What could promote autonomy more than giving someone a voice?

The importance of communication and Augmentative and Alternative Communication

What could promote autonomy more than giving someone a voice?

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Communication is central to most of our occupations, as well as being an occupation in its own right. We make jokes, ask questions, tell a carer the water in the shower is too cold, have conversations with friends, choose what shoes to wear, talk about what we did on the weekend and ask to listen to a specific song. But we don’t tend to think about how central communication is unless there’s a communication breakdown.

We all communicate in a variety of ways. We might use our voice, point at things, write things down and use our facial expressions and gestures.

What is Augmentative and Alternative Communication (AAC)?

For people who aren’t able to use their voice consistently and reliably, there are many ways to augment or replace verbal communication. This is typically referred to as Augmentative and Alternative Communication (AAC).

AAC can take many forms – examples include an alphabet chart, symbol chart, communication book or apps and devices that speak aloud.

People who use, or could benefit from, AAC need people around them who feel comfortable with AAC and how they communicate.

Our role

As OTs, we need to ask ourselves:

• do we have the skills we need to be a good communication partner?
• do we know how our clients say yes and no, and the communication tools they use?
• are we considering how we could integrate their AAC (or any AAC) into our OT sessions?
• are we considering communication as part of our holistic assessment?

Some of the most meaningful changes I make are with a laminated piece of paper and a qwerty keyboard.

While Augmentative and Alternative Communication squarely fits within Speech and Language Therapy, and their skillset is invaluable, there is a considerable role for OT within AAC and communication.

In the same way we work alongside our physiotherapy colleagues to look at walking and transfers, our nursing colleagues to look at pressure care and our social work colleagues to look at care packages (among many other examples) – we can also work alongside our Speech and Language Therapy colleagues to look at communication.

This might mean exploring ways to access communication if pointing is difficult, modelling AAC within our sessions and giving clients time to use their AAC system rather than deferring questions to family or carers.

Meaningful changes

Before moving into a specialist AAC role, I couldn’t have told you what AAC stood for. And I certainly wasn’t considering communication as often as I should have. Whereas now, some of the most meaningful changes I make are with a laminated piece of paper and a qwerty keyboard, asking how someone says yes/no, being comfortable with saying ‘sorry I didn’t understand that’ and just giving people the time and space to communicate.