAC APPS
Individuals with intellectual disability may use
smartphoneandtablet devices with AAC apps as
non-dedicated high-tech speech-generating AAC
devicesto make requests for preferred objects, in
academicsettingsand social communicationto
enhance the communication and social
functioning.

27. BENEFITS OF AUGMENTATIVE AND ALTERNATIVE
COMMUNICATION FORPEOPLE WITH
INTELLECTUALDISABILITY

28. BENEFITS OF AUGMENTATIVE AND ALTERNATIVE COMMUNICATION FOR
PEOPLE WITH INTELLECTUALDISABILITY
>Helps people with intellectual disability to communicate
when they can’t rely on speechandprovidefunctional
communication skills.
>Makes multimodal communication possible.
>Enhances spoken speech when speech is limited.
>Enhances daily interactions of people with intellectual
disability.
>Increases social communication and social
interactiontoenhancethe socialfunctioning.
>Enhances learning inacademicsettings.
>Enhances quality of life of people with intellectual
disability.