Augmentative and Alternative Communication and Language: Some Old and New Urgent Issues

Some children struggle with speech development and a small minority never achieve intelligible speech. This review explores research on the use of augmentative and alternative communication (AAC) to support their development of communication and language. There is no generally accepted definition of AAC or coherent theoretical framework, and the nature of AAC is rarely discussed. Most AAC research concerns short-term interventions and studies on AAC processes and development are rare. Longitudinal studies are generally lacking and many central issues in research on spoken language development have received limited attention in AAC research, including vocabulary use, figurative language, and bimodal and bilingual development. Communication is often slow among individuals with severe speech and motor disabilities and artificial intelligence has been suggested to increase conversational speed. Most research on AAC concern intervention and typically report short-term results, while many of the issues addressed in research on spoken language are not addressed. Theoretical and empirical bases for understanding AAC development are lacking. This implies that a significant basis for AAC intervention is lacking. After 40 years of research, there are still core issues that have not been sufficiently addressed. This paper outlines these issues to inform new directions in AAC research and practice.