Zisk Alyssa Hillary, Dalton Elizabeth
Interdisciplinary Neuroscience Program, University of Rhode Island, Kingston, Rhode Island.
Communication Disorders, University of Rhode Island, Kingston, Rhode Island.
Autism Adulthood. 2019 Jun 1;1(2):93-100. doi: 10.1089/aut.2018.0007. Epub 2019 Apr 13.
In recent years, technologies used for augmentative and alternative communication (AAC) have seen increasing development and availability. As a result, more and more autistic people are using AAC. With the increased use of AAC by autistic people, research on autism and AAC has also increased. However, the vast majority of this research focuses on nonspeaking autistic children. AAC use by autistic adults and by speaking autistic people has received limited academic attention. Speaking autistic adults often use AAC and many have publicly shared information about their strategies and experiences. In this article, we provide an overview of the speech differences autistic adults choose to support through AAC, including varying difficulties with speech depending on environment and content. We also discuss the technologies and strategies adopted by autistic adults, including free or low-cost tools that are not specific to AAC, mobile technologies, and signed languages or gestures. We explore barriers to AAC use, including a lack of awareness of relevant options, misconceptions about who AAC supports are for, and the cost of dedicated AAC applications or devices. We then provide suggestions for autistic adults, people supporting autistic adults, and researchers. Overall communication-rather than speech-should be prioritized. Mainstream communication technologies can support communication for autistic adults and a variety of tools can support communication across contexts. Further research into the use and effectiveness of AAC for autistic adults is needed, as is research on barriers to AAC use.
Augmentative and alternative communication (AAC) describes the ways people communicate without, or in addition to, speech. Research on AAC and autism has focused on nonspeaking children. However, autistic adults who use AAC sometimes tell each other about AAC. This community knowledge includes reasons AAC is important, useful AAC strategies, and barriers to AAC use. This article talks about autistic community knowledge about AAC and then makes suggestions. Autistic adults, including those who talk, may not always be able to meet all their communication needs with speech alone. Autistic people who use speech may experience intermittent, unreliable, and/or insufficient speech. The three main ways that autistic adults report on using AAC include: (1)Free or low-cost tools that are not specific to AAC (e.g., online chat rooms, text messaging applications, or handwriting).(2)Mobile applications designed for communication support.(3)Signed languages such as American Sign Language. Several barriers may prevent AAC use. These include the following: Knowledge of AAC optionsAttitudes about who AAC is useful forBeliefs that the use of AAC should be decreased if a person can speakCost of AAC devices and applications. Support autistics in defining their own communication needs, regardless of speech.Evaluate communication goals and match them with system features when making decisions about AAC.Prioritize all communication, not just speech.Explore a variety of options to support communication.Explore low- and no-cost options to support communication. What communication strategies do autistic adults see as effective?What AAC strategies are being used, in what environments, and by whom?What prevents effective AAC use?How can AAC specialists and autistic adults best collaborate to promote and evaluate AAC use?How can communication supports be designed to better meet the needs of autistic adults?
近年来，用于辅助和替代沟通（AAC）的技术得到了越来越多的发展且越来越容易获取。因此，越来越多的自闭症患者开始使用AAC。随着自闭症患者对AAC的使用增加，关于自闭症和AAC的研究也有所增加。然而，绝大多数此类研究都集中在不会说话的自闭症儿童身上。自闭症成年人以及会说话的自闭症患者对AAC的使用在学术上受到的关注有限。会说话的自闭症成年人经常使用AAC，许多人还公开分享了他们的策略和经历。在本文中，我们概述了自闭症成年人选择通过AAC来支持的言语差异，包括根据环境和内容在言语方面存在的不同困难。我们还讨论了自闭症成年人采用的技术和策略，包括非特定于AAC的免费或低成本工具、移动技术以及手语或手势。我们探讨了使用AAC的障碍，包括对相关选项缺乏认识、对AAC适用人群的误解以及专用AAC应用程序或设备的成本。然后，我们为自闭症成年人、支持自闭症成年人的人以及研究人员提供了建议。总体而言，应优先考虑整体沟通而非言语。主流通信技术可以支持自闭症成年人的沟通，并且各种工具可以支持跨情境的沟通。需要对自闭症成年人使用AAC的情况及其有效性进行进一步研究，同时也需要研究使用AAC的障碍。
辅助和替代沟通（AAC）描述了人们不通过言语或除言语之外进行沟通的方式。关于AAC和自闭症的研究主要集中在不会说话的儿童身上。然而，使用AAC的自闭症成年人有时会相互交流有关AAC的情况。这种群体知识包括AAC重要的原因、有用的AAC策略以及使用AAC的障碍。本文讲述了自闭症群体关于AAC的知识，然后提出了建议。自闭症成年人，包括那些会说话的，可能并不总是能够仅通过言语满足他们所有的沟通需求。使用言语的自闭症患者可能会经历间歇性、不可靠和/或不足的言语情况。自闭症成年人报告使用AAC的三种主要方式包括：（1）非特定于AAC的免费或低成本工具（例如，在线聊天室、短信应用程序或手写）。（2）为沟通支持而设计的移动应用程序。（3）如美国手语之类的手语。可能有几个障碍会阻碍AAC的使用。这些障碍包括以下几点：对AAC选项的了解、对AAC对谁有用的态度、认为如果一个人会说话就应该减少使用AAC的观念、AAC设备和应用程序的成本。支持自闭症患者确定他们自己的沟通需求，无论其是否会说话。在就AAC做出决策时，评估沟通目标并将其与系统功能相匹配。优先考虑所有沟通，而不仅仅是言语。探索各种支持沟通的选项。探索低成本和无成本的支持沟通的选项。自闭症成年人认为哪些沟通策略是有效的？在哪些环境中以及由谁在使用哪些AAC策略？是什么阻碍了有效的AAC使用？AAC专家和自闭症成年人如何才能最好地合作以促进和评估AAC的使用？如何设计沟通支持以更好地满足自闭症成年人的需求？
