AAC Glossary

Patricia Dowden, Ph.D., CCC-SLP

Abstract symbols: Symbols that do not resemble the referent at all. For example, the peace symbol is a drawing
that does not look like "peace" at all. (Beukelman & Mirenda, 1998)

Access method (or selection technique): The way in which the user interacts with a device to control it for
communication; the method an individual uses to select items for communication, e.g. pointing, single-switch
scanning, etc. There are two broad categories of access methods: 1) Direct selection and 2) Indirect Selection
(Dowden & Cook, 2002).

Activation feedback: Some devices have settings that determine what the user hears or sees while composing a
message. This feedback is not intended for the communication partner; it serves as a way for the user to check for
errors during composition. The prototypical example of activation feedback in AAC is letters or words appearing
on the visual display as one types; it could also be set to “say” those letters or words aloud as the user types.

Aided communication: Communication that requires something external to the body to represent meaning, for
example pointing to a symbol in a communication notebook (Beukelman & Mirenda, 1998)

Aided input: A technique used by the partner to enhance auditory comprehension by the AAC user. The speaking
partner uses writing, drawing or pointing to printed words or symbols to supplement the words he or she is
speaking, so that the AAC user can better understand. This technique is typically used with adults with receptive
language impairments due to aphasia and is one of many “facilitating techniques”.

Aided techniques: Methods of communication that require something external to the body to represent meaning;
for example a book, board or device (Beukelman & Mirenda, 1998)

Alphanumeric or numeric encoding: Messages can be stored under combinations of letters and numbers
(alphanumeric) or by numbers alone (numeric) (Beukelman & Mirenda, 1998). A prototypical example of this
encoding in AAC is the old Handivoice device in which the user would memorize 3-digit codes for individual
words. See more about "Encoding" below.

Auditory fishing: A setting that allows users to browse the items on the display through direct selection by
listening to the output at a reduced volume before making a selection (Dowden & Cook, 2002).

Auditory output: When the message is conveyed to the communication partner through sound. This includes
digitized speech (see below) or text-to-speech (see below). It also includes recorded non-speech sounds such as
sports cheers or environmental sounds such as beeps, doorbell sounds, and alarms.

Auditory scanning: A type of indirect selection in which the partner or the device say the items of the selection
set aloud for the user to make a selection (Dowden & Cook, 2002). See Partner Assisted Auditory Scanning below.

Auditory symbols: Selection set items that are presented in an audible manner, for example through Auditory
Scanning (see below) or Auditory Fishing (above).

Augmentative and alternative communication (AAC): An area of clinical practice that attempts to compensate
(either temporarily or permanently) for the impairment and disability patterns of individuals with severe expressive
communication disorders (ASHA, 1989)

Augmentative communication device (ACD): A phrase used by Washington State Department of Social and
Health Services and some equipment vendors to refer to equipment used by any AAC user to aid their
communication. Speech Generating Device (SGD) is a far more common term.
Automatic scanning: A type of single or dual switch scanning in which, once the scanning process begins, the
activation of the switch will interrupt the scanning and select that row or that item. Also called “autoscan” and
“interrupted scanning”. Devices can be set so that the switch also begins the scanning process, but that is not
essential.

Banking for voice output: According to Boston Children’s Hospital there are two types:
1. Message banking with your own voice: “…digitally record and store words, phrases, sentences, personally
meaningful sounds and/or stories using your natural voice, inflection and intonation.” These messages are
not used with TTS, but played as digitized speech.
2. Message banking by proxy: using someone else’s voice to digitally record and store messages “…because
issues of fatigue, pain or intelligibility…make it difficult for an individual to bank all messages.” The
individual may still opt to do a small number of important “legacy” messages, however. These messages
are not used with TTS, but played as digitized speech.
3. Voice banking for TTS: “…a process of recording a large inventory of your speech that is then used to
create a synthetic voice that approximates your natural voice” for text-to-speech voice output.

Cerebral Palsy: “…any one of a number of neurological disorders that appear in infancy or early childhood and
permanently affect body movement and muscle coordination but don’t worsen over time. Even though cerebral
palsy affects muscle movement, it isn’t caused by problems in the muscles or nerves. It is caused by abnormalities
in parts of the brain that control muscle movements. The majority of children with cerebral palsy are born with it,
although it may not be detected until months or years later… A small number of children have cerebral palsy as the
result of brain damage in the first few months or years of life…”
http://www.ninds.nih.gov/disorders/cerebral_palsy/cerebral_palsy.htm#What_is

Coded access: An access method in which the individual uses a sequence of body movements to retrieve items
from the selection set. For example, Morse code is a method of coded access that requires a different sequence of
finger-tapping movements (originally) or head movements (in AAC) for each letter of the alphabet. It is possible to
use coded access along with other types of encoding. In Morse code, the letters "S" "O" "S" stand for an entire
phrase (Save Our Ship); this is an example of encoding. Many people confuse these two uses of the term "code" in
our field (Dowden and Cook, 2002)

Communication notebook/board: Two low-tech AAC tools that an individual uses to express personally relevant
concepts by pointing to line drawings, words, pictures, numbers, and/or the alphabet. The communication board
contains the set of symbols on a flat surface; a communication book or notebook has several pages of symbols.

Context-dependent communication: Communication that is limited to some topics in some contexts or with some
partners; the individual is not able to communicate with everyone in their lives about all relevant topics.
Nonetheless, context-dependent communication is more effective than Emerging communication (see below)
because it is entirely limited to the "here and now" or shared knowledge by the partner. All individuals with
context-dependent communication are dependent on others for vocabulary. If a concept is not available to them,
some context-dependent communicators can use linguistic context (e.g. first letter hints, partial spellings, word
prediction and circumlocations) to get those concepts across. Others are unable to use these strategies due to
limited knowledge or limited access to linguistic tools and must resort to situational cues (e.g. pointing, mime, etc.)
and shared knowledge of the partner to convey such concepts.

Core vocabulary: Messages and words that are frequently used by many individuals across many contexts. This
vocabulary typically consists of "functor" words such as "is, was, he, she" and common nouns and primary verbs
(e.g. clothing, common actions, etc.). (Beukelman & Mirenda, 1992)

Dedicated SGD: A device that is eligible for Medicare/Medicaid funding because it can only function as an AAC
device. Some devices have to be specially modified by the manufacturer so that any non-AAC functions are locked
and unavailable. (AACfundinghelp.com as of 6/2011) Some companies now just use the expression
“Medicare/Medicaid Version” of a device. (Opposite: “open”)
Digitized speech: The computer reproduces messages that have been recorded and stored in digital format
(Beukelman & Mirenda, 1998). This type of speech output restricts the user to utterances that have been pre-
recorded.

Direct selection: A method of communication in which the individual specifically indicates the desired item in the
selection set without any intermediary steps. There are numerous types of direction selection methods used for
AAC devices/strategies. According to Beukelman & Mirenda (2006) they are: a) pointing with physical contact
and force; b) pointing without physical contact; c) pointing with contact and no force; and d) voice recognition.
Dowden & Cook (2002 and in press) add: e) picking up and exchanging and f) handwriting. (Note: message
retrieval methods are not considered "intermediary steps" here.)

Directed scanning: An access technique that combines elements of direct selection and single-switch scanning.
The individual uses a multi-switch array, for example, a joystick or arrow keys, to move the cursor in the desired
direction and to make a selection. A prototypical example in AAC is using a joystick plus “fire button” to make
selections from vocabulary or the alphabet for spelling on a communication device.

Dynamic Displays: A feature of some communication devices that allows the user to change the vocabulary
options that he can see. Navigating these displays is a bit like browsing the Internet in that you can move back and
forth between the displays with buttons. Although DynaVox did not invent this feature of communication devices,
their devices are prototypical examples of this feature, perhaps in part because of the device names.

Emerging communicator: An individual who does not yet have any reliable means of symbolic communication
that in not confined to a few rote expressions. Nonetheless, these individuals are typically very expressive through
non-symbolic communication, for example through gestures, facial expressions and body language (Dowden,
1999). This communication can be very useful with highly familiar partners, but it tends to be limited to the "here
and now" or rely heavily on the partner's shared knowledge.

Encoding: A message retrieval and/or rate enhancement technique (see below) in which the user selects a
predetermined sequence of items to retrieve a pre-programmed word, phrase or sentence. Codes can be based on
icons (symbols), alphabet letters, letters and numbers combined ("alphanumeric codes") or numbers alone (Dowden
& Cook, 2002)

Feature: A prominent characteristic of a communication device or a communication strategy. For example, voice
output is a feature of many AAC devices. Some features are fixed in a given device, for example dynamic displays,
while other features can be set as preferences or even assigned to individual vocabulary items, for example the type
of output, type of rate enhancement, etc. Some features can even be under the users control, for example the
volume and particular voice can be altered in different contexts in some devices.

Finger spelling/Manual alphabet: A method of communication via spelling that uses hand configurations to
represent letters of the alphabet. Usually, the partner watches the hand movements to understand the letter
sequence, but there is a form, called tactile finger spelling, that is used with partners who have visual impairments
as well as hearing impairments. It is important to note that finger spelling is not synonymous with sign language,
but rather just one component of a natural sign language such as American Sign Language.

Foils: items in a selection set that are not intended to be selected, for example, blank items, objects that are
disliked, or items that are not appropriate in a given context. These are used to determine reliability or consistency
with the communication technique.

Fringe vocabulary: A vocabulary specific or unique to a AAC user or to one activity or topic (Beukelman
&Mirenda, 1998) While one person’s fringe vocabulary may be another person’s core vocabulary, there are
prototypical examples of fringe vocabulary, such as names of people or places that are unique to a given user, or
vocabulary for a particularly unique topic of conversation or activity.
Gesture: An unaided method of communication that includes facial expressions, eye gaze, hand movements and
body postures (Beukelman & Mirenda, 1998). The meaning does not typically have to be learned, but is clear from
the movement itself.

Head-wand or -pointer: A stick held closely to the head (typically mounted on a cap) and used by individuals with
poor hand control to perform some tasks otherwise done by hand, such as reaching and pointing. Some AAC users
use headwands to select items on a communication display or device; this is a form of direct selection.

Icon encoding: A technique in which visual symbols are combined to store words, phrases or sentences. The icons
are usually abstract so that there can be multiple meanings associated with them. This technique serves as both a
message retrieval strategy (see below) and a rate-enhancement technique (also below). The prototypical example
of icon encoding is Minspeak, copyrighted by Prentke Romich Company.

Independent communication: The ability to communicate with both familiar and unfamiliar partners about any
topic in any context (Dowden 1999; Dowden & Cook, 2002 and in press). "Independent communication" does not
mean that the individual does not rely on technology or assistance from people in the environment.

Indirect selection: A method of communication that involves intermediary steps by the device or the partner,
usually to compensate for motor limitations of the user. Examples include single or dual switch scanning, directed
scanning and coded access (Dowden and Cook, 2002).

Inverse scanning: A type of single or dual switch scanning in which the user must activate the switch and
maintain pressure on it to keep the scanning going. The user then releases the switch to accept the row or the item.

Keyguard: A plastic or metal piece that fits over a device to make it easier for someone with
motor impairments to select keys correctly. Click on the image for an example. Note: don’t
confuse this with the new meaning for this word with cell phones, having to do with locking
cells on a keypad.

Key word signing: Signing only the key words in an utterance, sometimes done while speaking (Beukelman &
Mirenda, 1998)

Less/Least costly alternative: A phrase used by insurance companies and 3rd party payers to refer to equipment or
services that are less expensive but may still meet the patient's needs

Letter of justification: The letter by a physician and a clinician to a 3rd party payer (e.g. insurance company) to
request funding for an AAC device.

Locked-In Syndrome (LIS): An individual who is truly "locked-in" has no voluntary movement except vertical
eye movements and, in some cases, blinking, but the individual is conscious and could communicate given the right
AAC strategy accessed via the eyes. This is typically caused by a basilar artery stroke, tumor or trauma damaging
the pons or midbrain. (Beukelman & Mirenda, 1998)

Medical necessity: A phrase used by insurance companies and 3rd party payers to describe the equipment and
services a patient requires for health and safety needs. Insurance companies and 3rd party payers usually only
provide equipment and services that meet medical needs, as opposed to educational or social needs.

Message bar/screen: In some devices, the message appears as it is being composed, typically in a space at the top
of the keyboard.

Message banking: See Banking above.

Minspeak: A type of icon encoding (see above) used in devices by one manufacturer: Prentke Romich Company.
Morse code: An international system that uses a series of dots and dashes to represent letters, punctuation and
numbers. When an AAC user uses this system, the dots and dashes are more likely to be high or low pitch tones
(Beukelman & Mirenda, 1992) and the most common method is through two head switches.

Mouthstick: A wand that is held in the mouth and used by individuals with poor hand control to perform some
tasks otherwise done by hand, such as reaching & pointing. Some AAC users use mouthsticks to select items on a
communication display or device, a type of direct selection.

Navigation: Only the smallest devices show all the available vocabulary at once. Devices with a larger capacity
only show some vocabulary and require the user to find words/phrases that are not readily visible at first. An
individual who is not able to navigate proficiently will be unable to use that additional vocabulary during
communication.

Non-symbolic communication: Gestures, pointing, vocalizations, intonation, body language and facial expression
are examples of non-symbolic communication. It is limited to the "here and now," responding to what one sees,
hears or feels in the immediate environment.

Novel utterances: Unique messages that an individual produces to say exactly what is intended at a given moment.
They are the opposite of "preprogrammed" messages that must be composed and programmed ahead of time. True
independence in AAC necessitates the ability to create and deliver novel utterances, although nearly all AAC users
take advantage of preprogrammed messages at time for efficiency in communication.

Open AAC device: A Speech Generating Device (SGD) on which the user can also use non-AAC functions (e.g.
word processing software, internet access, etc.). These devices are not covered by Medicare or Medicaid funding
as of 6/2011. (AACfundinghelp.com) (Opposite: “dedicated”)

Opportunity Barriers: The obstacles imposed by other people, preventing AAC users from full participation. For
example, a teacher or SLP may believe that non-speakers cannot learn to spell, so literacy instruction is not
provided. Or a school may have a policy that prevents a child from taking a communication device home.
(Beukelman & Mirenda, 1998)

Output: The output is primarily thought of as the method by which information is conveyed to the partner; e.g.
visual output or auditory output. Some devices also connect to computers, cell phones and the internet, a type of
"electronic" output that is used to control the environment.

Partner influence: When one or more communication partners can affect the selection of messages by a user either
consciously or unconsciously. Examples include Facilitated Communication (FC) through a touch of the hand or
single-switch scanning through extensive cueing or partner assisted scanning (PAS) through intonation patterns.

Partner assisted (auditory) scanning: A method of partner assisted scanning (see below) in which the items are
named or read aloud by the partner.

Partner Assisted Scanning (PAS): A method of communication involving no technology in which the partner
identifies (by naming or pointing) the items in the selection set and waits for the user to signal (via a sound or a
movement) the item he/she wishes to communicate. This can be done one-by-one with items in a linear array (e.g.
A,B,C,D....) or via a group-item strategy (e.g. A - G, H - L, etc.) gradually narrowing down the selection. It can also
be done with words and phrases rather than letters of the alphabet. Typically, PAS is done with the partner
providing a combination of auditory cues (naming the letter or row) and visual cues (pointing to the letter or row).

Partner assisted (visual) scanning: A method of partner assisted scanning (see above) in which the
communication partner points sequentially to the items on the display. Typically, people learn to point to each row
first. Once the individual signals the correct row, then they point to each item in the row until the individual signals
a selection.

PECS: see Picture Exchange Communication System

Picture Exchange Communication System (PECS): A method of communication developed by Pyramid
Educational Corporation, in which the communicator picks up one or more symbols and hands them to a partner
(Beukelman & Mirenda, 1998)

Prediction: A rate enhancement technique in which the device or the communication partner guesses the end of a
word or phrase, based on previous selections. There are many types of prediction used in devices, some more
sophisticated than others.

Preprogrammed utterances: Messages that are composed and stored ahead of time either because the user cannot
compose the message in that form or to permit the user to deliver the message quickly and efficiently. They are the
opposite of novel utterances created by the user at the time of communication. An individual cannot obtain true
communication independence in AAC with only access to preprogrammed utterances, yet all AAC users need some
preprogrammed utterances for efficiency in some contexts.

Rate enhancement: A technique or strategy used to speed up AAC output because it is so much slower than
speech. Most rate enhancements can be grouped into two types: encoding and prediction (see above).

Recorded speech: See digitized speech above.

Reliable communication: The individual is able to communicate what he/she intends to communicate, not
accidentally push another key or convey a message that was not intended. Reliability is essential for communicative
competence.

Selection set: The visual, auditory, and/or tactile presentation of the items from which a message can be composed
by an individual using AAC. There is some debate about whether the selection set is limited to what the individual
can access without changing overlays or screens.

Selection technique: See access method (above)

Single or dual switch scanning: An "indirect selection" technique in which items are presented sequentially and
the individual activates a switch or otherwise signals to accept one of the items when presented. There are many
scanning patterns (e.g. linear, circular, row-column, group-item) and there are many scanning methods (e.g.
automatic scanning and inverse scanning). Scanning, like other indirect selection techniques, is only intended for
individuals who do not have sufficient motor control for direct selection techniques. See also directed scanning
(above).

Speech Generating Devices (SGD): Communication devices with speech output. This term has replaced an older
term (Voice Output Communication Aid or VOCA) that is still encountered in the literature. SGD is now used by
most funding agencies.

Speech (or voice) output: Many communication devices convey information to the partner with audible sound.
There are two types: digitized and text-to-speech (see above and below). See below for the confusing term
“synthesized speech”

Speech Supplementation Strategies: These are approaches for making speech more understandable (or
"comprehensible") to the partner even if the actual intelligibility of the speech itself does not change. These
techniques include first letter cueing with fingerspelling or an alphabet board, setting the context with a context
board, etc. For further information, see Dowden (1997).

Step scanning: A type of dual switch scanning in which the user uses one switch to advance the cursor through the
items in the selection set. When the cursor is on the desired item, the user activates the second switch to accept that
item.

Symbolic Language: Communication that uses something (e.g. a word, sign, picture, etc.) to represent a concept or
meaning. For example, sounds symbolize meaning in our speech while letters and words represent meaning in our
writing, and in AAC we use symbols you can hear, see or feel. Symbolic language permits us to talk beyond the
"here and now" about things in another time or place. In contrast, non-symbolic communication is limited to the
"here and now," for example, using pointing and gestures to respond to what one sees, hears or feels in the
immediate environment.

Synthesized speech: This term is used differently by different authors. Beukelman & Mirenda (2005) use it to
mean any kind of speech from a device, both text-to-speech (TTS) and digitized (recorded) speech. Many vendors,
Johnston & Feeley (2012) and the website AACTechConnect use it to mean text-to-speech only as in “this device
has both synthesized and digitized speech.” I avoid using this term for this reason.

Tangible or tactile symbols: Symbols that can be discriminated based on the use of touch such as shape, texture,
consistency (Beukelman & Mirenda, 1998)

Text-to-speech output (TTS): Speech produced when a computer translates the letter of the text into sounds, using
a complex set of pronunciation rules (Beukelman & Mirenda, 1998) This is the only type of speech that can permit
the user to type/spell and turn it into speech output. That is not true of digitized/recorded speech (see above).

Unaided communication: Methods of communication that require nothing external to the body to represent
meaning e.g. signing, gestures, vocalizations, etc. (Beukelman & Mirenda, 1998)

Visual output: Output for the communication partner that is seen rather than heard; e.g. visual display or printout.

Visual scene displays: A visual display on a communication device in which an entire screen or a portion of the
screen is one image on which there are hotspots or links to other pages that match the items depicted in the scene.
For example, there might be a picture of cupboards and the refrigerator in a kitchen. Touching the refrigerator
image will bring up a set of items such as milk, eggs, etc., while touching individual cabinets might display snack
foods, cereals, etc.

Vocabulary (or symbol) dictionary: Many devices come with a large vocabulary or symbol dictionary. This total
capacity should not be confused with the size of the vocabulary that can be available to the user during
communication. For example, the DynaVox with Gateway vocabulary has thousands of words in its dictionary, but
few users can utilize more than several hundred of them effectively.

Vocabulary size: All of the concepts that are available for the AAC user to communicate. This could be thought of
as the individual’s expressive vocabulary. This is different from the "vocabulary or symbol dictionary" of a device
and from the “selection set” (see above).

Voice banking: See Banking above.

Zoom: Making a target larger, either to make it clear visually, or to make the target easier to touch motorically.