“the use of devices or techniques that supplement or replace an individual’s spoken communication skills.” (Mustonen, Locke, Reichle, Solbrach & Lindgren, 1991) AAC Augmentative and Alternative Communication 1- Definitions

The American Speech Language Hearing Association (ASHA) “ AAC […] as both an area of research and a set of clinical and educational practices that attempts to study, 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)

“AAC is a system with four primary components: symbols, aids, strategies, and techniques.” (Beukelman & Mirenda, 2005) Symbol – a visual, auditory and/or tactile representation of conventional concepts. Aid – refers to a device either electronic or non- electronic used to transmit or receive messages. Technique – refers to the ways in that messages can be transmitted. Strategy – refers to the ways in which messages can be conveyed most effectively and efficiently.

2. Who uses AAC? More than 2 million people (adults and children) in the United (Matas, Mathy-Laikko, Beukelman, & Legresley, 1985). More than 10 millions in the world (Cossette & Duclos, 2003) Common causes (Kangas & Llord, 2005) : CongenitalAcquiredDegenerative Cerebral palsyStroke, LISALS AutismHead injuryMuscular dystrophy Mental RetardationSpinal cord injuryAIDS Physical disabilitiesCancerHuntington’s disease ALS: Amyothrophic Lateral Sclerosis LIS: Locked - in- Syndrome

2 categories of AAC systems (Beukelman & Mirenda, 1998; Romski & Sevcik, 1988). 3. Types of AAC systems a) Unaided communication systems Do not require any sort of external communication device for producing of expressive communications. Sign language Natural speech Facial expressions Gestures Non symbolic vocalizations

b) Aided communication systems line drawings and color pictures Recorded speech Synthesized speech Picture communication boards An alphabet display for pointing to letters to spell words Laptop computer or high tech equipment for example “eye tracking”.

Principle of “Eye tracking” VISIOBOARD from Metrovision Determines the position of both eyes and drives the orientation of the “eye” camera Measures accurately the eye gaze orientation from the relative position of the pupil and the corneal reflection images. The position of the mouse cursor is directly controlled by eyes gaze. Mouse clicks are triggered by the duration of fixation or by eye blinks or by an external contact

Jean Dominique Bauby (1952 – 1997) author of “The Diving Bell and the Butterfly”, dictated his book one letter at a time by blinking the correct letter. Example of Locked – in - syndrome 4. Conclusion Talk, communicate, is to allow exchange, but it is also able to express feelings. The need to communicate can be vital for dependents people such as children, elderly or sick people. Thanks to technical progress, advent of microcomputer, persons with severe disabilities would access to communication tools, options and possibilities that were unavailable until now.

References Johnston, Reichle, & Evans, J. (2004, February). Supporting augmentative and alternative communication use by beginning communicators with severe disabilities. American Journal of Speech Language Pathology, 13 (1): American Speech-Language-Hearing Association Roles and responsibilities of speech-language pathologists with respect to alternative communication:. Beukelman, Mirenda P Augmentative and alternative communication: Supporting children and adults with complex communication needs (3rd ed.). Baltimore: Paul H. Brookes Publishing Co. Cossette L, Duclos E A profile of disability in Canada Ottawa: Statistics Canada Hourcade, Pilotte, West, & Parette, (2004, Winter). A history of augmentative and alternative communication with severe and profound disabilities. Focus on Autism and Other Developmental Disabilities, 19 (4): Sigafoos J, Schlosser RW, Sutherland D La communication améliorée et alternative. In: JH Stone, M Blouin, editors. International Encyclopedia of Rehabilitation. Available online: