Technology and Therapy: The Use of AAC Devices in Applied Behavior Analysis

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A teacher and a boy use an ACC device while sitting at a desk.

The American Speech-Language-Hearing Association (ASHA) states, “AAC includes all of the ways we share our ideas and feelings without talking.” An example of AAC is American Sign Language (ASL), which deaf or hard-of-hearing people use to communicate. Other examples include digital devices that help convey the thoughts and feelings of nonverbal individuals, as well as facial expressions and text messages that serve the same purpose.

For individuals hoping to help those with difficulties or limitations in communicating, an online Master of Science in Applied Behavior Analysis program can prepare them to understand the benefits of AAC devices to encourage appropriate behaviors and how the proper use of AAC devices may be taught. In particular, AAC devices are beneficial in behavior therapy, as they allow patients to express emotion and understand how to adjust their behavior to improve their overall health. Take a look at how AAC devices help shape the field of behavior therapy.

Defining AAC

Augmentative and alternative communication refers to any type of communication that does not take place through speech. In a professional or clinical setting, this type of communication may include an individual with a mental health condition who uses a digital device to speak with others. In a more casual environment, it could be two friends writing and mailing letters to each other from different parts of the country.

According to ASHA, there are two primary categories of AAC: unaided systems and aided systems. Unaided systems refer to any type of communication that doesn’t involve speech and doesn’t require anything but a person’s body. This could include smiling to communicate happiness or gratitude, a hand wave to signify a greeting or hello, and crossed arms to express disappointment or nervousness.

Aided systems incorporate some sort of device to make nonverbal communication possible. For two friends writing letters, pens, paper, and envelopes constitute the device. For a nonverbal person, the device may be an iPad, which allows the individual to create messages, or a speech-generating device (SGD), which creates audio messages based on user input.

Both aided and unaided AAC systems can be used in behavior analysis to help individuals achieve improved  behavior outcomes. Many times, behavior analysts work with individuals to help them adopt more socially valued verbal behaviors, and AAC devices can sometimes be helpful in that regard.

For example, a nonverbal child with autism exhibiting undesirable behavior can use a speech-generating device to express his or her thoughts and emotions more clearly. In these situations, behavior therapists may work with speech language pathologists to determine which type of AAC or speech-generating device may best help a person achieve a more desirable behavior outcome. These professionals work together to identify behavior problems directly caused by speech and communication skills and how they can be resolved.

The Types of AAC

Although there are multiple AAC devices and methods, there are common types that behavior therapists and speech pathologists may use when working with patients. Unaided AAC, such as hand gestures, facial expressions, and bodily movements, does not require any sort of tech device. Aided AAC, however, is broken up into two categories: low-tech and high-tech. Low-tech AAC includes items such as a whiteboard with a marker, as well as photographs and drawings. High-tech AAC includes speech-generating devices, software or apps, and other recordable devices that can create and enhance communication, according to ASHA. Depending on the person and his or her unique conditions and challenges, many approaches and techniques may be used to build an AAC system. For example, a nonverbal person may use a speech-generating device when communicating with family at home but a whiteboard or tablet when speaking with acquaintances in public settings.

Below are examples of high-tech AAC devices.

Picture Tablets

This form of AAC can be an independent tablet or a program that is downloaded onto a device, such as an iPad. Picture tablets commonly display a grid of individual pictures that correlate to specific emotions or messages. When an individual presses one of these images, the app emits a verbal message. Picture tablets are particularly helpful for individuals who have limited speech capacity or are completely nonverbal.

Alphabet-Driven Devices

These devices can be useful for individuals who are nonverbal or who have difficulty speaking but are able to express themselves coherently through language, such as individuals who have ALS or another degenerative condition. With this type of device, the user looks at an on-screen alphabet or text system, and the device generates audio messages based on the user’s eye movement or other buttons or physical cues. This enables the user to “speak” through the voice of the computer.

Tactile Symbol Buttons

Similar to a picture tablet, this type of AAC device enables an individual to express a thought or emotion using buttons that correlate to specific messages. For example, blind or nonverbal people can press one tactile symbol button to indicate that they are hungry and another button to indicate they need to use a restroom.

Visual Scene Displays

Visual scene displays are a type of AAC device that can help individuals develop their language with the use of imagery. For example, in a visual scene display, a child might look at a personal photograph featuring a family visit to an exotic destination. “They capture the social interactions that are the contexts in which young children learn language and communication skills, and they replicate these contexts within AAC systems, thus providing visual contextual supports for the children’s language learning and use,” explains an article from the Augmentative and Alternative Communication Journal.

The Skills Needed for Effective AAC Usage

AAC technology can be immensely helpful in addressing behavior challenges and bridging communication and language gaps. But to ensure that AAC has the strongest impact on individuals, therapists need to possess the following skills.

Empathy Toward Verbally Challenged Persons

A behavior therapist familiar with AAC likely has a deep understanding of the benefits of certain communication tools. However, it may be the first time the behavior therapist’s patient is using these types of tools, and he or she may encounter a learning barrier.

Behavior therapists need to ensure that they express empathy and patience when using AAC to help individuals struggling with communication.

Strong Communication

Behavior therapists may also communicate with patients’ families, friends, and teachers, as well as other involved parties. As such, it’s crucial that therapists be able to clearly and concisely explain AAC devices, strategies and methods, desired outcomes, and patients’ progress. Additionally, behavior therapists can also help explain what to expect as those individuals monitor the use of an AAC device.

Passion for Innovation

New technology may enhance AAC procedures and help improve patient outcomes. Behavior therapists don’t have to purchase every new AAC-related gadget or device, but they should keep an eye open for new technology that can assist them in providing stronger therapy to patients.

Critical Thinking

One AAC device or strategy that proved to be beneficial to a person with a communication disorder may not be the best fit for another person with similar challenges. Behavior therapists need to think critically when deciding what AAC approach to use, as well as set realistic goals and expectations for the therapy. AAC may not solve all communication issues, but it can help people to forge stronger relationships and live more   lives.

Improve Communication and Change Lives Through AAC

Behavior therapists make a positive difference in the lives of countless individuals who may be struggling with behavioral issues related to language and communication. With their knowledge and utilization of AAC, they help to ensure that patients and clients have the ability to communicate their thoughts and feelings to others. Masters in Applied Behavior online program prepares students to become effective behavior therapists who understand AAC and how it facilitates communication and expression. Discover how you can make a difference today.


Recommended Reading:

Ensuring Quality and Efficiency: Clinical Supervisor Job Description

How to Encourage Positive Behavior in Developing Children

Leadership in Applied Behavior Analysis: What is a Clinical Director?


American Speech-Language-Hearing Association (ASHA), AAC Systems

American Speech-Language-Hearing Association (ASHA), Augmentative and Alternative Communication (AAC)

Augmentative and Alternative Communication, “New and Emerging AAC Technology Supports for Children with Complex Communication Needs and Their Communication Partners: State of the Science and Future Research Directions”

Boston Children’s Hospital, “AAC and Vision Impairment”

Cigna, Speech Generating Devices