page_title: Augmentative and alternative communication
section_title: History
hierarchical_section_title: Augmentative and alternative communication / History
caption_attribution_description: English: Early 1960s picture of user operating a electric communication device in the form of a sip-and-puff typewriter controller named the Patient Operated Selector Mechanism (POSM or POSSUM), which was developed in the United Kingdom. Released into the public domain by Possum company
context_page_description: Augmentative and alternative communication encompasses the communication methods used to supplement or replace speech or writing for those with impairments in the production or comprehension of spoken or written language. AAC is used by those with a wide range of speech and language impairments, including congenital impairments such as cerebral palsy, intellectual impairment and autism, and acquired conditions such as amyotrophic lateral sclerosis and Parkinson's disease. AAC can be a permanent addition to a person's communication or a temporary aid. Stephen Hawking used AAC to communicated through a speech-generating device.
  Modern use of AAC began in the 1950s with systems for those who had lost the ability to speak following surgical procedures. During the 1960s and 1970s, spurred by an increasing commitment in the West towards the inclusion of disabled individuals in mainstream society and developing the skills required for independence, the use of manual sign language and then graphic symbol communication grew greatly. It was not until the 1980s that AAC began to emerge as a field in its own right.
context_section_description: The history of AAC can be traced to the days of classical Rome and Greece, with the first recorded use of augmentative strategies with the deaf. The use of manual alphabets and signs was recorded in Europe from the 16th century, as was the gestural system of Hand Talk used by Native Americans to facilitate communication between different linguistic groups. The first known widely available communication aid was a letter and word-based communication board developed for, and with, F. Hall Roe, who had cerebral palsy. This communication board was distributed in the 1920s by a men's group in Minneapolis.
  The modern era of AAC began in the 1950s in Europe and North America, spurred by several societal changes; these included an increased awareness of individuals with communication and other disabilities, and a growing commitment, often backed by government legislation and funding, to develop their education, independence and rights. In the early years, AAC was primarily used with laryngectomy and glossectomy cases, and later with individuals with cerebral palsy and aphasia. It was typically only employed after traditional speech therapy had failed, as many felt hesitant to provide non-speech intervention to those who might be able to learn to speak. Individuals with intellectual impairment were not provided with AAC support because it was believed that they did not possess the prerequisite skills for AAC. The main systems used were manual signs, communication boards and Morse code, though in the early 1960s, an electric communication device in the form of a sip-and-puff typewriter controller named the Patient Operated Selector Mechanism (POSM or POSSUM) was developed in the United Kingdom.
  From the 1960s onward, sign language increased in acceptance and use in the Deaf community, and AAC also came to be viewed as acceptable for those with other diagnoses. Manual sign languages, such as Makaton, were advocated for those with both hearing and cognitive impairments, and later for those with intellectual impairment or autism with normal hearing. Research into whether primates could learn to sign or use graphic symbols spurred further interest the use of AAC with those with cognitive impairments.  The use of Amer-Ind hand signals opened the field to AAC techniques specifically for adult users.
  Blissymbols were first used in Canada in 1971 to provide communication to those not able to use traditional orthography; their use quickly spread to other countries. With improved technology, keyboard communication devices developed in Denmark, the Netherlands and the US increased in portability; the typed messages were displayed on a screen or strip of paper. By the end of the 1970s, communication devices were being commercially produced, and a few, such as the HandiVoice, had voice output. Countries such as Sweden, Canada and the United Kingdom initiated government-funded services for those with severe communication impairments, including developing centres of clinical and research expertise.
  The late 1970s and 1980s saw a massive increase of AAC-related research, publications, and training as well the first national and international conferences. The International Society for Alternative and Augmentative Communication (ISAAC) was founded in 1983; its members included clinicians, teachers, rehabilitation engineers, researchers, and AAC users themselves. The organization has since played an important role in developing the field through its peer-reviewed journal, conferences, national chapters and its focus on AAC in developing countries. AAC became an area of professional specialization; a 1981 American Speech-Language-Hearing Association position paper, for example, recognized AAC as a field of practice for speech-language pathologists. At the same time, AAC users and family members played an increasing prominent role in the development of knowledge of AAC through their writing and presentations, by serving on committees and founding advocacy organizations.
  From the 1980s, improvements in technology led to a greatly increased number, varie
caption: The Patient Operated Selector Mechanism (POSM or POSSUM) was developed in the United Kingdom in the early 1960s.
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