Promoting acceptance of augmentative and alternative communication by adults with acquired communication disorders

This article discusses components of the AAC Acceptance Model, a theoretical framework for understanding the factors involved in the acceptance of augmentative and alternative communication (AAC) by adults with acquired communication disorders. To clarify the AAC Acceptance Model, a case study is provided of an individual with acquired aphasia and apraxia of speech who seemed initially to be an “ideal” candidate for optimal use of AAC. A trial period conducted prior to acquisition of an AAC system included analysis of the client's communication behaviors using an AAC loaner device in conversation with unfamiliar partners in the clinical setting. After a device was acquired, the individual was reluctant to use it in public places with unfamiliar partners. Clinicians employed specific treatment techniques to promote AAC acceptance. Intervention focused on increasing the user's communicative effectiveness and comfort level in community-based interactions. This case study highlights the importance of all three branches of the AAC Acceptance Model (milieu, person, and technology) in the clinical decision- making process. In addition, the case study illustrates the need for appropriate clinical outcome measures for adults with aphasia.