How to Choose the Right AAC Device for Your Loved One

Augmentative and Alternative Communication (AAC) devices are crucial for individuals who face challenges with speech or communication. For people with conditions such as cerebral palsy, autism, stroke, ALS, or other speech impairments, choosing the right AAC device is a life-changing decision. It not only provides a means for the individual to express their needs, thoughts, and emotions but also fosters greater independence and participation in social interactions.

Choosing the right AAC device, however, is not a simple task. With a wide range of options available, it can be overwhelming to navigate the decision-making process. This article aims to provide a comprehensive guide to selecting the appropriate AAC device for your loved one, considering their unique needs, preferences, and abilities. The process involves understanding AAC technology, assessing the user's needs, and exploring available devices.

Understanding AAC Devices

AAC devices are tools designed to assist individuals who have difficulty with verbal communication. These devices can range from simple low-tech options, such as communication boards, to complex high-tech devices that use voice output and sophisticated software to facilitate communication.

AAC devices can be categorized into two main types:

1. Unaided Communication

Unaided communication involves methods that do not rely on external tools or devices. These methods include:

• Sign language: A visual form of communication using hand signs and facial expressions.
• Gestures: Non-verbal communication using body movements.
• Facial expressions: Conveying messages through expressions, such as smiles, frowns, and raised eyebrows.

Although unaided communication can be very effective, it may not be suitable for individuals who have limited physical abilities or cognitive challenges that make non-verbal communication difficult.

2. Aided Communication

Aided communication involves using tools or devices to help express thoughts, needs, and ideas. These devices are further divided into:

• Low-tech devices: These include communication boards or books, which may consist of pictures, symbols, or letters. Users can point to or indicate selections to convey messages.
• High-tech devices: These are electronic devices, such as speech-generating devices (SGDs), that use touch screens, eye-tracking, or other input methods. These devices are capable of producing synthesized or recorded speech.

High-tech devices are commonly equipped with advanced software that allows users to store pre-programmed phrases, customize their communication, and even interact with others through various apps.

Key Considerations When Choosing an AAC Device

Selecting the right AAC device for your loved one requires careful consideration of several factors. These factors vary based on the individual's physical abilities, cognitive skills, communication needs, and personal preferences. The process typically involves the following steps:

1. Assessing the Individual's Communication Needs

The first step in selecting an AAC device is to assess the communication needs of the individual. This assessment should be comprehensive and take into account the person's communication goals, such as:

• Expressing basic needs: Does the person primarily need a device to request food, drinks, or help?
• Expressing emotions and opinions: Does the individual need to communicate feelings, preferences, or opinions?
• Social communication: Is the goal for the individual to interact socially with family, friends, and peers?
• Educational or professional communication: Does the individual need to communicate for learning or working purposes?

A speech-language pathologist (SLP) is often involved in this assessment process, as they can help identify the best communication strategies and devices based on the individual's abilities and goals.

2. Physical Abilities and Input Methods

It is essential to consider the person's physical abilities when choosing an AAC device. Some individuals may have full control over their hands and fingers, while others may have limited mobility or require alternative input methods. The device should align with the individual's motor skills to ensure ease of use and functionality.

• Touch-based input: Many high-tech AAC devices use touch screens where users tap, swipe, or press symbols or words.
• Eye-tracking technology: For individuals with limited motor control, eye-tracking technology can allow them to select words or phrases by simply looking at them on a screen.
• Switches and buttons: Some individuals may require larger buttons or external switches to control the device, especially those with limited fine motor skills or muscle control.
• Head tracking or sip-and-puff: For individuals who cannot use their hands, specialized equipment allows them to control the device with head movements or by using a sip-and-puff system.

The goal is to match the input method with the user's abilities to ensure they can operate the device independently and effectively.

3. Cognitive Abilities and Communication Complexity

Cognitive abilities play a crucial role in choosing the right AAC device. Devices range from those that offer simple communication options with minimal cognitive load to those that provide complex language systems that require more advanced cognitive processing.

• Simple communication devices: These may use pictures, symbols, or a limited number of words or phrases. These devices are ideal for individuals with cognitive challenges who may find complex systems overwhelming.
• Complex communication devices: These devices may offer a wide range of vocabulary, sentence structures, and even the ability to create new phrases. They are better suited for individuals who can understand and process more complex language systems.

The device chosen should provide an appropriate level of cognitive challenge while ensuring that communication remains functional and effective.

4. User Preferences and Comfort

The user's preferences should be a central consideration in the selection process. Communication is a deeply personal experience, and the individual should feel comfortable and motivated to use the device. Factors such as the appearance of the device, the ease of navigation, and the personalization of features should all be considered.

• Personalization: Many high-tech AAC devices allow users to customize the interface, vocabulary, and voice output. Customization options can make the device feel more personalized and comfortable for the user.
• Voice output: Some individuals may prefer a specific voice style or language option. Many AAC devices offer a choice of male or female voices, as well as regional accents and languages.
• Portability and aesthetics: For some individuals, the portability and design of the device may be important. Lightweight, compact devices may be more appealing to users who need a device they can take with them easily.

5. Technology and Software Features

Technology plays a critical role in the effectiveness of an AAC device. The right device should have the necessary software and features to support the individual's communication needs. Key features to consider include:

• Text-to-speech capabilities: High-tech AAC devices often convert text or symbols into speech. The quality of the voice output should be clear and natural to ensure effective communication.
• Pre-programmed vocabulary: Some devices come with a set of pre-programmed words and phrases that can be used immediately. Others allow users to add and modify their vocabulary as needed.
• Language options: Consider whether the device supports the user's preferred language and dialect, as well as multiple languages if necessary.
• Compatibility with other devices: Ensure that the AAC device can work well with other technology the user may already be using, such as smartphones, computers, or tablets.

6. Durability and Battery Life

Durability is another important factor to consider, especially if the user is active or prone to accidental drops. The device should be able to withstand the wear and tear of daily use. Battery life is also crucial, as a device with a short battery lifespan may disrupt communication if it runs out of power during critical moments.

7. Cost and Insurance Coverage

The cost of AAC devices can vary significantly, with high-tech devices often being quite expensive. It is important to consider the available budget and explore insurance coverage options. Many insurance providers, including Medicare and Medicaid, cover AAC devices, but the process of securing coverage can be time-consuming and may require a prescription from a healthcare professional.

Additionally, there are several funding options available through non-profit organizations, government grants, and private foundations that may help subsidize the cost of AAC devices.

8. Support and Training

Selecting an AAC device is just the first step in the process. Ongoing support and training are essential to ensure the device is used effectively. Many AAC providers offer training programs for both the user and their caregivers, teaching them how to maximize the device's features. Additionally, technical support is crucial for troubleshooting and maintenance.

The Process of Choosing an AAC Device

Choosing the right AAC device is a collaborative process that typically involves input from the individual, family members, caregivers, speech-language pathologists, and other healthcare professionals. Here is an outline of the general steps involved:

1. Consultation with a Speech-Language Pathologist (SLP): The SLP will conduct an assessment to evaluate the individual's communication needs, physical abilities, and cognitive skills.
2. Device Trials: Many AAC providers allow users to trial different devices before making a final decision. This hands-on experience helps both the user and the family understand how the device works and whether it meets their needs.
3. Customization: Once a device is chosen, it is customized to fit the user's needs. This may involve selecting vocabulary, customizing buttons, or adjusting the voice settings.
4. Training and Support: Ongoing training is provided to help the user and caregivers learn how to use the device effectively.
5. Regular Follow-Up: It is important to regularly check in on the device's effectiveness and make adjustments as needed. Communication needs may change over time, and the device should be updated to reflect these changes.

Conclusion

Choosing the right AAC device for your loved one is a crucial decision that requires careful consideration of many factors. The right device can enhance communication, improve quality of life, and promote independence. By working closely with healthcare professionals, exploring different options, and involving the user in the decision-making process, you can ensure that the chosen device will meet their unique needs and provide them with the tools to communicate effectively.

AAC devices are more than just tools---they are bridges that connect individuals with the world around them, and with the right support, they can empower individuals to express themselves and lead fulfilling lives.

View Product