1. With physical and Learning Disabilities
AAC for children age 5+
With physical and Learning Disabilities

2. Plan What is AAC? Who uses AAC? The impact of AAC Cost-effectiveness
Why speech and language therapists?
Service provision

3. We need your money!

4. communicate more easily."
What is aac?
“Extra ways of helping people who find it hard to communicate by speech or writing.
AAC helps them to:
communicate more easily."
Source: ISAAC

5. What is aac?

6. What is aac?

7. What is AAC? gestures signing symbols word boards communication boards
books
Voice Output Communication Aids (VOCAs)

8. Who do we want funding for?
286,000 children (180,000 boys, 106,000 girls) age in the UK have a learning disability (Source: Mental Health Foundation)
There are 770,00 disabled children under the age of 16 in the UK. That equates to 1 child in 20. (Source: Contact a Family)

9. Learning Disabilities
Which children use AAC?
Cerebral Palsy
Autism
Down Syndrome
PMLD
Brain Injury
Rett Syndrome
Muscular Dystrophy
Stroke
Learning Disabilities

10. “Without communication no-one can ever really know you” (Pistorius, 2011)

11. AAC is a human right
The UN Convention on the Rights of persons with disabilities states in article 21 that:
“Parties shall take all appropriate measures to ensure that persons with disabilities can exercise the right to freedom of expression and opinion, including the freedom to seek, receive and impart information and ideas on an equal basis with others and through all forms of communication of their choice...”  (b) “...Including by accepting and facilitating the use of sign languages, Braille, augmentative and alternative communication, and all other accessible means, modes and formats of communication of their choice by persons with disabilities in official interactions.”
Article 9, 2(g)  also states:
“Parties shall also take appropriate measures to promote access for persons with disabilities to new information and communications technologies and systems, including the Internet.” (RCSLT, 2017)

12. Impact of AAC on children
Very quickly Callum was able to communicate with the rest of the children in his nursery class and get them to sing the song he chose or listen to the story he wanted…
Better peer interactions for children with aided AAC and SLT support (Therrien, Light & Pope, 2016)
Now Jenni has access to a range of communication support systems she is able
to live a more independent life and will be starting college in the autumn.
Increased independence for young AAC users (Bailey et al., 2006)
Sophie can now communicate with her mother and they have started to develop a mother/daughter relationship that was previously missing.
Sophie can express her likes and dislikes and her sense of humour.
Increased opportunities to interact with family members, including extended family (Bailey et al., 2006)
(Case studies from Communication Matters, 2013)

13. …and on adults
“High-technology AAC may be beneficial across a range of diagnoses and ages” (Baxter, Enderby, Evans & Judge, 2012)
NICE guidelines e.g. for MND: the multidisciplinary team should have prompt access to AAC services ‘to maximise participation in activities of daily living and maintain quality of life’ (NICE Guidelines, 2016, p.22)
1:55

14. Why ? SLTs are communication specialists (RCSLT, 2017)
They can incorporate different communication approaches e.g. unaided and aided devices (RCSLT, 2017)
Nearly one third of all AAC equipment is abandoned if there is inadequate expertise to assess and identify the right equipment, or insufficient support available in its use (Blackstone, 1992)
AAC users need continued support (Communication Matters, 2013)

15. The Role of the SLT
SLTs are specialists in communication difficulties and as such are an integral part of multidisciplinary teams that support AAC assessment, provision, use, training and support. (Source: RCSLT Resource Manual for Commissioning and Planning Services for SLCN: AAC, 2011)
The role of an SLT:
Overall, to incorporate different communication approaches, including both unaided and aided methods, that best meet the communication needs of the person.
To assess an individual whose impairments preclude their use of natural speech and/or writing as a primary form of communication. To assess their communication partners and the environments in which communication occurs.
To assess and document AAC methods, components and strategies to maximise functional communication by individuals.

16. The Role of SLT
To develop and implement intervention plans that maximize effective and successful communication between individuals who use AAC and their conversational partners.
To use evidence-based practises to evaluate functional outcomes of AAC, particularly relating to increased participation and enhanced quality of life.
To advocate for increased responsiveness from local and national government and educational agencies to individual who uses AAC’s communication and funding needs.
Source: American Speech-Language-Hearing Association. (2002).
Augmentative and alternative communication: knowledge and skills for service delivery
[Knowledge and Skills]. Available from

17. Service Provision
Referrals are accepted from health, education and social care professionals working in local teams.
The SLT is an integral part of a multi-disciplinary team who prescribe and assess AAC systems, strategies and equipment appropriate to the needs of the individual.
Clients will be assessed in the most appropriate location for them. Prioritisation is given to clients without functional communication, with rapid degenerative conditions and those at risk of developing psychosocial or behavioural difficulties as a result.
Equipment is then trialled with the client, if appropriate.

18. Service Provision
All clients using AAC shall receive adequate training to utilize it with all necessary information in an appropriate format to them. Training will also be provided to communication partners, as appropriate.
The clients will receive ongoing support in case of difficulties or malfunctions of equipment. The frequency of support is determined on a case-by-case basis.
Ongoing assessments of their needs and the functionality of their AAC will be provided.
Source: NHS England, AAC Service

19. Cost Effectiveness Difference £10.3m £120.9m Cerebral Palsy ASD
Improved quality of life
Reduced likelihood of mental health difficulties
Increased participation and contribution in society
Munton, T. (2013). Augmentative and Alternative Communication (AAC) support in Scotland: A review of the research, literature and cost benefit analyses. Edinburgh: NHS Education for Scotland
Cerebral Palsy
ASD
Lifetime costs of high tech AAC
£44.8m
£153.7m
Lifetime benefits
£55.1m
£227.7m
Difference
£10.3m
£120.9m

20. Cost Effectiveness
Less likely to be admitted to hospital inappropriately
Hospital stays are likely to be shorter
Less educational and care support needed
£ 84, in care savings per year for a child with quadriplegia living at home
The Scottish Government (2012). A Right to Speak: Supporting Individuals who use Augmentative and Alternative Communication. Edinburgh: APS Group Scotland

21. …And that’s for high-tech devices!
Cost Effectiveness
…And that’s for high-tech devices!
The potential cost-benefit savings are potentially even higher for low tech alternatives

22. Why you should choose to give your money to AAC for children?
AAC can help a huge variety of children with a huge variety of conditions and needs
AAC can be something as simple as a Makaton course for a parent, but could be life changing
AAC is cost-effective! You gotta spend money to make money people
You could help a child communicate who has no other means
Communicative children can grow into communicative adults. You are helping a person across their lifetime.

24. References
Bailey, R.L., Parette, H.P. Jr., Stoner, J.B., Angell, M.E., Carroll, K. (2006). Family Members' Perceptions of Augmentative and Alternative Communication Device Use. Language, Speech, and Hearing Services in Schools, 37(1),
Baxter, S., Enderby P. , Evans P. & Judge, S. (2012). Interventions using high-technology communication devices: A state of the art review. Folia Phoniatrica et Logopaedica, 64, 137–144
Blackstone, S. (1992). Re‐thinking the basics. Augmentative Communication News, 5(3). Accessed on 14 March, 2017, from
Communication Matters. (2014). Other ways of speaking: Supporting children and young people who have no speech or whose speech is difficult to understand. Accessed 14 March, 2017 from
NICE Guidelines. (2016). Motor neurone disease: assessment and management. Accessed 14 March, 2017 from
Pistorius, M. (2013). ‘Communication: An AAC User’s Perspective’, Communication Matters Conference In Communication Matters. Shining a light on augmentative and alternative communication. Accessed 14 March 2017 from df
Royal College of Speech and Language Therapists. (2017). Role of speech and language therapy in augmentative and alternative communication. Accessed 14 March, 2017 from
Therrien, M.C.S., Light, J., & Pope, L. (2016). Systematic review of the effects of interventions to promote peer interactions for children who use aided AAC. Augmentative and Alternative Communication, 32(2),