But They Can Talk... Why Do They Need AAC?
- Caitlin Burke
- Jul 2
- 3 min read
One of the many things speech-language pathologists can help with is augmentative and alternative communication or AAC. Sometimes, we get stuck on only considering AAC for nonspeaking or minimally speaking individuals. These cases are pretty clear. If someone cannot speak or can only say a handful of words, they obviously need a communication system as an alternative to speech. But what about using an AAC system part-time to augment speech? This scenario is frequently not considered. I mean, why would someone need AAC if we’ve seen them talk, right? Before we dive further into this idea, we need to review some concepts.
A Continuum of Speech
Nonspeaking: does not communicate with spoken words
Minimally speaking: has a very limited number of spoken words or short phrases
Unreliably speaking: may say things that do not match their intended meaning
Intermittent speaking: can use spoken language sometimes, but not always
Insufficient speaking: is not able to use spoken language to fully/completely meet communication needs
Nonspeaking and minimally speaking individuals are often the ones speech-language pathologists (and other stakeholders) advocate on behalf of for access to AAC. The need for AAC is less obvious and may even be dismissed completely for unreliably, intermittent, and/or insufficient speakers. However, the Spoon Theory metaphor may explain why these individuals could benefit from additional communication supports and strategies.
Spoon Theory
Unreliable, intermittent, and insufficient speakers are often autistic. We also know that autistic individuals tend to have sensory, motor, social, and emotional regulation differences, all of which can negatively impact communication. Autistic individuals have used the Spoon Theory metaphor, created by Christine Miserandino, to describe their limited daily energy reserves. Let’s quickly review Spoon Theory before circling back to how part-time AAC can help!
Spoon Theory Concepts:
One spoon equals one unit of energy
Daily tasks cost spoons (e.g., getting dressed may cost less spoons than socializing)
Each person begins their day with a fixed number of spoons
Autistic individuals start their day with less spoons than neurotypicals
Once you run out of spoons, you can attempt to “push through” and “borrow” spoons from tomorrow, but this leads to burnout and the need for recovery time
Rest, pacing, and preserving spoons is crucial for autistic individuals
An autistic individual who is an unreliable, intermittent, and/or insufficient speaker, can use AAC when they are low on energy, out of energy, or trying to preserve energy for other daily tasks that require high levels of executive functioning.
Reasons to Consider Part-Time AAC Use
Let’s face it – socializing and communicating are hard for autistic individuals – they cost spoons. Constructing sentences on the fly during fast paced conversations while also navigating social nuances… not easy!
Common features of AAC, including word and sentence prediction, picture symbols, motor planning principles, and the ability to prestore lengthy messages, can support the preservation of energy. An autistic individual may choose to use AAC in situations that typically take a lot of energy, such as giving a class presentation or ordering at a restaurant.
Part-time AAC use could also help during (but most likely after) moments of stress, sensory overload, or meltdowns, in addition to giving the individual the option to expand upon or clarify spoken language where other modes are communication (e.g., gestures, facial expressions) would not suffice.
Remember, communication isn’t functional unless the individual is able to express their thoughts. Only the individual knows whether or not there is a mismatch between their communication and their thoughts and they should be presented with the option to use AAC.
Resources & References
corbin, endever* & Donaldson, Amy. (2023, Jan 19). "ASHA Voices: Why Some Autistic People Choose AAC and Oral Speech." The ASHA Leader. ASHA Wire. https://leader.pubs.asha.org/do/10.1044/2023-0119-podcast-autism-AAC-choice/full/
Hillary Zisk, A. & Dalton, E. (2019, Apr 13). “Augmentative and Alternative Communication for Speaking Autistic Adults: Overview and Recommendations.” Autism in Adulthood, 1(2), 93-100. https://www.liebertpub.com/doi/10.1089/aut.2018.0007
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