Current and Future AAC Research Considerations for Adults with Acquired Cognitive and Communication Impairments

Abstract

Adults with acquired language impairments secondary to stroke, traumatic brain injury, and neurodegenerative diseases are candidates for communication supports outside of the traditional restoration-based approaches to intervention. Recent research proves repeatedly that augmentative and alternative communication (AAC) provides a means for participation, engagement, conversation, and message transfer when individuals can no longer expect full return of pre-morbid communication skills and that inclusion of communication supports should begin early. We discuss current research and future directions for integrated systems of technical supports that include low-technology, high tech, and partner-dependent strategies for adults with severe and chronic aphasia, cognitive-communication problems resulting from traumatic brain injuries, and primary progressive aphasia.

Communicative Competence for Individuals who require Augmentative and Alternative Communication: A New Definition for a New Era of Communication?

“…This research has established empirical evidence of the positive impact of AAC (Beukelman et al, 2007;Bopp, Brown, & Mirenda, 2004;Branson & Demchak, 2009;Fried-Oken et al, 2012;Ganz et al, 2011;Machalicek et al, 2010;Roche et al, 2014;Schlosser, Sigafoos, & Koul, 2009;Walker & Snell, 2013;Wendt, 2009) and has demonstrated that these gains come at no risk to speech development or recovery (e.g., Millar, Light, & Schlosser, 2006;Romski et al, 2010). As a fi eld, we should take pride in this increased research base that has resulted in advances in evidence-based AAC services.…”

“…The greater range of ages and disabilities served has necessitated a greater range of AAC interventions, including those designed (a) to build communicative competence for the fi rst time with those who have developmental disabilities through instruction in linguistic, operational, social, and strategic skills (e.g., Snell et al, 2010); (b) to re-build communicative competence with those who have acquired disabilities or temporary conditions, capitalizing on existing linguistic and social strengths and teaching operational and strategic skills to bypass limitations in these domains to maximize communication performance (e.g., Costello et al, 2010;Light & Gulens, 2000;Petroi et al, 2014;Simmons-Mackie, King, & Beukelman, 2013); to sustain communicative competence for as long as possible with those who have degenerative neurogenic disabilities through implementation of AAC supports (e.g., Fried-Oken et al, 2012).…”

“…AAC interventions are no longer viewed only as a last resort to be implemented with individuals with no speech or extremely limited speech, once traditional speech and language interventions fail; rather, an increasing number of professionals now understand the potential benefi ts of AAC intervention for those who are at risk for speech and language development (e.g. Romski et al, 2010), who rely on speech but require augmentation to clarify or enhance intelligibility (e.g., Hanson, Beukelman, & Yorkston, 2013), who are recovering following a stroke or traumatic brain injury (e.g., Petroi, Koul, & Corwin, 2014), who are experiencing the loss of speech or language skills due to degenerative conditions (e.g., Fried-Oken, Beukelman, & Hux, 2012), and who may have temporary conditions (e.g., Costello, Patak, & Pritchard, 2010). As a result, AAC interventions are now implemented with a much larger and more diverse population, including individuals across the life span, both younger and older than ever before, and individuals with a wide array of disabilities who present with a much more diverse array of needs and skills than ever before.…”

The Changing Face of Augmentative and Alternative Communication: Past, Present, and Future Challenges

“…Over the past 30-40 years, there have been substantial changes to these practices. There is now a growing body of empirical evidence documenting the positive outcomes of AAC intervention (e.g., Beukelman, Fager, Ball, & Dietz, 2007;Bopp, Brown, & Mirenda, 2004;Branson & Demchak, 2009;Fried-Oken, Beukelman, & Hux, 2012;ganz, et al, 2011;Machalicek et al, 2010;Schlosser, Sigafoos, & Koul, 2009;Wendt, 2009). Moreover, there is evidence that AAC interventions pose no risk to speech development or recovery (e.g., Beukelman & Mirenda, 2013;Millar, Light, & Schlosser, 2006;Schlosser & Wendt, 2008).…”

“…There is a growing body of research that demonstrates convincingly that individuals with complex communication needs can derive substantial benefits from AAC (e.g., Beukelman et al, 2007;Branson & Demchak, 2009;Fried-Oken, Beukelman et al, 2012;ganz et al, 2011;Machalicek et al, 2010;Schlosser et al, 2009;Wendt, 2009), with no risk to speech development or recovery (e.g., Beukelman & Mirenda, 2013;Millar et al, 2006;Schlosser & Wendt, 2008). The accumulated research evidence extends across the life span of individuals with a wide range of developmental and acquired disabilities, and supports the positive impact of a wide range of AAC techniques, including unaided systems such as signs; aided systems such as nonelectronic low-tech symbols or symbol boards; and hightech speech-generating devices.…”