Augmentative and Alternative Communication (AAC)

Augmentative and Alternative Communication (AAC) can be used when an individual has difficulty with spoken communication. More information on AAC can be found on the Communication Matters website, and in their free leaflets on AAC

AAC covers a range of strategies. Some AAC involves no technology, or paper and some AAC involves technology which can range from ‘low’ and ‘light’ technology to ‘high tech’ voice output communication aids.

In this video Russ and Diane explain their communication strategies.

In this video Ellen explains her use of a voice output communication aid, which she controls through a headswitch.

AAC and the Barnsley AT Team

Our team provides a specialised service for AAC to people of any age: supporting local teams in working with individuals to understand their AAC needs; and in providing specialised communication aids. The NHS England service specification defines what our service should do and how it should interact with local services.

Referral Criteria

The AAC service specification states that an individual who would access a specialised AAC service would have both of the following:

  • a severe/complex communication difficulty associated with a range of physical, cognitive, learning, or sensory deficits;
  • a clear discrepancy between their level of understanding and ability to speak.

In addition, an individual must:

  • be able to understand the purpose of a communication aid;
  • have developed beyond cause and effect understanding; and may:
  • have experience of using low tech AAC which is insufficient to enable them to realise their communicative potential.

The specification also applies the following exclusion criteria to all referrals:

  • pre-verbal communication skills; 
  • not having achieved cause and effect understanding;
  • have impaired cognitive abilities that would prevent the user from retaining information on how to use equipment.

Further guidance on the referral criteria have been developed by the NHS England Clinical Reference Group (see Key Documents section below).

Provision Criteria

Specialised AAC services have a remit to provide and maintain ‘specialised communication aids’ (NHS England Prescribed Services Manual). Further guidance on what equipment is provided has been developed and approved by our NHS England commissioning office (see Key Documents section below).

Service Provision across Yorkshire and Humber

The way in which AAC is delivered in the region is changing. Please visit our service transition information page to find out the current status.

Key Documents

  1. AAC Commissioning Guidance – published by NHS England, particularly aimed at CCG AAC service commissioning.
  2. Local AAC Service Specification –  produced by the AT Team to guide local service development.
  3. Local Service AAC Resource Pack – a resource to support local service provision of AAC.
  4. Specialised AAC Service Specification – the NHS England specification of what should be provided by specialised AAC services.
  5. AAC Referral Criteria Guidance developed by NHS England Clinical Reference Group, AAC subgroup:
    1. AAC Referral Criteria Guidance document
    2. AAC Referral Criteria Flowchart
  6. Provision criteria – guidance on provision of ‘specialised AAC aids’, approved by Barnsley AT team NHS England commissioning office.
  7. Prescribed Services Manual (NHS England website)
  8. Referral form and guidance.