1. Alternative and Augmentative Communication Solutions for Children and Youth with Autism

2. Why use AAC Support communication Augmentative/ Alternative
Receptive language Support e.g.,
-Routine Strips
- Social Stories
Expressive Language Support
Words to express choices, ideas, feelings
- Words to replace behaviours

3. What is the Clinic for Augmentative Communication (CAC)?
Expanded level AAC clinic accredited by Assistive Device Program (ADP).
Sees clients with complex clinical and/or technical needs.
Can authorize full range of communication devices approved by ADP.
Team includes SLP, OT, Technician, Program Assistant, and Admin Support
Provides assessment, consultation and prescription of augmentative and alternative communication (AAC) systems
Located primarily at Thurston site, with one SLP at Renfrew site
Service may be provided at other OCTC sites or in homes/schools as required

4. Types of AAC
There are many different ways to communicate:
Unaided modes
Aided modes
Exchange systems (e.g. PECS)/pointing system (e.g. communication book or VOCA)
Light tech/low tech/high tech

5. Unaided Modes
No external devices is needed to send the message (natural means)
The child communicates using movements or sounds he can make on his own
Examples: sign language, vocalizations, pointing, facial expressions, body language
Cheaper, more portable, always available/accessible, require less set-up/preparation time, may seem more natural, allow for eye contact with partner, may be faster

6. Aided Modes
An object or a device is used to communicate the message
Examples: communication book, theme board,picture exchange, topic board, pen and paper, electronic device, etc.)
Requires less motor control, are usually understood by a wider range of partners, may make fewer demands on memory

7. Picture Exchange Communication System (PECS) vs Pointing System
PECS provides an essential step in learning to engage in social interactions (e.g. giving a picture of desired item for that item).
However, a pointing system may be useful if child demonstrates the following:
- communicates directly with a partner
- has “more to say”
Example

8. Light tech systems
Light tech: communication boards, books, themeboards, topic/alphabet boards
- cheaper than technology
- requires less maintenance (e.g.: cleaning, battery charging)
- more portable/light weight
- never breaks down
- may be considered less obtrusive (e.g.: users who are very sensitive about appearing different)

9. Low tech/high tech devices
Low/High tech allows for:
greater independence
increased flexibility in communication due to voice output (e.g.: can get attention, talk to someone at a distance, talk in a group, interrupt and be better able to control conversation, talk to people who can’t see or understand visual symbols etc.)
user may be viewed as more competent if has technology

10. Themeboard example (light tech)

11. Topic Board

12. What type of AAC system is the most appropriate for an autistic child?
It is the same for any other child - There is no one system that is best for all ASD clients
It is important to determine the child’s:
Communication needs
Skills and Abilities
The child’s communication partners
The contexts within which communication occurs

13. AAC needs Needs can be related to a number of variables:
Who are the client’s partners? Potential partners?
Where and when does the client need/want to communicate?
What does the client need or want to communicate about?
Specific patterns of skill and disability – e.g. , Literacy? Motor skill?
Client’s personal preferences
Individuals with ASD tend to learn to request first. BUT do not stop there. Individuals with ASD can learn to communicate for other reasons. When they have limited speech we often only provide vocabulary and practice to make requests. At higher levels, PECS starts to address commenting, e.g., I see; I have – again, the vocabulary choice is often limited to the teaching task and not extended to life experiences and what the individual may WANT to say.

14. Skills and abilities How does the individual communicate now?
Why – what reasons are important?
Motor skills – can the individual: - point, gesture, make signs, turn pages of a book.
Cognitive skills: attention, world knowledge, understanding of language, cause and effect, communicative intent, joint attention, categorization
Does he use behaviours?

15. Skills and Abilities Symbol skills: recognition and use
- what kind of symbols does he/she understand
- how quickly does he/she learn to use a symbol/sign to communicate
- what strategies are effective
Sensory skills
Vision and hearing
Are there specific ways we need to design symbol layouts to ensure the client can find and select symbols?

16. Skills and Abilities Device trial? - is it motivating to the client?
- is it motivating to the Team?
- high or low tech?
- what are the vocabulary needs?
- can the client navigate a high tech device?
Consider communicative need first – I.e., in what contexts would “out loud” speech be advantageous?

17. Resources Community SLP’s Individual Authorizers All About AAC
Referral to the Clinic for Augmentative Communication

18. How to make a referral to CAC?
Call OCTC Intake Services at ext to initiate a referral
A CAC referral will be sent for you to complete. It must be signed by the parent/guardian.
Questions or unsure if referral is appropriate? Call CAC program administrator at x4319