According to Bob Williams, who uses augmentative and alternative communication (AAC), ‘the silence of speechlessness is never golden. We all need to communicate with each other – not just in one way, but in as many ways as possible. It is a basic human need, a basic human right. And more than this, it is a basic human power.’

Communication is an essential part of humanity. It is what connects us, helps us to understand each other’s thoughts and ideas, share information and build social relationships. The team at the Centre for Augmentative and Alternative Communication (AAC) in the Faculty of Humanities at the University of Pretoria has been actively debunking the common myth ‘that not being able to talk implies one has nothing to say’.
 
AAC describes communication methods that either supplement the speech of such individuals or provide an alternative way of communication for those who cannot speak at all, for example some children with cerebral palsy or people who have suffered brain stem strokes. AAC may also be implemented as an alternative or supplementary method for supporting comprehension. It therefore does not focus solely on improving speech, as does traditional speech therapy, although it may sometimes be implemented alongside traditional speech therapy. Research has shown that AAC does not hinder the use or development of speech. AAC strategies and techniques include using natural gestures and signs from sign language in a keyword strategy (keyword signing), using communication boards with a range of different symbols and using speech-generating devices. Since the ultimate goal is to achieve functional communication to enable full participation in all valued life activities, AAC intervention also focuses on overcoming barriers in the physical and social environment that may hinder communication and full participation—and this typically includes partner training and physical adjustments to the environment.

One important barrier that has to be overcome is the difficulty experienced by people with severe communication disabilities when they attempt to access health care systems. In this regard, Constance Ntuli (a disability advocate at the CAAC) shared the following: ‘I really didn’t enjoy going to the hospital, because sometimes I felt judged and for a mother with disabilities it is sometimes twice as hard as for a normal mother. The information is provided so quickly and so many unfamiliar terms are used that I do not always understand what is said. There is no time for me to type my questions on my AAC system or even to respond to their questions.’ Difficulties with understanding health information are experienced by many persons with communication disabilities and the COVID-19 pandemic has exacerbated the situation. One issue that we all have to deal with during this time is the need for easily accessible and reliable health information. For persons with communication disorders, navigating this landscape can be exceedingly challenging. Health information is often couched in confusing and inaccessible language and provided in formats and modalities that do not support comprehension and retention. As a result, persons with communication disabilities may be under- or misinformed, with consequent detrimental effects on health outcomes.

This October we celebrate Augmentative and Alternative Communication Awareness Month and the CAAC, Future Africa (UP) and UNICEF are focusing on the development of health education materials for persons with severe communication disabilities. This project will involve persons with severe communication disabilities, caregivers, health care professionals and postgraduate students in the development and dissemination of materials for use when dealing with persons with communication disabilities. The new materials will be made available during our training webinars and on our website by the end of November.

Shakila Dada (Director, CAAC)

Kerstin Tönsing (Professor, CAAC)

Constance Ntuli (Disability advocate, CAAC)