Clinic for Augmentative Communication

What is AAC? About CAC Make a referral Eligibility criteria FAQs

What is Augmentative and Alternative Communication (AAC)?

Augmentative and Alternative Communication (AAC) refers to communication methods that supplement or replace speech or writing. These can include non-verbal communication techniques such as facial expressions, eye gaze and gestures, as well as systems and devices such as:

communication displays with pictures/symbols/words
electronic expressive communication devices with voice output ("Speech-Generating Devices")
adapted computer systems

About the Clinic for Augmentative Communication (CAC)

CAC may provide communication services to children and youth (0-18 years of age):

with limited speech or whose speech is hard to understand to meet daily needs at home and/or
who have difficulty producing written work at home

The CAC is designated as an expanded level clinic by the Assistive Devices Program (ADP) and therefore is able to prescribe a range of AAC devices and obtain funding for lease or purchase, as appropriate.

Our team

The CAC team members have specialized skills in the area of AAC. They include:

speech-language pathologists (SLP)
occupational therapists (OT)
communicative disorders assistants (CDA)
technician
administrative assistant

Our services

Assessing to match an individual's needs and abilities to an AAC system.
Developing recommendations and strategies to help communication skills.
Obtaining and setting up recommended equipment.
Initial training for the client, family and other team members to help them learn to use the system.

Please note that our clinic does not provide ongoing therapy.

Make a referral

To make a referral, community speech-language pathologists or parents (together with the child/youth’s community speech-language pathologist) can complete the online referral form.

Make a referral

This referral form provides important information about the client’s needs and abilities to determine eligibility for CAC Face-to-Face Communication assessment.

If you are unsure if your child/youth is followed by a speech-language pathologist, please contact the school principal and/or resource teacher to find out the name of the speech-language pathologist or to request a referral to speech-language pathology services.

If you have any questions or require a paper referral form, please contact access Team at 613-737-2757 or toll free: 1-800-565-4839.

Eligibility

We strongly recommend that you discuss your AAC needs with your speech-language pathologist or occupational therapist before making a referral to our clinic. For more information on eligibility, select one (Face to Face or Writing Aids) of the following:

Face to Face Communication

To be eligible for a Face to Face Communication assessment, the child or youth must require the use of AAC in the home (not only at school) and meet criteria for one of the following:

Child or youth is non-speaking and able to intentionally use a minimum of 20 or more symbols (e.g. symbols, pictures, PECS) to express themselves (e.g. request, comment, share information, etc.) and has a need for a more complex communication system (i.e., access to a large vocabulary, spelling, combining symbols to produce novel ideas, a need to take multiple turns in a conversation).

Note: If your child uses less than 20 symbols at this time to intentionally communicate their wants and needs or only labels/points to symbols when named, we strongly encourage you to contact your community speech-language pathologist (SLP) involved with your child or youth (daycare, CHEO, school board or private clinics) to continue developing their understanding and use of symbols for a future referral to the clinic.
Child or youth is non-speaking or able to speak but is not understood and has a severe motor or visual impairment that limits the use of communication symbols (i.e. have difficulty seeing or physically pointing to pictures).

Note: The child/youth is not required to use a minimum number of symbols to communicate to be eligible for CAC services.
Child or youth can use speech and has a large spoken vocabulary, but speech is difficult for others to understand (e.g. may have a diagnosis of apraxia, dysarthria or motor planning difficulties)

Writing Aids

To be eligible for Writing Aids funding through CAC the client must:

have a long-term physical disability or fine motor impairment that precludes written communication without the use of specialized equipment.
require an augmentative or alternative communication aid to enhance or replace written output required to perform Activities of Daily Living for a period of six (6) months or longer.
have regular and ongoing needs at home to independently perform writing related tasks.
be able to generate basic ideas independently using a formal symbolic representational system and must have a demonstrated need and potential to transfer ideas to written form.

Note: Eligibility may be extended to children under the age of 6 with severe physical limitations who can:

recognize some letters
have some sight words
who have great difficulty with age-appropriate pen and paper tasks
who are not able to access a standard keyboard and mouse

The Writing Aids eligibility forms can be completed and returned to CHEO Access Team.

Referral form — to be filled out by parents/caregiver or Occupational Therapist

Writing Aids screening form — to be filled out by Occupational Therapist

Other services

All About AAC

The CHEO Clinic for Augmentative Communication (CAC) is pleased to offer a consultation service to help you learn more about augmentative and alternative communication (AAC).

All About AAC is open to speech-language pathologists and occupational therapists working with children who use or may need to use AAC, either for face-to-face communication (e.g.: picture boards or voice output devices for children who are unable to speak) or for written communication (e.g.: adapted computers for children who are physically unable to write). A CAC speech-language pathologist, occupational therapist and/or program assistant will be available for one-on-one consultation. We can:

share ideas about putting AAC into practice
discuss possible referrals to CAC
guide you in planning interventions for your clients using AAC
demonstrate particular AAC equipment of interest
consult regarding potential school equipment prescriptions

Please note that this is not an assessment service and the client should not attend with you, although parents, caregivers, educators and other service providers are welcome to accompany you.

All About AAC runs from September to June. Consultations can be scheduled at your convenience, for approximately one hour, at our sites in Ottawa, Renfrew, or Cornwall (NB: consultations in Cornwall are provided by a speech-language pathologist only). Telephone consultation or videoconference can also be arranged.

To book an appointment for All About AAC, please call (613) 737-7600, ext. 4346.

Your call will be directed to a CAC speech-language pathologist or occupational therapist who will discuss your needs and book an appointment with you. We are able to provide a limited number of appointments each month.

Warrick AAC Library

This is a service provided by the Clinic for Augmentative Communication (CAC) to support communication, language and literacy development for children who use augmentative and alternative communication systems. The Warrick AAC Library provides adapted reading for children with special needs.

What’s available?

Adapted books & materials
Text resources
Single message voice output devices
Multiple message voice output devices
Boardmaker Symbol making software
iPad trials (with free communication apps)

Who can use this service?

Anyone interested in supporting communication, language and literacy development for children and youth with special needs.

More information

For more information or to make an appointment, visit or call:

2211 Thurston Drive, Ottawa ON.
CAC technician: (613) 737-7600, ext 4887 or by email at CACEquipmentLoans@cheo.on.ca.

Frequently asked questions

Who can make a referral?

Referrals to CAC are accepted from parents and community speech-language pathologists (with parent/guardian consent). Parents should fill out the form together with their speech-language pathologist. The referral forms can be found in the “Make a referral” section of the website.

If your child has previously been seen in CAC for face to face communication or writing aids assessment and their system is no longer meeting their basic communication needs at home, please contact the CAC program manager at 737-7600 x 2379 to request a re-referral.

What should we expect?

There are six general stages to the CAC referral/assessment process:

Referral
Review of referral to confirm eligibility
Assessment
Dispense and/or recommendations
Initial training/coaching
Discharge

Where will the assessment take place?

Assessment sessions typically take place at our clinic located at the CHEO Thurston site or at any of our CHEO sites. However, in certain circumstances, your child or youth’s therapist can work with you to find an appropriate alternative including virtual care.

What happens during an assessment?

Assessments may take multiple appointments. Before the assessment, your clinician will gather information about your child’s preferred activities to encourage them to participate. You may bring the following:

a few favourite activities where there are opportunities for your child to communicate (e.g.: favourite toy, family photos and/or photos of a favourite outing/trip, books, puzzles, nut/peanut free snack etc.)
the communication tools that you and your child or youth use (i.e. pictures, photos, communication book, PECS binder, communication device, etc.)
a video of your child or youth communicating at home, at school or in another familiar environment.

What types of AAC communication systems are available?

There are many types of AAC communication systems available, including dedicated devices, tablet devices (e.g. iPads), communication apps, communication boards and books. Each type has its own benefits and drawbacks, and the choice depends on the specific needs and abilities of the individual.

Is there funding available for communication systems?

There is a cost associated with all communication systems that are purchased or leased.
If eligible, the Assistive Devices Program (ADP) through the Ministry of Health and Long-Term Care provides funding for a portion of the cost of eligible equipment.
The remaining cost (client portion) is paid by the client/family or may be paid by a third party (i.e., Assistance for Children with Severe Disabilities (ACSD), Easter Seals Society, Muscular Dystrophy Association, etc.). You can discuss f unding options with your therapist.

How and when can iDevices be used for augmentative communication?

Many families are interested in exploring the iPad as a communication device for their child with special needs. The iPad with an appropriate communication app can be a very valuable communication tool for many children, but it is not necessarily the best tool for everyone. Some clients may need a device that requires less controlled movement than an iPad. Others may have more success with a simpler device, or with a means of communication that does not use technology at all, such as a communication board or book. Some clients may do better with a device whose only function is communication, rather than a device that serves many different purposes, such as the iPad.

Talk to your child’s speech-language pathologist if you are not sure about the best augmentative communication approach for your child. Therapists can request consultation through our All About AAC service to find out about different options. Eligible clients can be assessed in CAC to determine the best AAC approach to meet their needs.

If you do wish to explore the use of the iPad for augmentative communication, and are considering making a referral to CAC, it is important to understand the role of the CAC team in recommending and supporting iPads:

CAC can only recommend an iPad and communication app after a thorough assessment of the client’s communication needs and abilities. Depending on what we find during this assessment, we may recommend an iPad, another communication device, or no device at all.
If you purchase a communication device (including an iPad with a communication app) before your CAC assessment, you will not be able to receive funding for it through the Assistive Devices Program (ADP). If the device you purchased is meeting your child’s basic communication needs, you may not be eligible for ADP funding for other communication devices, and CAC involvement may be limited. We are unable to provide support or training for devices we did not recommend, but we would be happy to share some written resources with you or provide you with links to on-line resources.
ADP will only provide funding for an iPad and communication app together as a bundle. If you already own an iPad, there is no ADP funding available to purchase just a communication app.
CAC can only recommend an iPad with a communication app that is approved by ADP. CAC staff may be able to provide you with some information about other apps, but we cannot assess these apps with your child or prescribe them for you.
CAC can only prescribe a communication device (including the iPad with an approved app) to meet every day, functional communication needs at home or in the community. We cannot prescribe communication devices for use solely at school.
CAC cannot prescribe an iPad if it will be used primarily as a tool for language development, learning or recreation. To find out more about using an iPad for functions other than communication, you can talk to our Adaptive Toys and Tech Resource Centre team at toysandtech@cheo.on.ca.