“I Want Coffee” Is Just a Start: Why Adult AAC Should Support the Whole Conversation
Imagine sitting at the breakfast table. You want coffee, and your communication app helps you ask for it.
That’s useful, no doubt. But maybe you have a few more things to say…
Maybe you want the blue mug. Maybe you want a little cream today. Maybe you’d like to remind your husband that yesterday’s coffee could have stripped paint off the kitchen cabinets.
The request, the preference, and the joke all belong in the conversation.
Now imagine that, until recently, you could have said all of that without giving it a second thought. After years or decades of speaking, you’re learning a different way to get your message across.
October is AAC Awareness Month, and I think that makes it a perfect time to bring more attention to adults facing this change.
Adults with acquired communication difficulties already have a lifetime of relationships, routines, opinions, humor, and personal ways of communicating. AAC should help them continue expressing who they already are.
Because sure, getting a cup of coffee matters. But so does having something to say over it and having the means to say it.
Adults Belong in the AAC Conversation, Too
AAC stands for “augmentative and alternative communication.” It includes tools and strategies that support or replace speech, from gestures and picture boards to speech-generating apps and devices.
Many people associate AAC with children who are developing communication skills. That can leave another group out of the picture: adults who encounter AAC for the first time after a medical event or a progressive condition.
A stroke may cause aphasia, which affects language. A brain injury or head and neck surgery may also change how someone communicates. ALS, Parkinson’s disease, and primary progressive aphasia can create changing communication needs over time.
These conditions affect people differently. Some primarily affect speech; others can affect understanding, finding words, reading, or writing. The right support depends on the individual.
And an adult doesn’t have to be completely unable to speak to benefit from AAC. It may provide temporary support after surgery, supplement speech that is tiring or difficult to understand, or become a longer-term way to communicate.
A Change in Communication Happens Within an Existing Life
For an adult who has spent decades speaking, learning to use AAC can mean adjusting familiar ways of participating at home, at work, and in the community.
They may be used to telling stories at family gatherings, making decisions with a spouse, or checking in with a friend. Those conversations still matter when speaking becomes difficult.
That’s why adult AAC should look beyond a simple checklist of basic requests. It should support the relationships and roles the person wants to continue, along with new things they want to do.
Personalization can help. Familiar photographs and relevant phrases can reflect someone’s daily life. But the larger goal is continued participation: helping that adult have a say in the conversations and decisions that matter to them.
“How Was Your Day?”—Staying Connected
Much of everyday conversation has no practical task attached to it.
We ask about someone’s day. Check in on a friend. Talk about the dog’s latest adventure – like stealing a sandwich right off the table.
These exchanges play a critical role in keeping relationships going. Adults who acquire communication difficulties need opportunities to initiate them, ask questions, and share news.
A familiar greeting or a question about a loved one can be a useful starting point. But there should also be a way to communicate something new, using tools and strategies suited to the person’s abilities.
Conversation partners can help by making space for a response and including the adult in the exchange. A conversation may take longer, but it can still be worth every minute.
“I Disagree”—I Still Have a Point of View
Adults have opinions. Sometimes strong ones.
They might disagree about movies, complain about the weather, and make jokes that their families have heard just short of a million times.
Acquired communication difficulties shouldn’t mean that everyone else gets to do all the deciding—or all the talking.
AAC should offer ways for the user to agree, disagree, refuse, correct a misunderstanding, and contribute an idea. Messages such as “Give me a moment” or “Please let me finish” can help someone hold their place in a conversation.
The person using AAC should help guide what they want to express, with support as needed. Their point of view deserves to be heard—even when everyone else would prefer a different opinion.
“Here’s What I Need You to Understand”—I Want a Say in My Care
Healthcare conversations are another place to go beyond basic requests.
Someone may need to communicate pain or ask for help. They may also want to understand a recommendation, explain a concern, or express a preference about their daily care.
“Please explain that again.” “This feels different from yesterday.” “I have a question before we continue.” These kinds of messages give adults ways to participate in their own care.
If you’re communicating with an adult who uses AAC, here are some guidelines:
- Address the adult directly.
- Allow time for them to respond.
- Check your understanding instead of assuming you know what they mean.
After all, a message is only useful when someone has the opportunity to communicate it—and someone else takes the time to listen.
Ease of Use and Access Matter
An adult exploring AAC may also be dealing with fatigue or changes in vision, movement, attention, or memory. A system needs to fit how that person can use it in everyday situations.
More features don’t automatically make a system a better fit. Clear navigation, readable text, recognizable images, suitable button sizes, and easy access to frequently used messages can matter more.
A speech-language pathologist with AAC experience can help assess communication and access needs, explore options, and support learning. Needs may change during recovery or as a condition progresses, so the approach should be reviewed and adjusted over time.
AAC Can Work Alongside Speech
It’s important to note that using AAC doesn’t mean giving up on speech. Someone might speak part of a message, point to a photograph, write a word, or use an app for another part.
They may use different methods with different people or at different times of day. AAC simply adds another way to get the message across when speech alone isn’t enough.
Adults should be supported in using whatever combination of speech, gestures, writing, facial expressions, and AAC tools that works for them.
Where APP2Speak Fits into the Picture
APP2Speak is one option for adults exploring a speech-generating app.
It offers preset photo-based communication pages, along with custom pages that can use personal photographs and phrases. Its text-to-speech feature allows users to type messages and save frequently used words and phrases. Users can also record a familiar voice for personalized speech output.
These options can support everyday requests and provide ways to ask questions, share a thought, or take part in a familiar conversation. For someone who can use its text-to-speech feature, there’s also room to compose a new message when the conversation takes an unexpected turn.
APP2Speak won’t be the right fit for everyone. Remember, the starting point is always the individual: what they want to communicate, how they can access it, and what kind of support they need.
Make Room for the Whole Conversation
Let’s return to that cup of coffee.
The adult asking for it may have spent decades sharing stories, making decisions, and teasing the person across the table. A change in communication shouldn’t leave them watching those conversations happen without them.
AAC Awareness Month is an opportunity to make sure adults with acquired communication difficulties are included when we talk about who may benefit from AAC—and what it should help them do.
The question is bigger than whether someone can ask for their drink of choice. It’s whether they have the support to participate in the life and relationships that matter to them.
That includes having a say about the coffee.