Apraxia Defined

There are many methods of AAC, and various examples are classified into categories below, informed by lectures from Crystal King, MSEd, MT-BC, who specializes in AAC and teaches on this topic at Florida Gulf Coast University. Low tech AAC involves no batteries or voice output, mid tech AAC uses batteries but may have programming limitations, and high tech AAC uses batteries and has wider programming capabilities.

 

Another way to categorize some AAC methods is identifying text-based communication and non text-based communication methods. Text-based communication uses purely words, while other types of AAC may use pictures along with words. One consideration is that some individuals who were interviewed for this project expressed preference for text-based communication, as it recognizes that the individuals communicating are capable of reading and literacy, in contrast to picture-based AAC, which may imply the individual is unable to read the words presented.

 

Examples listed below include AAC methods used by clients at Music Therapy St. Pete as well as examples mentioned by Crystal King and encompass only a small sample of AAC options available.

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Low Tech:​

• Gestures

• Sign Language

• Writing or drawing

• Pointing to parts of the arm or hands​​

To present a couple of options, assign each option or potential answer to either an area of the forearm or each hand. For example, assign one answer to the wrist and one to the inner elbow area or assign one answer to the left fist and one to the right fist and ask the individual to point to the option they prefer. ​

• Quadboards

To create a quadboard, use a dry-erase marker to section off four quadrants on a small markerboard by making a cross in the center of the board. Ask a question with four options and write one possible answer in each quadrant. When presenting the board, hold it in front of the individual on their dominant side. Remove it from their field of view by lifting up the board at a right angle, then hold it directly in front of their dominant hand for the individual to point to the desired option. Providing an option of "something else" may be an effective way to ensure the individual does not feel like they have to agree to an option they do not truly prefer just because that is what is offered.​

• Letterboards

Letterboards are AAC tools that display the alphabet, enabling individuals to point or tap the letters of words they wish to spell, providing room for a large vocabulary of words. ​Spelling to Communicate (S2C) is a text-based communication method using letterboards that several of the clients with apraxia at Music Therapy St. Pete use to communicate. Individuals who use this method may choose to identify as spellers, as they spell to communicate. S2C teaches clients the purposeful motor skills to spell words to a communication partner using a letter board. Communication partners hold the letterboard near the dominant hand of the individual while they are seated and provide appropriate prompting while the nonspeaking individual points to each letter in the words and sentences they wish to spell.

• Picture words or boards

Mid Tech:

• Step by Step Switches

These are colored buttons that may be programmed to play certain words or phrases by recording said words or phrases onto the switch beforehand. When the switch is pressed each time, it plays the recorded words or phrases one at a time.​​

High Tech:

• Text-based communication apps on an iPad

  • Proloquo4Text​: This text-to-speech app shares a keyboard on the screen equipped with word and sentence prediction capabilities and a single screen layout, providing opportunities to program in commonly used phrases and a voice output option and available at the price of $119.99.​

  • iMean: An app available for iPad and iPhone that provides a digital letterboard with three word prediction options as well as yes or no buttons, at the price of $4.99.​​

  • Apple's Live Speech

  • Chatterboards​​: A free app that allows a person to create personalized vocabulary boards with customizable buttons with editable text, colors, images, and audio playback features.

Additional Resources:

The Meraki Collective provides services to nonspeaking individuals learning to communicate using this type of AAC and provides opportunities for spellers looking to find community with others.  

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Communication 4 All is an online resource providing additional information about typing to communicate. Elizabeth Bonker, a poet, lyricist, and co-author who is affected by autism and types to communicate, provides free resources to those learning to spell and advocates for nonspeakers.

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Communication for Education is a webpage with valuable trainings geared toward educators and anyone else working to support spellers. Their trainings provide clear definitions and useful strategies, and they share feedback and thoughts from spellers as well.

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Watch this recent CBS interview below with advocate Jordyn Zimmerman to hear her perspective on AAC: