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Some kids living with cerebral palsy have severe speech problems, which make it extremely difficult and sometimes even impossible to communicate orally. Augmentative and alternative communication (AAC) can help these children express themselves and connect with family, caregivers, and others.
What is AAC?
Augmentative and alternative communication (AAC) is any type of communication except for oral speech. It can include anything that helps children express themselves. For instance, hand gestures, pictures, facial expressions, and writing a note or typing an email would all be considered forms of ACC.
There are two types of ACC, including aided AAC and unaided AAC. Unaided AAC is any form of non-oral communication that doesn’t involve technology or equipment (waving, using sign language, making faces, etc.)
Aided ACC continues to evolve, and with constantly-changing technology, children with disabilities have many more options to communicate than ever before. Some examples of aided AAC include:
- Communication boards
- Tablets (e.g., iPads)
- Speech-generating devices
- Communication books
Benefits of ACC
Communication is essential for children, regardless of disability. For those that have difficulty expressing needs, ideas, and feelings to caregivers and parents, ACC is an invaluable way to bridge the communication gap. It can also be life-saving. If a child has certain ailments or pains, it’s crucial that they have a way to communicate what hurts to loved ones.
Another benefit of ACC is an increase in learning, which helps children with disabilities stay on the same level educationally, or at least as close as possible to their peers. If children are incapable of communicating effectively, they won’t be able to ask a question if they don’t understand an assignment or what’s being taught.
For children who have physical disabilities that limit mobility, communication boards and other devices can be mounted to wheelchairs to provide a way for them to communicate while on the go. The devices can also be installed in a way that reaches eye level perfectly for each child.
Is Your Child a Good Candidate For ACC?
Before deciding on ACC and determining which type is best for your child, a pediatrician will generally recommend working with a speech/language therapist and an assistive technology (AT) specialist. These professionals can evaluate the child and discern not only what the problem areas are, but also what type of ACC will be the most beneficial. Some children may work better with tablets, while others learn faster with communication boards. There are also children who need to incorporate a series of both aided and unaided ACC into their lives.
Generally, AT professionals and speech/language therapists will look for the following things when assessing a child:
- What cognitive disabilities the child has
- What physical disabilities the child has
- If the child shows motivation and interest in ACC
- If the child shows a keen interest in a particular way of learning
These are just a few of the things that may be assessed when deciding if ACC will work for your child, but there will be other factors to look into, as well.
Key Findings in ACC Studies
A study on ACC was published by the National Institutes of Health (NIH) entitled, Implementing augmentative and alternative communication in inclusive educational settings: a case study. It reviewed the following key findings after a high school student with cerebral palsy began using ACC:
- The student’s intelligibility increased 
- The student’s relationship with peers became more enjoyable
- The school staff became more comfortable teaching the student
- The student’s socialization increased
In another study, carried out by AssistiveWare and professors from the University of San Diego and the California State University at San Marcos, researchers studied Apple products (smartphones and tablets) and their benefits related to ACC. The following key findings were determined:
- Up to 80% of ACC users and their families surveyed in the study reported improvement in independence, behavior, and overall well-being 
- Apple’s iOS devices and AAC apps on the devices are beneficial for all ages, ranging from children in the intervention stages of communication to senior citizens
- Apple iOS devices have been so successful with ACC that the availability of this technology seems to be accelerating quickly
- Many people may not be using the full range of functions that tablet apps can provide; further studies are needed to see the true scope of capabilities
Of course, Apple products are just one of the many types of ACC devices that provide communication apps. There are numerous alternatives available, some of which are provided at no charge to children with cerebral palsy and other disabilities that limit communication. To see if your child qualifies, speak with your child’s speech therapist or pediatrician.
The Future of Communication and Cerebral Palsy
Whether it’s through communication boards and tablets, or non-aided ACC such as sign language and using distinct facial expressions, many children with cerebral palsy benefit from ACC. 
As technology progresses, and even more options open up, the future of children with cerebral palsy has never looked brighter.
- Stoner JB , et al. (n.d.). Implementing augmentative and alternative communication in inclusive educational settings: A case study. - PubMed - NCBI. National Center for Biotechnology Information.
Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/20497075
- AAC in English-speaking countries: Survey results. (n.d.). AssistiveWare - What will you say?.
Retrieved from: https://www.assistiveware.com/blog/survey-aac-in-english-speaking-countries
- Alignment between augmentative and alternative communication needs and school-based speech-language services provided to young children with cerebral palsy. (10, September). PubMed Central (PMC).
Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3243446/