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Areas Covered


A communication mode used as a supplement to or as an alternative to oral language. AAC includes gestures, sign language, picture symbols, the alphabet, and computers with synthetic speech. AAC modes can be low-tech or high tech depending on the unique needs of each client.

Augmentative and alternative communication (AAC) includes all forms of communication (other than oral speech) that are used to express thoughts, needs, wants, and ideas. We all use AAC when we make facial expressions or gestures, use symbols or pictures, or write.

People with severe speech or language problems rely on AAC to supplement existing speech or replace speech that is not functional. Special augmentative aids, such as picture and symbol communication boards and electronic devices, are available to help people express themselves. This may increase social interaction, school performance, and feelings of self-worth.

AAC users should not stop using speech if they are able to do so. The AAC aids and devices are used to enhance their communication.

What are the types of AAC systems?

When children or adults cannot use speech to communicate effectively in all situations, there are options.

Unaided communication systems – rely on the user’s body to convey messages. Examples include gestures, body language, and/or sign language.

Aided communication systems – require the use of tools or equipment in addition to the user’s body. Aided communication methods can range from paper and pencil to communication books or boards to devices that produce voice output (speech generating devices or SGD’s)and/or written output. Electronic communication aids allow the user to use picture symbols, letters, and/or words and phrases to create messages. Some devices can be programmed to produce different spoken languages.


An impairment in the comprehension and expression of language resulting from localized damage to the brain, typically following a stroke. Aphasia may affect reading, writing, speaking, understanding and gestures.


A disorder resulting from impaired auditory perception. CAPD is characterized by difficulty processing, discriminating, memorizing, and/or attending to auditory information.

Cognitive Retraining

Cognition refers to thinking, reasoning, and perceptual abilities. Cognitive retraining includes the restoration of cognitive skills and the implementation of strategies to compensate for the impaired ability. Important cognitive skills include attention, concentration, memory, organization, judgment and problem solving. Therapists utilize functional daily living activities to restore these skills. Strategies, using the clients’ areas of strength, are designed to compensate for weaker skill areas.


A disorder characterized with difficulties in any of the 3 stages of swallowing. The goal of treatment is to reduce aspiration, improve the client’s ability to eat and swallow, and to optimize nutritional status.

Hearing Impairment

A hearing impairment is abnormal or reduced hearing sensitivity, including conductive and sensorineural losses. Aural habilitation aims to minimize communication difficulties associated with hearing loss. This process may include amplification, counseling, communication strategies training, speech perception training, family instruction and speech and language therapy. Speech Language Pathologists work closely with Audiologists to ensure an appropriate program for clients with a hearing impairment.


Language is a system of arbitrary sounds, gestures, or marks used by a community to communicate ideas and feelings. This system includes receptive language (understanding) and expressive language (use). Language is composed of phonology, semantics, morphology, syntax and pragmatics.

  •  Phonology: The speech sound system of a language, including the rules for combining sounds. An individual with a phonological processing disorder may substitute, omit or add sounds in words. These atypical sound patterns may decrease speech intelligibility at the word, phrase, sentence and/or conversation level. Academically, a student may not be able to participate in classroom discussions, answer questions verbally or volunteer answers do to limited intelligibility.
  • Semantics: The study of meaning, including the surface and underlying meaning of language. Semantics includes concepts such as vocabulary terms, categories, word associations (antonyms, synonyms, etc), salient features, and inferences. Academically, a deficit in semantics could interfere with understanding directions, responding appropriately to questions, reading comprehension and the development of appropriate descriptive language (oral and written).
  • Morphology: The units of meaning that make up the grammar of a language. These units refer to the meaningful details signaled by suffixes and prefixes (e.g., plurals, possessives, comparatives, verb tenses) in words. Academically, deficits in morphology can limit the understanding and expression of these meaningful details (e.g., understanding the difference between “dog” and “dogs”). Oral and written language is often reduced to major content words, lacking modifiers and contained to present tense. Difficulties with changing word forms in spelling and language arts would be apparent.
  • Syntax: The rules governing the arrangement of language units (words) in sentences and of sentences in narratives. Academically, a disorder of syntax could cause difficulties in reading comprehension, and understanding and responding appropriately to questions and directions. The understanding and expression of meaning changes signaled by varying word order would be disturbed; particularly in complex sentences including clauses or inverted questions. Oral and written language patterns could be limited to a few simple sentence patterns.
  • Pragmatics: The study of language use and the contexts (social situations) in which they are performed. Pragmatic deficits, while usually considered most handicapping socially, may also affect academic performance. In the classroom, a student may not demonstrate what he knows if he cannot volunteer to respond, answer appropriately or stay on topic. He will also have trouble learning if his listening behavior is poor, he fails to ask for additional information, or he constantly interrupts. In social situations, his verbal and nonverbal behavior is reflected in his ability to take turns, put himself in another’s place (perspective taking), use polite conventions and communicate differently with adults and peers.

A language disorder is characterized by impaired comprehension and/or expression of spoken, written, or other symbol systems, involving phonology, semantics, morphology, syntax, and/or pragmatics in any combination.

Social Skills

Pragmatics is the use of language in social situations. Social interaction requires a set of highly complex skills and is often difficult for children with Autism and/or language Disorders to acquire. Expressions social skills groups teach essential social skills through a structured atmosphere and facilitates the understanding of when and how to use these social skills in “real world” environments. The social skills groups are part of a treatment program that provides our clients with intensive training, experience, and practice in developing and maintaining peer relationships and self-esteem. Skills addressed in social skills groups include:

Communication Related:

  • Listening/Distractions
  • Non-Verbal
  • Body Proximity
  • Rules of Conversation
  • Following and giving directions
  • Asking questions and making comments
  • Problem solving

Play Related:

  • Turn taking
  • Cooperative Play
  • Rules of Games
  • Sportsmanship
  • Manners
  • Negotiating

Emotion Related:

  • Self-Regulation
  • Perspective Taking
  • Humor
  • Tone of voice

Speech Disorders

  • Articulation: Articulation is the ability to use the speech mechanism in order to produce speech sounds appropriately. An articulation disorder is characterized by atypical production of speech sounds (distortions) that may interfere with a person’s intelligibility.
  • Fluency: A disorder of fluency affects the flow of speaking characterized by atypical rate, rhythm, and repetitions in sounds, syllables, words and phrases. This may be accompanied by excessive tension and/or struggle behavior. Disorders of fluency include stuttering and cluttering.
  • Voice: A disorder of voice is characterized by the abnormal production and/or absences of vocal quality, pitch, loudness, resonance, and/or duration, which is inappropriate for an individual’s age and/or sex.