I appreciate the opportunity to visit schools on a regular basis. In fact, as I write this to you, I have been to 12 schools in the last 2 weeks. As the State Director of Special Education, I ask for the opportunity to see the students with the most severe disabilities in every school I visit, whether such students are in inclusive or self-contained settings. While at times I see students' communication needs being addressed, this is not always the case, and sometimes I see students with limited oral communication skills with insufficient access to augmentative and alternative communication methods (AAC). To bring more consistency to the use of AAC statewide, DESE is offering the accompanying memo and student case studies to provide guidance on this important topic.
AAC is a type of assistive technology that can assist students with disabilities that impede their ability to communicate. The attached memo is intended to provide guidance on when a referral for AAC may be appropriate; explain how AAC may help students with disabilities to enhance their communication skills and reach their full potential; reference applicable laws and best practices; and direct IEP Teams and other relevant parties to additional AAC resources.
Thank you for your efforts to support the communication needs of our students with disabilities. If you have questions about this memo, please contact the Office of Special Education Planning and Policy.
Augmentative and alternative communication (AAC) is a form of assistive technology that can help students with disabilities that impede their ability to communicate to meet their education goals and participate fully alongside their nondisabled peers in all aspects of their education. This memo is a reminder to IEP Team members and other district staff to consider how AAC may be used, consistent with law and best practices, to serve students with disabilities who are unable to communicate effectively using oral speech. As explained more fully below, districts should be prepared to promptly refer such students for an AAC evaluation; ensure the provision of AAC aids, devices, and services appropriate to the students' needs; and arrange for students, family members, relevant school staff, or others substantially involved in the major life functions of the child to receive AAC training, if needed.
Augmentative and alternative communication (AAC) refers generally to methods of communication that enhance (augment) or replace natural speech and other conventional forms of expressive and receptive communication. AAC includes communication devices and aids as well as services that support the use of AAC. It includes speech-generating devices and other types of assistive technology, as well as low-tech and no-tech aids or approaches such as picture boards, facial expressions, and gestures.
AAC should be considered for those students who cannot communicate effectively through oral speech, including students with autism, cerebral palsy, intellectual disabilities, congenital disabilities, selective mutism, muscle disease, sensory impairments, and traumatic brain injury.
Special educators in Massachusetts should be familiar with the purpose and use of AAC. The Massachusetts Educator Licensure Regulations require candidates seeking a teaching license in moderate or severe disabilities to receive "instruction on the appropriate use of AAC and other assistive technologies," and define AAC as follows:
Augmentative and Alternative Communication: Methods of communication other than oral speech that enhance or replace conventional forms of expressive and receptive communication to facilitate interaction by and with persons with disabilities who are nonverbal or have limited speech, including, but not limited to: specialized gestures and signs; communication aids such as charts, symbol systems, visual supports, and language boards; mouth sticks; and electronic communication devices such as switches, head pointers, eye tracking, dynamic displays, auditory scanning, and voice output devices.
See 603 CMR 7.02 and 7.03(3)(c).
In addition, three federal laws address the communication needs of students with disabilities, which may include the need for AAC. The Individuals with Disabilities Education Act (IDEA) requires IEP Teams to consider a student's possible need for assistive technology devices and services whenever an IEP is developed. Districts must provide AAC if it is needed for a student with an IEP to receive a free appropriate public education (FAPE). The IEP Team must also determine whether the student needs to use the AAC device at home or in other settings, in order to receive FAPE.
The goal of having an AAC device is for it to be used in academic and nonacademic activities throughout the day. As such, the Team should include AAC services required for FAPE in the IEP, so that the device is customized, maintained, and repaired as necessary, and training on the device is provided to those who need it. Those trained may include not only classroom teachers, other school staff, and peers, but those outside of school who are substantially involved in the major life functions of the child. See 34 CFR 300.6(f). It is the responsibility of the school district to provide training and other AAC services contained in the IEP, either directly or through contracted providers.
The Americans with Disabilities Act (ADA) and Section 504 of the Rehabilitation Act (Section 504) require schools to provide AAC for students with disabilities if needed to assure equal access to the school's programs and services. Under the ADA, a public school must make certain its communication with students who have disabilities is as effective as its communication with students without disabilities.
For more information on the federal laws relating to students with disabilities who may require AAC, please see: "Frequently Asked Questions on Effective Communication for Students with Hearing, Vision or Speech Disabilities in Public Elementary and Secondary Schools." This federal guidance document, jointly issued in 2014 by the U.S. Department of Justice and the U.S. Department of Education's Office of Special Education and Rehabilitative Services (OSERS), provides resources for school districts and parents, helpful student case studies, and questions and answers that distinguish between IDEA and ADA requirements.
We also encourage IEP Teams to review the MA Department of Elementary and Secondary Education's 2012 guidance entitled "Access to Learning: Assistive Technology and Accessible Instructional Materials." AAC is one form of assistive technology. The 2012 guidance document includes a Frequently Asked Questions (FAQ) section that addresses district financial responsibility under IDEA for the purchase of assistive technology devices and services; when in the IEP development process assistive technology should be considered and where in the IEP it should be included; responsibility for retaining, repairing, or replacing assistive technology devices; and other assistive technology issues in the context of the IEP process. The guidance also includes a list of organizations and websites that are helpful resources for schools and parents on AAC and other types of assistive technology for students.
The American Speech-Language-Hearing Association, PrAACtical AAC, and the AAC Institute also can provide information and resources specific to AAC.
Federal law defines the school district's responsibility to provide assistive technology, including AAC, to students with disabilities who need such devices or services to receive a free appropriate public education and have equal access to the school's programs and services. Prompt evaluation of a student's need for AAC, as well as provision of required AAC aids, devices, and services, can help students with disabilities that impede their ability to communicate to meet education goals and participate fully alongside non-disabled peers in both academic and nonacademic domains. We encourage IEP Team members and other school district staff to review the federal guidance and other resources regarding AAC and assistive technology referenced herein, as well as the Student Spotlights document that accompanies this memo. If you have questions or suggestions, please contact the Department's Office of Special Education Planning and Policy.
Access the curriculum and gain academic skills
Students with communication deficits are at high risk of falling behind academically.2 AAC may be needed to assist a student with disabilities who is nonverbal or has limited communication skills to access the curriculum, or learn academic content and skills such as vocabulary, grammar, conversation or public speaking.
Example: At age three, a student diagnosed with autism had no speech. An evaluation revealed that the student had an understanding of language, but he was not able to use language to communicate with others. AAC allowed this student to begin to communicate his needs and wants through language. By kindergarten, he was able to actively participate in class using AAC and was making substantial academic progress.
Example: Since five years old, a student diagnosed with cerebral palsy had been using a wooden stick attached to her baseball cap to point to pictures and letters to communicate in her mainstream classroom. In second grade, her standardized language scores were substantially below grade level. Then, an AAC assessment (together with her increased desire to communicate with friends) resulted in her obtaining a portable speech generating device with a wireless infrared pointer. This gave her the freedom to communicate across a variety of settings and people without relying on others. By the fifth grade, her three-year re-evaluation revealed age-appropriate language skills. With support from the speech-language pathologist, she participated in MCAS, receiving a proficient score in ELA.
Learn with non-disabled peers
AAC may be needed to allow a student with disabilities who is nonverbal or has limited communication skills to participate fully in a regular education classroom, in extracurricular activities with non-disabled peers, and in community-based learning opportunities for transition-age students.
Example: For a younger child, AAC may allow access that is as basic as participating in story time alongside his or her non-disabled peers. As the student grows older, a more sophisticated AAC device may be needed to allow the student to participate by contributing his or her own ideas in group projects with non-disabled peers. For a transition-age student participating in community-based learning opportunities, a high-tech AAC device may be needed to allow the student to communicate effectively with a cashier at a grocery store, a waiter in a restaurant, or a co-worker or supervisor at a job site.
Address behavior challenges
It is not unusual for students with disabilities who have communication deficits to express themselves (including their frustration at being unable to communicate effectively) in a physical manner that may be perceived as challenging behavior.3 AAC may be needed to offer students an alternative - and socially accepted - means of expression, to reduce or replace inappropriate behaviors and allow the student to be more available for learning.
Example: A third grade student diagnosed with autism, who has limited use of functional speech, uses a communication book to help structure and communicate her thoughts. Unexpected changes to her daily routines often resulted in the student biting her hand, hitting others, and dropping to the floor, which led to her being removed briefly from class to calm down. Over time, staff taught her to use her communication book to communicate her feelings. She learned to identify how she is feeling to her teachers and parents, and independently request a break or calming activity. This has helped develop self-regulation and maximize learning opportunities, while allowing more positive peer interactions. In addition, the student made academic progress.
Example: A fourteen-year-old student, diagnosed with cerebral palsy and an intellectual disability, was frustrated and angry because few people could understand him. An evaluation revealed that he was more intelligent than had been realized and had strong understanding of language. An iPad with speech-generating software was introduced, allowing the student to be understood by others. His whole perspective on his education improved as he became able to participate fully in school.
Participate in all aspects of the education program
AAC may be needed so that a student with disabilities who is nonverbal or has limited communication skills has the opportunity to communicate and interact with other persons (including teachers, aides, administrative staff, students and others involved in a student's learning) in all aspects of the student's education (including all learning environments) to the fullest extent possible.
Example: A student diagnosed with Down Syndrome has limited use of functional speech. He has an iPad which has an app that helps him communicate during unstructured times of the day at school. During recess, the student is able to communicate with other students about what happened when he and his family went camping over the weekend. In this and other ways, the student uses AAC to form meaningful relationships with his non-disabled peers.
Example: A ten-year-old student diagnosed with a rare genetic disorder cried every day during morning meeting. It was discovered that the student was crying because he was thirsty. AAC has allowed this student to communicate appropriately to the teacher that he is thirsty and needs something to drink, so that the student could participate in morning meeting without crying.
Example: By taking her speech-generating device home and using it to communicate with her parents, a fifteen-year-old student with cerebral palsy is able to tell her parents what is happening at school on a daily basis -- for example, any learning difficulties in the classroom, any communication challenges at school, homework assignments, and extracurricular activities. This allows the parents to support their daughter's learning and, at the same time, gives the student opportunities to practice and generalize her ability to communicate with her AAC device.
1 The student examples contained herein are real Massachusetts cases in which the student was eligible to receive an AAC device or services under the Individuals with Disabilities Education Act (IDEA) and/or the Americans with Disabilities Act (ADA).
2 See Sturm, J., Spadorcia, S., Cunningham, J., Cali, K., Staples, A., Erickson, K., & Koppenhaver, D. (2006), What happens to reading between first and third grade? Implications for students who use AAC. Augmentative and Alternative Communication, 22(1), 21–36.
3 See Walker, V & Snell, M (2013), Effects of Augmentative and Alternative Communication on Challenging Behavior: A Meta-Analysis, Augmentative and Alternative Communication, 29:2, 117–131, DOI: 10.3109/07434618.2013.785020.
Last Updated: April 2, 2018
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