Augmentative and Alternative Communication Systems (AAC) are forms of expression.

different from spoken language. which aim to increase (augmentative) and/or compensate
(alternative) the communication difficulties and the language of many people with difficulties in
this area.

Communication and language are essential for every human being to relate to others.
others, to learn, to enjoy, and to participate in society and today, thanks to these
systems should not be hindered by difficulties in oral language. For this reason,
all people, whether children, youth, adults, or the elderly, who for any reason have not
acquired or lost a sufficient level of speech to communicate satisfactorily,
They need to use a AAC.

Among the causes that may make the use of an AAC necessary, we find cerebral palsy.
(PC), intellectual disability, autism spectrum disorders (ASD), diseases
neurological conditions such as amyotrophic lateral sclerosis (ALS), multiple sclerosis (MS), or the
Parkinson's disease, muscular dystrophies, craniocerebral trauma, aphasias or the
diverse types of multiple disabilities, among many others.
Augmentative and Alternative Communication Systems (AAC) is not incompatible but
complementary to the rehabilitation of natural speech, and can also aid in its success
when this is possible. One should not hesitate to introduce it at an early age, as soon as
difficulties are observed in the development of oral language, or shortly after any
accident or illness has caused their deterioration. There is no evidence that the use of
CAA inhibits or interferes with the development or recovery of speech.

What resources are used?

Augmentative and Alternative Communication includes various symbol systems, both graphic
(photographs, drawings, pictograms, words or letters) as gestural (miming, gestures or signs)
manuals) and, in the case of the first, it also requires the use of support products. The various
symbol systems adapt to the needs of people with different ages and motor skills,
very disparate cognitive and linguistic (abilities).

Support products for communication include technological resources, such as

artificial speech communicators or personal computers and tablets with special programs,
that allow different forms of access adapted some for people with very limited mobility
reduced, and they also facilitate the incorporation of different pictographic sign systems and
spelling, as well as different output forms including voice output. They can also
to consist of non-technological resources, such as boards and communication books.
To access computers, communicators, boards, or communication books there are various
strategies and instruments generically referred to as strategies and support products for the
access, such as pointers, adapted or virtual keyboards and mice, or switches.

Symbol systems

In previous lines, we have divided the symbol systems for AAC into gestural and graphic.
In both cases, we find a gradation from very simple systems that adapt to people.
with cognitive and linguistic deficits of various degrees, up to complex systems that
allow advanced levels of sign language (based on manual signs) or assisted (based on
graphic signs).

In the case of gestural symbols, this gradation ranges from the use of miming and gestures for use
common up to the use of manual signs, generally in the order corresponding to the language
spoken; it is what is called signed language or bimodal. The sign languages used by the
non-hearing individuals are not considered AAC, as they constitute languages that have developed and
they are acquired naturally, just as happens with spoken language. The use of signs
manuals require sufficient motor skills, such as may be the case of
people with intellectual disabilities or Autism Spectrum Disorder.
Graphic symbols range from very simple systems based on drawings or photographs to
progressively more complex systems such as pictographic systems or traditional spelling
(letters, words, and phrases). Thanks to the communication support products and the various
resources for access, graphic systems can be used by people with mobility
reduced, even in cases of extreme severity. For this reason, in addition to being used, as in the case
previously, it is used by people with intellectual disabilities or ASD, it is also used by people with
motor disabilities (CP, ALS, MS, etc.).

Pictographic systems are applied to people who are illiterate due to age or the
disability. They have the advantage of allowing from a very basic level of communication, that it
adapted for people with low cognitive levels or in very early stages, up to a level of
very rich and advanced communication, although never as complete and flexible as the one that can be
achieve with the use of written language. The most used pictographic systems in the various
territories of the Spanish state are the SPC system (Pictographic Communication System) and the system

Support products for communication

We can divide communication support products into basic and technological. The boards
Communication supports are basic support products that consist of surfaces made of materials
various in which graphical symbols are arranged for communication (photographs,
pictograms, letters, words, and/or phrases) that the person will indicate to communicate. When the
symbols are distributed across several pages we talk about communication books.

Among the technological products, we find electronic communicators especially

designed for that purpose and the laptops or tablets with special programs that
they turn into communicators. Dedicated or emulated electronic communicators in
computers are customized with the graphic symbols required by each person and are characterized
because they are portable and adapt to the appropriate access methods for each person (keyboards,
mice, switches, etc.). They have an output for messages in the form of speech
digitized or synthesized, as well as often from other outputs such as screen, paper
printed or even environmental control functions. For example, on the website [Link] there
You can find various versions of an organized pictographic vocabulary (CACE-UTAC),
made with different communication programs, and prepared to be customized and used
directly on personal computers (which thus become communicators), as well as
to be printed and to build communication books.
Support products for communication

To indicate the graphic symbols in communicators, boards, and communication books, there are
five fundamental strategies, namely:

o Direct selection: consists of pointing or pressing the keys directly with the finger,
the gaze or with other parts of the body, to indicate the pictograms, words or letters
that want to communicate. Pointers of different types are examples of products of
support that can facilitate selection or direct access.
o Mouse selection: only for electronic products, it involves accessing with a
mouse to keyboards or grids with symbols for on-screen communication. It can be
use a wide variety of adaptive mice, in the form of joystick, trackball, as well as
the facial mouse (controlled by head movements), the mouse controlled by the
look or the multimouse, consisting of five keys or switches.
o Dependent exploration or scanning: only in boards or books, it consists of the fact that the
the interlocutor should point out, one by one or in groups, rows and columns, the symbols or
letters to communicate, until the assisted speaker indicates with a gesture that it has been given
with whom I wanted to communicate.
o Independent exploration or scanning: only for electronic products, in this
It is the communicator or device that presents the different options to communicate.
until the assisted speaker selects the one that suits them by pressing a switch.
There are many types of switches that can be activated with different parts of the
body.
o Encoded selection: in this case, each symbol or letter has a code, for example, a
a number of two or three digits or a color and a number, so that the assisted speaker
indicate directly or by sweeping this code to transmit the symbol or letter. From
this form with few keys or boxes can access a large number of symbols.

Thanks to the different strategies and support products for access, no matter how restricted it is
find a person's mobility, it is almost always possible to find a solution so that
can access communication, as well as other activities, such as assisted mobility, the
control of the environment or access to the computer for writing, drawing, gaming, or communication
through the network.

How can we promote the success of the intervention with AAC?

The systems and support products for the CAA are only a means or a necessary condition.
so that the person with speech disabilities can communicate, develop their abilities and
to participate in the world around her, but they are never enough. What is truly
the process of education, training, and guidance that must accompany them is important.
The intervention process must start with an assessment of the capacities, skills,
needs and desires of the person, as well as the characteristics, supports, demands and
environmental restrictions, in order to define the components that the system will have or
systems that will be most suitable. It will be necessary to select with great care the
support products, as well as access strategies, and for non-reading AAC users, there will be
to make a good selection of the signed or pictographic vocabulary that will be taught.
This evaluation process should not be occasional but continuous throughout life.

The training and teaching must focus on both the person and their environment, including
all the contexts in which they participate or wish to participate, as well as all the significant people
of these contexts, including professional and, above all, family, colleagues, and friends. This
teaching must take place in educational and therapeutic environments, but also in environments
natural environment, in a 24-hour approach that ensures the person will be immersed in a good
language environment, surrounded by sensitive and competent interlocutors, and involved in
interesting and enriching activities.

To promote the success of the intervention with AAC, the most important thing is to ensure that the person
If you have a speech disability, have interesting things to communicate to others, know how to do it.
and have listeners who want to hear you and know how to understand you. This objective should not
to leave it in the hands of chance, but it must be achieved through effort and success
competent professionals, supported by an increasingly aware and free society
prejudices.

In recent years, due to the increasing number of people diagnosed with the disorder of
autistic spectrum individuals who do not possess verbal communication skills the families foundation in
Support for individuals with autism spectrum disorder called Blue Hope wishes to develop
an AAC (Augmentative and Alternative Communication system) that fits the idiosyncrasy of
our Nicaraguan culture, since currently the existing systems were developed in
Other countries have cultural differences that are difficult for people with autism to apply.
our country, and they were also created in the 70s, more than 50 years ago.

Below is a list of alternative augmentative communication systems for the

people with autism that are currently used in Nicaragua.

PECS
The Image Exchange Communication System (Lori Frost and Andrew S. Bondy, 1985) was
developed as a unique, augmentative and alternative teaching system that teaches the
individuals with ASD and other communication deficits to begin verbal communication,
it can also be used from an early age. PECS does not require complex materials nor
Dear, it was created by educators keeping families in mind, so it is prepared
to be used in a variety of situational contexts. Its basic principle is to obtain objects
Highly motivating events, this implies that motivation is the driving force of communication.
For this reason, the first step is to define in cooperation with the parents the motivator of the
person with ASD (food, object, or activity). The PECS is easy to apply and does not require
imitation, eye contact, facial orientation or motor skills that are not present in the
repertoire of the person. The goals of PECS are aimed at teaching the child:

• To start communication spontaneously

• Directing your communication to people

• Clear communication, with defined gestures and a specific number of images.

There is a virtual application of this communication system.

Unable to access external content such as YouTube links.

One of the most supportive tools currently for people with autism who are non
Verbales is the portal CentroAragonés for Augmentative and Alternative Communication. In this
portal
LetMeTalk is a free communicator for Android and iOS that provides voice and support for communication.
in any area of a person's life.

LetMeTalk allows you to select images and build a sentence that can later be read.
using the synthesized voice of the device. The selection of vocabulary may respond to
a PECS system (Picture Exchange Communication System) or a more traditional one
AAC (Augmentative and Alternative Communication).

The application contains more than 9000 [Link] their database. In addition to the
9000 default pictograms installed in the application can have stored images added.
on the device or insert photos using the device's camera.

AraBoard is a set of tools designed for alternative communication and

augmentative, whose purpose is to facilitate functional communication, through the use of images and
pictograms, to people who present some type of difficulty in this area. Given the versatility
Among these tools, AraBoard can also be used to create boards with routines.
simple and boards to anticipate the completion of any planned task.

AraBoard allows us to create, edit, and use communication boards for different devices.
(computer, smartphone or tablet), as well as for different operating systems.

Pictotranslatorit is a project developed to facilitate communication with people who have

difficulties in expression through oral language and communicate more efficiently
through images.
Designed as a useful tool for parents and professionals to be able to communicate,
any place easily and without wasting large amounts of time organizing what is wanted
transmit.

It has the appeal to adults, if they register in the application, of being able to customize the images.
with personal pictograms. Such pictograms will only be seen under your personal user and not by
the rest of the users of the application.

Another advantage of being a registered user is that you can save your phrases whenever you want.
favorite them in your user space so that you can use them later whenever you want, without having to
reassemble the sentence again.

You can also print the phrases with pictograms that you want or easily share them in the
social networks or by email. We have kept in mind at all times while developing the application,
to achieve an intuitive and easy-to-use tool, and we believe we have succeeded.

Pictotraductor uses the pictograms from ARASAAC by default.

Website

[Link]

DictaPictoit's an app that allows you to convert a voice or written message into images.
immediate. Designed to help people with autism or those who use systems
pictograms to improve their communication, their aim is to enhance access to information and
facilitate the understanding of the environment regardless of the people surrounding the person
with AAC, get to know these augmentative and alternative communication systems.

The translation from voice to pictograms occurs automatically from a spoken phrase.
of the user; initially converting it into text and, from there, into the pictograms/images that
they represent the words.
Implement ARASAAC pictograms.

Project page:

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In Nicaragua, non-verbal individuals with autism lack alternative means of communication.

augmentatives that allow them to communicate with other people through information technologies
modern ones, such as the use of cell phones, tablets, or computers. But there is also a limitation
larger lacks systems that allow these people to learn how to use these AACs and
of professionals who are willing to teach them