AAC or Augmentative and alternative communication are techniques used to send messages from one person to another when speech is not possible, like when a person paralyzed due to ALS. We use some forms of AAC everyday, such as when we write someone a note or communicate through gestures. Simply put, AAC is communication without speech.
One high tech example of AAC is the use of electronic devices that speak for a person as a response to either entries on a keyboard, finger movements, puffs of air, or eye movements. One example of a person using this type of communication is Stephen Hawking, a famous physicist who has also been stricken with ALS.
AAC can also be as low tech as writing on a piece of paper or pointing to symbols on communication boards. I have posted a video below of a woman with ALS whose form of AAC is pointing a laser at a communication board. This is a very beneficial technique for a person with ALS because it needs very minimal movement.
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