AAC
ANNOTATION
Md. Asaduzzaman
Assistant Professor of Audiology and Speech-Language Pathology
PISER, Dhaka Cantonment, Dhaka-1206
Core Vocabulary vs. Fringe Vocabulary
• Core Vocabulary: A set of high-frequency, everyday
words that appear in most conversations. They are
the “building blocks” of language.
• Examples include pronouns, common verbs, articles,
and prepositions such as “I,” “you,” “want,” “more,”
“help,” etc. These words are used across many
contexts and make up roughly 75-80% of daily
communication.
Core Vocabulary vs. Fringe Vocabulary
• Fringe Vocabulary: A collection of more specific words
that are used less frequently and usually relate to
particular topics, interests, or situations.
• Examples include words like “giraffe,” “spaceship,” or
“ballet.” Although important for detailed
communication, fringe words are more situational
because they add the extra “flavor” or specificity to
language.
Core Vocabulary vs. Fringe Vocabulary
Aspect Core Vocabulary Fringe Vocabulary
High (75–80% of everyday Low (only used in
Frequency
words) specific contexts)
Can form whole sentences on Often used alongside
Usage
their own core words for detail
dinosaur, museum,
Examples I, you, want, more, help
ballet, spaceship
Often less concrete (e.g., Easier to visualize
Picturability
“want”) (e.g., “giraffe”)
AAC for Multilingual Users
AAC for Multilingual Users
• Augmentative and Alternative Communication
(AAC) systems for multilingual users are designed
to support individuals who communicate in more
than one language.
• These systems allow for seamless switching
between languages, include vocabulary sets and
voices appropriate for each language, and adjust
display settings (e.g., interface language) for the
user's linguistic needs.
AAC for Multilingual Users
• Example: Imagine a bilingual child who speaks
both English and Spanish. An AAC app (such as
Proloquo4Text) can detect whether the child is
typing in English or Spanish and automatically
select the correct voice output and vocabulary
bank. In one classroom the system might display
“hello” and, in another with family, it might
switch to “hola” without additional setup.
Evidence-Based Practice in AAC
• Evidence-based practice (EBP) in AAC means
using intervention strategies and technologies
supported by scientific research combined with
clinical expertise and informed by the user’s (and
family’s) preferences. The goal is to make
decisions that lead to the most effective
communication outcomes.
Evidence-Based Practice in AAC
Evidence-Based Practice in AAC: Key Points
• Research Evidence: Interventions, like training in
core vocabulary or device selection, are chosen
because studies have shown they can reduce
communication frustration and improve language
skills.
• Clinical Expertise: Speech-language pathologists use
their hands-on experience to tailor AAC strategies to
individual needs.
• Client and Family Input: The preferences, lifestyle,
and cultural background of the user direct how and
which AAC strategies are applied.
Evidence-Based Practice in AAC: Key Points
• Example: A clinician may choose a particular
speech-generating device because meta-analyses
and clinical trials have demonstrated it improves
message formulation speed. The decision is then
discussed with the client’s family to ensure it fits
with daily routines.
Speech-Generating Devices (SGDs)
• Speech-generating devices (SGDs), also known as
voice output communication aids, are electronic
AAC tools that produce auditory output. They
convert text or symbols into speech so users with
limited natural speech can “talk” using the
device.
Speech-Generating Devices (SGDs)
AT VS. AAC VS. SGDs
Speech-Generating Devices (SGDs): Examples
• Touchscreen SGDs: Devices like tablets or
dedicated communication systems where the
user taps on icons to form messages.
• Customizable Voices: Some SGDs offer pre-
recorded phrases or synthesized speech options,
allowing users (or their families) to choose a
voice that suits their age and personality.
Speech-Generating Devices (SGDs): Examples
• Real-World Use: Famous users such as
Stephen Hawking relied on SGDs to
communicate complex thoughts
through technology.
Eye-Gaze Access in AAC
Eye-gaze access is a method that uses a user’s eye
movements to control an AAC device. This feature is
particularly useful for individuals with motor
impairments who cannot always use their hands.
Eye-Gaze Access in AAC: How It Works
• An infrared camera or sensor tracks the movement of
the user’s eyes.
• By fixating on a symbol for a set period (dwell time),
the device “selects” that item.
• The system then either speaks the corresponding
word or expands to a new page of vocabulary.
• Example: A child who can’t use a touchscreen due to
limited motor control might use eye-gaze. By looking
at the picture of a “ball,” after a short dwell, the
device speaks “ball,” helping the child communicate
without needing physical contact.
Eye-Gaze Access in AAC: How It Works
Static vs. Dynamic AAC Displays
• Static Displays: These are fixed communication boards
(often printed or non-electronic) where symbols do not
change. They provide a constant set of vocabulary and are
typically arranged in grids. Example: A printed picture
board with buttons or icons for “eat,” “drink,” and “play.”
• Dynamic Displays: These are electronic interfaces
(typically on tablets or dedicated devices) that change
based on user input. They may show different pages or
levels of vocabulary as needed. Example: An app on a
tablet that first shows general categories (food, activities)
and then, when “food” is tapped, shows a variety of food
icons.
Static vs. Dynamic AAC Displays
Feature Static Displays Dynamic Displays
Interactive; change with user
Nature Fixed (do not change)
input
Limited set, always Extensive, organized in layers
Vocabulary
visible or pages
Often used in low-tech
Found in modern electronic
Usage or print-based AAC
SGD systems
systems
Tablet-based communication
Example Printed AAC board
app
Static AAC Displays
Dynamic AAC Displays
Pragmatic Competence in AAC Users
Pragmatic Competence in AAC Users
• Pragmatic competence is the ability to use language
effectively in social contexts. For AAC users, it is about
knowing how and when to use their device in different
situations (e.g., turn-taking in conversation, adjusting
language style for different partners).
Pragmatic Competence in AAC Users: Key Aspects
• Sociolinguistic Skills: Understanding social rules such as
politeness and appropriate topics.
• Conversational Skills: Skills like initiating conversation,
topic maintenance, and repair strategies.
• Adaptation: Adjusting messages based on context (e.g.,
using a different greeting with a teacher versus a friend).
• Example: An AAC user might be taught to use a “please” or
“thank you” icon when making requests, or to signal when
they want to contribute during a conversation. Tools such
as The Pragmatics Profile help clinicians assess and build
these skills.
AAC and Cognitive Load
AAC and Cognitive Load
• Cognitive load in AAC refers to the amount of mental
effort required to navigate and use the communication
system. High cognitive load can slow down communication
and increase frustration, whereas systems designed to
reduce load help users focus on messages.
AAC and Cognitive Load:
Strategies to Reduce Cognitive Load
• Simplify Displays: Use a limited number of icons per page
(often emphasizing core vocabulary) to avoid
overwhelming the user.
• Organize Vocabulary: Group symbols into familiar
categories so that related items are easy to find.
• Consistent Layouts: Keeping the layout and symbol
placement consistent across sessions minimizes the
amount of mental “searching” the user must do.
• Example: If an AAC device shows 20 icons on every screen,
a user might struggle to quickly select the right one. By
reducing the number of icons to 6-8 per page and grouping
them (e.g., food items in one group), the effort (or
cognitive load) is lessened.
Iconicity in AAC Symbols
• Iconicity refers to how closely a symbol resembles (or
visually represents) the object or concept it stands for.
Symbols with high iconicity look very much like what they
represent, making them easier to guess or learn, especially
for early learners and emerging communicators.
Iconicity in AAC Symbols
Iconicity in AAC Symbols: Examples
• High Iconicity: A clear line drawing of a dog that
unmistakably represents “dog.”
• Low Iconicity: An abstract symbol or even a word (e.g.,
“dog” in text) where the connection isn’t visually obvious.
• Why It Matters: High-iconicity symbols can facilitate faster
learning and easier communication for users new to AAC,
while over time-once a user is more experienced-systems
may also include less iconic (more abstract) symbols to
save screen space or improve efficiency.
AAC for Hearing Impairment
• AAC for individuals with hearing impairments is adapted to
support people who may have difficulty perceiving spoken
language. These systems rely more on visual symbols, text,
sign language, and other non-auditory cues to facilitate
communication.
AAC for Hearing Impairment
AAC for Hearing Impairment
AAC for Hearing Impairment: Key Elements
• Visual Supports: Picture boards, written text, and captions are
common.
• Multimodal Communication: Combining visual signs with
technology (such as apps that convert text to speech) to
enhance understanding.
• Customization: The system may include settings or features
tailored to the specific needs of a person who is deaf or has
hearing loss.
• Example: A teenager with hearing impairment might use an AAC
app on a tablet that provides highly visual support (large, clear
icons and text) and also integrates sign language videos. In
classrooms or medical settings, these devices ensure the user
can participate fully even in environments that are not
acoustically ideal.
AAC and Natural Speech
• In AAC studies, researchers often limit the scope to how AAC supports
or complements natural speech rather than replaces it.
• Example: A study may exclude participants with degenerative
conditions like ALS who are entirely non-verbal and instead
focus only on children with developmental delays who may
develop natural speech over time with AAC support.
• Reason for Delimitation: To study how AAC acts as a bridge to
speech, not as a permanent alternative.
Inner Language Development in AAC Users
• Studies might only examine external communication
behaviors (e.g., symbol selection, vocabulary use) and not
assess internal or mental language processes such as
thought formulation or silent self-talk.
• Example: A research project evaluating AAC interventions
may not explore how users think or process language
internally, due to challenges in measuring cognitive-
linguistic development in non-verbal populations.
• Reason for Delimitation: Inner language is difficult to
observe directly and may require neuroimaging or
longitudinal qualitative tools, which are outside the study's
scope.
Synthesized Speech
Synthesized Speech
• Synthesised speech is artificially generated speech produced by a computer or
electronic device instead of a human voice. It is a key feature of many
Augmentative and Alternative Communication (AAC) systems and text-to-
speech (TTS) [Link] speech converts text or symbols into
spoken words using a speech synthesis engine. It allows individuals who
cannot speak to communicate effectively.
• Researchers may limit their focus to text-to-speech (TTS) devices that use
English-only synthesized voices, excluding bilingual or naturalistic voice
cloning technologies.
• Example: A study on AAC user satisfaction with synthesized speech may not
include devices offering natural-sounding voice banks or emotionally
expressive output, focusing only on standard robotic voices.
• Reason for Delimitation: To maintain consistency in evaluation and limit the
number of variables (e.g., language, voice quality, prosody).
Synthesized Speech: How It Works
• Input: The user types text or selects symbols/pictures.
• Processing: The speech synthesis software interprets the input.
• Output: The software produces artificial human-like speech through a speaker
or headset.
Suggested Reading
• [Link]
autism/
• [Link]
• [Link]