Music Therapy and Augmentative and Alternative Communication (AAC)

Written By Anna Laura McAfee, MMT, MT-BC

PECS, sign language, talkers, switches, AAC devices… Augmentative and Alternative Communication (AAC) methods come in many shapes and sizes, and often the devices and are referred to as something different for each individual that uses them. AAC refers to the different ways in which a person communicates outside of verbal communication, whether this is with body language, gestures, a communication device, or through a Picture Exchange Communication System (PECS; ASHA.org). People who use AAC devices often do not communicate verbally or it is not always a reliable mode of speech. The aim of AAC devices is to minimize frustrations surrounding communication and “maximize communication power” (Light & McNaughton, 2013). Ultimately, having access to alternative and augmentative means of communication can help support self-determination and identity.



Music therapy provides a unique opportunity to explore and support AAC through playing music. While music may not replace language or speech, we find different ways to express ourselves without the need for words or verbalizations by using instruments and/or vocalizations. Music therapy can also support functional communication, often through the use of other devices, such as sign language, PECS, switches, or speech generating devices, like Touch Chat or Proloquo2go (Devlin & Meadows, 2021). A music therapist may help a person practice functional communication, such as labeling instruments, requesting or protesting songs, and choosing activities. Additionally, implementing alternative forms of communication like AAC devices into music therapy allows the person to practice communication skills in a natural environment using a highly motivating subject - music (Gadberry, 2011)! Consistently using these communication methods in natural environments helps to generalize the use of communication in everyday life - not just at school or with a speech-language pathologist.



Here at Empower, we have several community members who use AAC devices to communicate, such as Liam! During music therapy sessions, Liam often uses his high-tech AAC device to request instruments, help write songs, and direct playing instruments or movements. Liam is also often seen before sessions requesting “Mrs. Kate” on his device. According to Liam’s mom and his music therapist, Kate, incorporating the AAC device into music therapy sessions has helped Liam build confidence, express himself, and be creative.

These photos are shared with explicit permission from the individuals depicted, or their legal guardians where applicable, for the purpose of sharing and promoting our activities. Any further use or distribution of these images without prior consent is strictly prohibited.

Anna Laura McAfee, MMT, MT-BC

Hiya! I’m Anna Laura, a board-certified music therapist (MT-BC) in Nashville, TN. I’m from Western Arkansas, which is where I completed my Bachelor of Arts degree in music from the University of Central Arkansas with minors in interdisciplinary studies and psychology. During my bachelor's degree, I completed research on using music therapeutically with older adults with dementia and their family caregivers. In August 2018, I began the music therapy equivalency and master’s degree program at Appalachian State University in Boone, North Carolina. During the equivalency portion of my studies, I explored individual and group-based music therapy in older adult residential facilities, special education classrooms, after-school programs for teenagers, adult medical settings, and residential facilities for people with intellectual and/or developmental disabilities (I/DD). In December 2020, I completed my internship at Opportunities for Positive Growth in Marion, Indiana, where I provided individual and group music therapy for children, teenagers, young adults, adults, and older adults with I/DD, autism, and neurocognitive disorders.

After internship, I returned to Appalachian State to complete my master’s degree in music therapy (MMT). During my graduate coursework, my focus was mainly on promoting self-determination and self-advocacy in teenagers and young adults with I/DD who communicate in extraverbally/nonverbally. I have taken courses in play therapy, special education, and child and adolescent therapy. I have also completed a graduate practicum promoting social skills with neurodiverse college students post-COVID quarantine. In December 2021 I completed my thesis titled “Promoting Self-Determination in Individuals with I/DD who Communicate Extraverbally: Reflections and Implications for Practice”.

I have professional experience working in public schools, assisted living facilities, and inpatient and outpatient psychiatric hospitals, focusing on academic, emotional, social, and communicative strengths and areas for potential growth.

I am passionate about disability rights and self-advocacy, and my main emphasis as a clinician is to help promote autonomy and self-determination, build a trusting and therapeutic relationship, and to help provide a space in the music for people to be themselves and express who and where they are.

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