Many neurodevelopmental disorders interfere with how children develop their communication skills through speech. There are also children who never speak or who do so with limitations. Supporting children with these difficulties to ensure their inclusion and social participation is one of the skills of speech therapy. These professionals work with children and their families so that, through alternatives to speech, children can establish an effective form of communication. In most situations speech therapy professionals are the starting point for the introduction of communication systems, and it is through these that families learn about the different types of systems and their functions. The goal is to reduce the frustration and behavioral changes that can be triggered by children not being understood by the people they want to communicate with. Assistive Communication Technologies Augmentative and alternative communication (AAC) systems are a set of tools and strategies that help make communication of a child (and also adult) more effective and functional. Augmentative communication complements, but does not replace other forms of communication; Alternative communication uses methods, modes, or strategies to replace a form of communication. There are several types of augmentative and alternative communication systems, and their use should be adapted to each child and need . They can be divided into low-tech and high-tech systems. Low-tech systems Low-tech systems can be, for example: Communication boards, books, or charts with symbols, images, or written words; Cards with symbols, images, or written words; Gestures. These systems do not need or resort to electronic devices for communication. They are frequently used in clinical practice as therapeutic intervention tools, as a bridge to promoting linguistic skills in children , including: Vocabulary expansion; Sentence organization; Understanding instructions; Task planning; Facilitating interaction with communication partners; Emotional or behavioral regulation. High-tech systems High-tech systems use electronic or digital devices to facilitate communication. These include, for example, tablets with communication applications/software (which include symbols, images, or written words), voice communicators, or eye-controlled systems. How to choose the most appropriate communication system The choice of the most appropriate communication system for each child is made by the healthcare team, the child, and their family, taking into account the specificities of their case. To optimize the functionality of augmentative and alternative communication, the following should be considered: Taking into account the child's needs in different contexts; Training parents, educators/teachers, and other communication partners in the use of the system; The ease of integrating the system into daily life; Positive reinforcement of attempts at interaction through the augmentative and alternative communication system; Time given to the child to become familiar with and use the new way of communicating; Frequency and use of the system in various life contexts; Not having fears about the implementation and experimentation of the system, even when the child has not yet acquired all the learning of it. It is important to know: Augmentative and alternative communication systems do not delay speech. On the contrary, they help children express their needs when: They do not yet have the vocabulary to do so or cannot produce it; They have difficulty coordinating different skills simultaneously; They do not have sufficiently developed/integrated linguistic structures. Author: Marta Martins and Speech Therapy team at the Center for Neurodevelopment and Behavior of Children and Adolescents The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
