AAC TERMINOLOGIES

Symbols, Aids, Strategies, Techniques

4 components of AAC

1. Representation of the idea through unaided and/or aided means 

2. (Devices) Assistive devices and or means to transmit and/or receive messages 

3. Productivity and efficiency of message transmission

   • How we can make AAC fast and  effective

4. Access and choice of messages 

   • Everything else in between

   • What to press; how it’s pressed; arrangement of the system

Tablet

• High-tech 

• Aided communication 

• Dedicated system

Appropriate When

• Things to consider: 

  • Financial 

  • Operational skills 

  • Cognitive abilities 

  • Linguistic skills 

    • As it is not only pictures, but also letters and words

• We keep in mind the patient’s abilities to decide on which device to use

• If we have these set of skills, we need to assess the abilities to decide what appropriate device to use

Red button/Switches

• Not that flexible, but can be combined with others 

• Dedicated system

Appropriate When

• Appropriate for patients with limited mobility

  • Head bumping; shouldering; etc.

• The big con is that patients are limited to one or two messages per button.

  • May be impractical  for communication

• There is a risk that the child may be dizzy

• You have to be creative in using them 

ASL

• Unaided 

• Sign language

• When they can understand a system as there is a system in sign language 

• Can the patient actually understand those symbols? 

  • You can’t expect that from patients with cerebral palsy, etc.

• Fine motor skills are necessary for the symbol execution

• Some people consider sign language as AAC and some don’t

Dedicated Device

• An AAC device or piece of equipment that is designed specifically to operate as a communication aid

• Used solely for communication 

• Ex: Communication Boards, Switches

Integrated Devices

• _ device (including speech generation) that allows for use as a traditional computer complete with internet access and software or apps that perform tasks unrelated to the production of speech

• Ex: iPad

Unaided Communication Systems

• Communication modality that does not require any external equipment (DaFonte, 2019)

Speech Generating Devices

• Aided Communication

• Sophisticated AAC technology

• Devices that have synthetic or digitized speech output 

• Different features such as voice banking, symbol sets, dynamic display, etc.

Non-Speech Generating Devices

• Tools to support communication that are non-electronic

Communication Boards

• Visual display from which they select symbols

• These include simple letter boards, symbol boards, etc.

Tactile Boards

• Tangible or tactile symbols are (usually small) objects that can be held in the hands, shown to a communication partner, and handed over as a communicative act

• Usually used for patients with visual impairments.

Sample Unaided Devices

• E-Tran 

  • Usually used in the hospitals 

  • Just presented in front of the patient 

  • Eye gazing or eye tracking 

  • For financial constraints

• Picture Exchange Communication System (PECS)

• Picture Schedule System

Symbols

• This is “something” that represents something by association, resemblance, or convention (Merriam-Webster, 2019)

• The something else is termed the referent and might include vocabulary concepts such as people, actions, objects, places, descriptors, questions, social words, and so on

Referent

• The one that you are referring to 

  • Might include vocabulary concepts such as people, action, objects, and more.

  • For every symbol, we can refer to nouns, verbs, etc. 

Unaided, Aided Symbols

1. Symbols that the human body can produce (i.e., gestures, signs, finger spelling, etc.)

2. Symbols that need external tools to produce messages

Static, Dynamic

Traditional View

1. Pictures that don’t move

2. Pictures that move

Iconic, Opaque

Traditional View

1. Easily recognizable 

2. Hard to recognize

Symbol Set, Symbol System

Traditional View

1. Just a set of images

2. Has its own system

Iconicity

• Refers to the degree to which an individual perceives the relationship between a symbol and its referents

• It refers to the continuum that describes symbols by ease of recognition

• A challenge in using such term is its continuum system

  • Is relative to each person

  • Could be transparent to one person but opaque for another

  • Ex. The Roman Alphabet is transparent to us but may be Opaque to someone that uses a different writing system

Transparent, Translucent, Opaque

1. Highly guessable, given that it visually resembles its reference

2. Less apparent and needs more information for decoding

3. A symbol that is not readily obvious to the user, even when additional information is provided

Linguistic Characteristics

• The language involved in this particular set of symbols 

• Divided into three: Nonlinguistic, Prelinguistic, Linguistic

Nonlinguistic, Prelinguistic: Transitional Symbol System. Prelinguistic: Symbol Set, Linguistic

LINGUISTIC CHARACTERISTICS

1. Symbols do not possess any inherent linguistic characteristics

   • Ex. Pictures in the internet

2. More refined but unsophisticated linguistic characteristics in the form of internal logic

3. Inherent linguistic characteristics (with limitations) in the form of internal logic

4. Unlimited communication possible; Alphabet based 

Internal logic, Expansion Capability, Vocabulary Size, Representational Range, Correspondence to the Language of the Wider Community

Characteristics of a Quaternary Continuum of Symbols (Linguistic) 

Internal Logic

• Presence and sophistication of generative rules to allow symbol expansion

  • Can be absent, limited, defined, sophisticated

• A set of symbols has rules that can be mixed and combined to make more items

  • Higher internal logic = symbols that have the ability to create more meaning 

• Ex.

  • dog, cat, water bottle, chair 

    • Can we combine them to create another symbol? No 

    • No internal logic because you cannot create something new 

  • letters d,o,g 

    • Can we combine them to create another symbol? Yes 

    • Higher internal logic  

• Why are nouns, pronouns, etc. more sophisticated? 

  • You can combine and create more new messages 

• Non-linguistic symbols have no rules

Expansion Capability

• Degree of vocabulary expansion beyond an initial group of symbols as a result of varying degrees of internal logic

• Do the symbols have the ability to create new symbols?

• Higher internal logic = higher expansion capabilities 

Vocabulary Size

• Number of symbols within a particular collection

• How many symbols can be generated

  • From these symbols, what other symbols can be made

• Ex. Alphabets: Unlimited; Words: Limited

Representational Range

• Degree of ability of symbols to represent the morphological, semantic, and syntactic components of spoken and/or written language 

• Can the symbols represent something concrete to abstract

• Ex.  Alphabets: Unlimited; Picture Cards: Very limited

  • Picture Cards are limited to the concepts they can portray; there is not a lot of room to customize and combine messages

  • Touch (for tactile-based AAC) struggles to represent more abstract concepts such as feelings, colors, plurality, prepositions, adjectives, tenses, names, etc.

Correspondence to the Language of the Wider Community

• Degree to which a symbol system corresponds to the components of the natural language of the broader (i.e. persons without disabilities) community

• How close are the symbols to widely used language (speech, alphabet)  

• Ex. Pictures: Poor Correspondence

Acoustic, Three-Dimensional, Animated, Two-Dimensional

Physical Attributes

1. Symbols produced as synthetic speech through speech-generating devices (SGDs)

   • Ex. If you press something, there will be a sound

2. Object-Based Symbols; Ex. Real objects 

3. Symbols that require movement to assist in conveying meaning; Ex. GIFs

4. Symbols categorized as static (i.e., those that do not include movement) and kinetic (i.e., those in which movement or animation is one of their key elements)

   • Ex. Pictures on the phone

Objects, Pictorial, Line Drawing, Phonemic/Phonetic Based, Alphabet Based, Vocal

Design Attributes (6)

Aided Symbols

• Symbols that require an external aid or assistive communication device to display and transmit.

Aided Symbols: Nonlinguistic Symbols

• Also referred to as symbol groups due to its little to no inherent linguistic characteristics

Characteristics	Description
Internal logic	Absent
Expansion capability	None
Vocabulary size	None
Representational range	Very limited
Correspondence to the language of the wider community	Poor

Three-Dimensional Symbols

• Are often object-based symbols and include real objects, miniature objects, and tangible and textured symbols

Real Objects

• First aided AAC approach used with infants and older beginning communicators who have developmental disabilities

• Unable to represent letters or use an iPad

Miniature Objects

• Careful selection to the potential communicator's impairments and abilities (i.e., size and tactile similarity).

• Can be used for kids with visual impairment that struggle to relate pictures/ use symbols to communicate

Partial or Associated Objects

• _

  • Part of the referent that share the same feature

  • Ex: T-Shirt → button

• _

  • Related to the referent

  • Ex: Play a board game → give a dice

Tangible Symbols

• The system uses concrete or “tangible” symbols

• Besides individuals with visual impairments, tangible symbols are a great help in assisting children in the early prelinguistic stages to grasp (literally as well as cognitively) what symbols are.

• Something that is widely used for kids with visual impairments or low cognitive abilities.

Two-Dimensional Symbols

• Possess the Dimensions of Height and Width but not Depth.

• Photograph, Emoji, Generic Line Drawing, Clipart, Any type of picture

Animated Symbols

• Two-Dimensional Symbols that Require Movement to Assist in Conveying Meaning

• Something that moves

• Animated Graphics, Autism Language Program, Dynasyms, Library of Internal Picture Symbols

Animated Graphics

• Set of 114 animated symbols that was introduced by the Center for Communication Enhancement at Boston Children’s Hospital in 2009.e

Aided Symbols: Prelinguistic Symbols

• Symbol sets are lower-level pre-linguistic symbols that have rudimentary internal logic.

  • Not much language is involved 

• A developer based on pictures or symbols 

Characteristics	Description
Internal logic	Limited
Expansion capability	Minimal
Vocabulary size	Small
Representational range	Narrow
Correspondence to the language of the wider community	Fair

Dynasyms

• Are not just a group of pictures or visual symbols but a visual language system organized semantically with strategies for picturing concepts with categories having common shapes and colors. 

Imagine Symbols

• The ultimate goal of _ symbols was to develop symbols that could be easily learned by people with cognitive and/or other disabilities 

Lingraphica Concept Images

• flexibly customizable, interactive, and highly stimulating, allowing for a range of human-computer user interactions 

Mulberry Symbols

• The aim was to develop a symbol corpus that was free of cost, and in fact, these symbols are free to use based on the creative commons license terms. 

Participics

• are symbols (i.e. pictographic images) initially created focusing on helping people with aphasia. 

Pics for Picture Exchange Communication System

• can be used for a wide range of purposes. For instance, the symbols can be used to create printed communication boards, schedules, literacy activities, visual supports, and overlays for SGDs.

Aided Symbols: Prelinguistic Symbols (Transitionary Symbol Systems)

• Symbols have developer-defined rules for creating new ones beyond the original corpus, but the expansion rules tend to be somewhat rudimentary and not sufficiently developed to allow for ultimate expansion capability.

• Not as comprehensive in allowing symbol users to communicate freely

• Defined, but unsophisticated = Set of rules to adhere 

  • Ex. Number of exclamation points to define → Good, Better (!), Best (!!)

  • Not standardized

Characteristics	Description
Internal logic	Defined, but unsophisticated
Expansion capability	Limited
Vocabulary size	Larger
Representational range	Broader than a symbol set
Correspondence to the language of the wider community	Good

Makaton Symbols

• In appearance, they are black line drawings easy to interpret, as they look like what they represent and can be easily drawn on white boards with markers during free-flowing spontaneous communication.

Picture Communication Symbols

• remains as one of the most commonly used aided symbol sets in the world, as the developers have kept up with the latest technology over the decades.

• Includes 5 different types.

Widgit Symbols

• Approach where the user learns the rules that govern the symbols so knowledge can be applied to understanding novel symbols

Aided Symbols: Linguistic Symbols

• are the most sophisticated level of aided symbols due to their sophisticated and comprehensive internal logic that allows virtually unlimited expansion capability, that is, there are no limitations in terms of creating new symbols.

• Alphabet-Based Symbols, Phonemic-/Phonetic-Based Symbols, Line Drawings

Characteristics	Description
Internal logic	Sophisticated
Expansion capability	Unlimited
Vocabulary size	Unlimited
Representational range	Unlimited
Correspondence to the language of the wider community	Excellent

Alphabet-Based Symbols, Phonemic-/Phonetic-Based Symbols, Line Drawings

AIDED SYMBOLS: LINGUISTIC SYMBOLS (3)

Polysemy, Sequentiality, Intrinsic Factors, Iconicity

Potential Issues with Aided Symbols

1. Words have multiple meanings

   • Ex. when shown a symbol of a cup of water = drinking, thirsty, (one symbol can mean a lot of things)

2. Syntax, word, and picture combinations may be confusing for both the user and the communication partner

   • Does not necessarily follow the rules of grammar

3. Age, developmental status, neurological status, language and literacy skills, sensory capabilities, culture, and world experience (Mineo Mollica, 2003)

4. The association that the individual forms between the symbol and its referent (Schlosser, 2003)

Unaided Symbols

• Symbols that do NOT require aid or assistive communication devices to display and transmit messages.

  • Use of body 

• Not usually advocated for by SLPs as it is a different language already

Continuum of Symbolization Development

Context, Partner, Conventionality

• Importance of _ diminishes as you move from non-symbolic to Symbolic

• Magnitude of _’s role diminishes as you move from Non-Symbolic to Symbolic

• _ increases as you move from Non-Symbolic to Symbolic

Unaided Symbols: Nonlinguistic Symbols

• Also referred to as presymbolic symbols

• Idiosyncratic actions, movements, and/or sounds

Potential Communicative Acts

• Any behavior that another person interprets as meaningful and may include a range of behaviors, such as changes in respiration, body movement, vocalization, eye gaze, facial expression, and/or problem behavior (Sigafoos et al., 2000)

Gestures

• Actions produced primarily with fingers, hands, and arms (i.e., upper extremities) but can include facial features and full body movements (Iverson & Thal, 1998)

Beats, Iconic, Metaphorics, Cohesives, Deictics

Gesture Types:

1. The hands move along with the rhythm of speech.

2. The hands depict some visual aspect of what the speaker talks about, e.g., the movement of putting on a hat to depict “HAT”.

3. The hands depict an abstract idea, e.g., spreading the arms to indicate the concept of “LARGE”.

4. The hands move to indicate a repetition or continuity, e.g., half-circular movements to indicate “AND THEN”

5. The familiar pointing or “deictic” gesture to refer to something.

Unaided Symbols: Linguistic Symbols

• Involves the representational thinking skill – the ability to hold an image of something in mind when the person, place, object, or activity is removed in space and/or time.

  • There is a specific symbol for a specific item

  • Manual Sign/Simplified Sign, Simultaneous Communication, Key Word Sign, Makaton, Alphabet-Based Symbols, Phonemic-/Phonetic Based Symbols

Manual Sign/Simplified Sign

• We reserve the term “manual sign” for gestures that are used in a systematic and consistent way in communication.

• Within AAC, manual signs are often borrowed from an existing sign language.

Simultaneous Communication

• The simultaneous presentation of manual sign and speech was intended to make spoken language structures more visually transparent, and hence, easier for deaf children to understand and acquire.

  • Signing while speaking

Makaton

• The purpose of _ is to develop a person’s spoken output in combination with other AAC supports.

Motor Ability/Control, Visual access to gesture/manual signs, Cultural Considerations, Iconicity

Issues with Unaided Symbols (4)

Content Words, Function Words, Personalized Vocabulary, Core Vocabulary, Fringe Vocabulary

Types of Vocabulary (5)

1. Words that carry the main meaning (e.g., words for people, actions, objects, places, questions)

2. Words that provide structure for our sentences (e.g., articles, conjunctions, prepositions)

3. Vocabulary words and messages that are specific or unique to the individual

   • Something close to the child, something they use daily, or something motivating

   • E.g., family members, favorite food, preferences, etc.

4. Words that are relatively common and relatively frequently used by a variety of individuals in different situations (i.e., go, want, more, the, a, I)

   • Commonly used in everyday settings

5. There are words that will occur only in relation to specific activities, contexts, places, topics and demographic groups

Vocabulary Selection for Non-literate Individuals

• Nonliterate individuals are unable to spell well enough to formulate their messages on a letter-by-letter basis and are not expected to develop or regain these spontaneous spelling skills 

• Primarily aims to meet their daily, ongoing, functional communication needs in a variety of environments

• Used for daily interaction like wait, go, family member names, weewee, ihi etc.

Coverage Vocabulary, Development Vocabulary

Vocabulary Selection for PreLiterate Individuals

• Preliterate have not yet developed reading and writing skills 

1. Vocabulary that is needed to communicate essential messages

2. Vocabulary to support their language development 

Timing Enhancement, Message Acceleration, Fatigue Reduction, Social Media

Vocabulary Selection for Literate Individuals

1. Messages that have important timing requirements (time-sensitive messages) are usually stored and retrieved in their entirety

2. are words or messages that occur so frequently and are so lengthy that the use of an encoding strategy is used for retrieval 

   • One chunk of information is represented by one icon

     • E.g., full name, birthdays, etc.

3. Result of not having the quick and efficient vocabulary

   • E.g., like how speaking and typing all day is tiring 

4. Put words that are relevant for the user

   • Interview

   • Facebook

   • Communication Diaries

   • Check the ecological inventory

     • Do Interview regarding the child’s immediate surroundings

     • To get information regarding what words are relevant to the child

Grid Display

• Each language concept is represented by a graphic symbol of some sort (e.g, photograph, line drawing, written words) organized in a round pattern

• Static

  • Constant

  • Doesn’t move 

• Dynamic

  • Can move

  • You can navigate different folders

Schematic

• These are also referred to as an activity grid display

• Arrangement of symbols on separate pages by events, activities, or routines (Drager et al.,

  • Good for first-time users for familiarization but it's difficult to use when organizing longer messages

Taxonomic

• INsert pic

• Organization of symbols through generic categories

• Used for older children

• Talks about the part of speech

• Ex. Nouns, verbs, people, places, animals

Semantic-Syntactic

• _-_ grids displays organized symbols based on the parts of speech

• Same parts of speech are grouped in one column

• Messages are in order from left to right

• Fitzgerald Key (insert pic)

  • Color-coded symbols

  • Used as a reference/guide to see which symbol will be pointed to next

• Reserved for individuals who are literate

Pragmatic Organization Dynamic Displays

• Organization of vocabulary with the intended focus of increasing social functions/functional communication

• Combination of different symbols

Chronological

• Organization of symbols through chronological sequence of events 

• For individuals who usually sticks to a routine

Other Grid Displays

• Clustered Display

  • Display is based on the internal color of the symbols

• Distributed Display

  • Symbols are dispersed without specific format and sequence

• Hybrid Display

  • Combination of visual scenes along with one of the various grid layouts

• Alphabetical Display

• Keyboard

Visual Scene Displays

• Vocabulary concepts are organized according to the activities, routines, and events within which these concepts are learned and used.

  • Maybe used for patients with aphasia who need context clues 

Scanning

• Access Technique

•  sequentially presenting stimuli for categories of stimuli to which the person can respond

• Scanning or indirect selection would require multiple steps for activation 

• Green button is used to navigate

• Red button is used to select/confirm

Linear scanning, Group Scanning

• Indirect Selection Scanning Method

  1. _ _

• Pros: Makes sure that the patient really wants the item

• Cons: You have to get to several points just to reach the symbol

  2. _ _

• Doesnt necessarily have to be in a row or column

  • Can be preset

Directed (Inverse) Scanning, Step Scanning, Automatic (Regular or Interrupted) Scanning

Indirect Selection Control Techniques

1. _ _ Scanning

   • Cursor moves when the user activates the device; selection will happen when the device (i.e., switch) is released

2. _ Scanning

   • One to one correspondence of cursor movement and switch activations; selection happens when you stop activating the device 

3. _ _ _ _ Scanning

   • Cursor moves automatically; selection happens when you press the device (i.e., switch)

   • Operating system is automatic

     • If wala kang ginagawa then magmmove sya

Direct Selection

• User has direct control over and access to the communication tool that is used 

• Direct selection has a one-to-one relationship between the motor act and the resultant selection

• Only requires you to move and point at the item

Physical Contact, Physical Pressure or Depression, Pointing (No contact)

Direct Selection Selection Method

1. E.g., using an ipad

2. Needs pressure point to click and type messages

   • e.g. keypad

3. Pointing and eye gazing

Timed Activation, Release Activation

Direct Selection Activation Strategies

1. Identification of the item on display and sustained contact for a predetermined time for activation 

   • E.g., for patients with tremors

   • Hold for a particular amount of time

2. Identification of an item on display, sustaining contact with a predetermined time for activation, and selection happens after you release the symbol (52:20) timestamp of example 

Digitized, Synthesized

Voice Output

1. A time damper's replication of active human speech 

2. translate the user's input (choosing letters, words, or symbols) into computer-generated speech

3 Primary Purpose of Strategies

• To enhance message timing

• To assist grammatical formulation of messages

• To enhance Communication Rates

• Double check ppt

Encoding

• A strategy that is often used to increase access to vocabulary and to improve communication rate is to store complete words, phrases, or sentences in AAC technology and to assign a code of some type to the stored message to retrieve the entire word or message (Vanderheiden & Lloyd, 1986).

  • There is a specific code/icon to press

Truncation Codes

• Encoding Single Words

• Abbreviation of words according to the first few letters

Target	Code
HAMBURGER	HAMB
COMMUNICATION	COMM
NETFLIX	NET

Contraction Code

Encoding Single Words

• Inclusion of the most salient letters

  • Consonants

Target	Code
HAMBURGER	HMBGR
COMMUNICATION	CMNC
NETFLIX	?

Salient letter codes

• Encoding Sentence and Phrases

• Initial letters of the salient words are used for encoding

Target	Code
OPEN THE DOOR	OD
CLOSE THE DOOR	CD
GIVE ME JUICE	GJ

Letter Category Codes

• Encoding Sentence and Phrases

• First letter refers to the category folder second letter refers to the specific messages

• Dependent on the user or developer

Target	Code
HELLO TEACHER	GH G - greetings H - Hello teacher
OPEN THE DOOR	AO A - action  O - Open the door
WHAT’S YOUR NAME	QW Q- question W- what’s your name

Minspeak or Semantic Compaction

• Iconic Encoding/Unity/Lamp

• A popular encoding technique that includes iconic codes, specifically combinations of symbols (line drawings)

Prediction

• involves a dynamic retrieval process in which options are offered to an individual with complex communication needs according to the portion of a word or message that has already been formulated.

  • E.g., typing the word “ca”, the device can already predict “cat”

Language Prediction

• Message construction can be supported using statistical and syntactic knowledge of written language to predict (anticipate) the next character/word/phrase.

Word Prediction

• predicted words can be listed below the cursor, or can be displayed in a window above the keyboards

Message Prediction

• Storing whole phrases, sentences, and paragraphs in AAC systems, which can be made available to the person using prediction based on context-appropriate prediction and rules of pragmatics or by structuring the content appropriately…