What is AAC?
Augmentative and alternative communication (AAC) is an important clinical intervention for many people with motor neurone disease (MND).
This information is for health and social care professionals working with people with MND. It provides suggestions for best practice in AAC provision, and where to find more information.
The term Augmentative and Alternative Communication covers a wide range of techniques and communication aids that support or replace spoken and/or written communication. These may be used to communicate face-to-face or remotely, for example through social media, email or instant messaging.
AAC is commonly used to refer to electronic communication aids and products (high-tech) but equally it includes simple, non-electronic (low-tech) options.
- Low-tech examples of AAC include pen and paper, gesture, signing, symbols, communication charts, and letter, word or picture boards or books.
- High-tech examples include voice output communication aids (VOCAs) and specialist soft and hardware on mainstream computers.
Low-tech AAC systems can often prove more effective than high-tech systems. Such options should always be considered in MND, even if high-tech options are being explored or used. People may use both high and low-tech systems, depending on a given situation.
Increasingly, AAC technology should be compatible with other assistive technologies, such as environmental control systems. However, AAC is not simply about access to a computer and must have communication as its primary outcome.
Benefits and challenges of AAC
- It can support communication and interaction with family, friends and professionals when speech intelligibility is reduced.
- It can promote psychological and emotional wellbeing.
- It can help to maintain autonomy and control over decision-making.
- It can enable ongoing access to electronic communication, such as social networking and email.
- It may help to maintain employment.
- Composing words, sentences and messages through an AAC system is almost always slower than natural speech production. This can be a physical and emotional challenge for people with MND and those they’re communicating with.
- As physical symptoms change, so can needs for equipment. Ongoing monitoring and assessment of needs and abilities is therefore necessary.
- For some people with MND, cognitive change can make communication more challenging.
See our information on cognitive change and frontotemporal dementia
Securing funding can be problematic, particularly if needs change rapidly.
- England: NHS England provides funding for specialist assessments and subsequent provision of AAC equipment.
- Wales: a similar system is being put in place in Wales, with funding provided by the Welsh Government.
- Northern Ireland: funding for specialist AAC is provided through its five health and social care trusts.
See our information on Funding for AAC