Imagine being in a foreign country where people speak a language you do not understand, and when you try to make yourself understood, you can’t. Now, imagine having a tool at hand that allows you to translate everything you don’t comprehend: the role of AAC is exactly this. Augmentative and Alternative Communication (AAC) is an approach that, through the use of techniques, strategies, and technologies, creates real opportunities for communication for all those who have difficulty using the verbal communication channel. AAC refers to an area of research and clinical and educational practice that studies and attempts to compensate for temporary or permanent communication disabilities, activity limitations, and participation restrictions of people with severe disorders in language and/or speech production and/or comprehension, concerning oral and written communication modes.
It is defined as “augmentative” precisely because, contrary to some unfortunately still widespread beliefs, it does not replace but rather increases the natural communication abilities of the person, including verbal language where conditions allow. The symbols or images used by AAC qualify as alternative tools that accompany and stimulate oral production. We are used to think that the only way to communicate is exclusively through words, but let’s consider people who are deaf, mute, or deaf-mute: sign language is essential for making themselves understood by others and for understanding them.
Once again, try to imagine being a child with neurodiversity who is entering a new classroom at school for the first time. New teachers, classmates, unknown people with whom you have never spoken before and who have a different way of communicating from yours. Finally, imagine having clear symbols at your disposal to make yourself understood and to understand those who use them to communicate with you: isn’t it a completely different story?
Children and adolescents with various autistic spectrums do not only need special education teachers or educational materials but also an active class that makes them feel part of the group. They need to be involved just like all the other students. Inclusion, relationships with others, and playing together help the most vulnerable individuals feel part of something, feel understood, and lay the foundations for future integration into society.
For this reason, for several years now, the Lazio Region has been experimenting with a specific assistance service in schools for students who have difficulties in understanding and producing language and therefore need AAC interventions for school integration.
Since 2020, the cooperatives Mirjac Onlus and Tutti giù per terra Onlus, under the supervision of Dr. Fabiana Sonnino, specialist in clinical psychology and an individual and group psychotherapist, have trained, supervised, and coordinated the AAC assistance service in various schools. They expanded from 12 institutions in the 2020/2021 school year to 33 in 2021/2022, 34 in 2022/2023, and reached 44 during 2023/2024. The number of students supported by these assistants has increased exponentially over the years, from 20 students in the 2020/2021 school year to 92 during 2023/2024. These figures represent a tremendous success for the cooperatives and for AAC, demonstrating how demand from schools has increased due to significant improvements observed both in the affected individuals and in the inclusion practices employed.
Dr. Francesca Lattanzi, the coordinator of AAC within the schools reached through the aforementioned cooperatives, emphasizes that a tangible example of the success of the service in the school environment—and beyond—is represented by the visual schedule. This is a clear list composed of images that represent the activities to be carried out during the day. This tool helps to reduce, and in some cases even completely eliminate the anxiety of not knowing how the day will unfold. More importantly, it increases the possibility of greater autonomy, a crucial factor in alleviating the frustration often felt by neurodivergent individuals. This autonomy can involve activities such as going to the bathroom or getting one’s school materials, processes that may seem trivial to neurotypical individuals. However, when performed independently by those who usually cannot, these activities can represent a significant step toward integration, socialization \and inclusion in school, especially in middle schools or high schools, where the autonomy of students without specific vulnerabilities is almost total.
However, AAC is not exclusively aimed at those with atypicalities but also at those considered “neurotypical.” According to Dr. Sonnino, the use of images, diagrams and symbols is essential for maintaining high levels of attention among students regarding the school curriculum and helping them better understand the topics covered, especially given the historic low in attention spans due to the advent of social media.
Therefore, it’s necessary to raise awareness of AAC among the entire school staff because, as a novel support system, it’s not well known and is often a source of skepticism. According to Dr. Sonnino, despite strong advocacy from families promoting AAC in recent years, many schools are reluctant to adopt this method since the school staff is not adequately trained, and some teachers still do not believe in its effectiveness. Instead, everyone should be included in this awareness-raising effort, starting with school collaborators, cafeteria staff—if present—canteen workers, administrative staff, and, of course, the teachers.
The use of AAC is also essential for integrating students who are native speakers of other languages and those with communication difficulties within their class. If lessons, textbooks, and school programs in general were supplemented with AAC tools, understanding would be facilitated for those who speak another language because they could use images, symbols, and written words in both their native language and the language of the host country. Additionally, Dr. Sonnino emphasizes the importance of producing AAC-translated textbooks and supplementary materials adapted to the specific curriculum of each school year so they can be used by everyone.
Supporting this, it is important to mention the experience of Dr. Silvia Nazzicone, a psychologist and coordinator of various projects for the cooperative Tutti giù per terra, concerning “The Betrothed”, a cornerstone of Italian literature. Thanks to AAC’s implementation in schools, an autistic teenager in the eighth grade, considered “low-functioning,” was able to understand the work alongside his classmates. This was to the satisfaction of the student, his teachers, and his parents, as the classmates were also helped by the summarizing and clarifying features offered by the AAC translation.
Despite the significant achievements brought about by the inclusion of AAC assistants within educational institutions in recent years, the Lazio Region has decided to take a step back, withdrawing from previous commitments and creating a severe gap and a general state of disorientation around the issue. Starting from the 2024/2025 school year, following Determination No. G07784 of 06/06/2023, the regional authority, after 7 years of providing the service, announced that the intervention practices of AAC assistants carried out so far will not continue or be confirmed in the following years. The management has been transferred to the municipalities — except for secondary schools — inevitably leading to a highly fragmented situation. As demonstrated by the previously reported data, due to the successes and improvements achieved through the service, the interruption of this assistance program would be a significant loss, both for students with specific disorders and disabilities and for all their classmates.
As we ponder the future of AAC assistance within Rome and surrounding areas, the question remains open. This is an important practice that is still to be fully explored and has much to offer to ensure that everyone has the same opportunities and tools so that no one ever feels excluded.