Augmentative Alternative Communication (AAC)

What Is AAC?

AAC stands for Augmentative Alternative Communication

  • Augmentative comes first because we always want to “augment” what someone already uses to communicate, whether it be speech, gestures, body language
  • Alternative for those who have some speech, but their speech is difficult to understand or isn’t enough to meet their needs
  • Low Tech – are simple types of communication systems that include communication picture boards, Picture Exchange Communication System (PECS) and use of signs/gestures.
  • High Tech includes speech generating devices made specifically for communication and communication apps installed on phones, tablets, or i-Pads that produce speech as buttons are activated.


How will AAC help my child?

  • AAC provides additional support for verbal speech so your child can use multiple modalities to communicate, for instance hand gestures or more formal signs along with verbal output and maybe symbol pictures. We all use a variety of ways to communicate, including writing notes, texting, etc. in addition to speaking. Your child deserves the right to have access to all the tools available to communicate.
  • AAC is visual and concrete – providing more than verbal words to assist with recalling words to express. AAC symbols don’t disappear once they are touched like verbal words do when we speak them. AAC communication symbols remain as a reference or reminder as to what was verbally said. They also provide a cue to the child for what they are thinking and might want to say.
  • AAC reduces the pressure of using only spoken words which often is a source of frustration for children who struggle to communicate.
  • AAC can help your child be understood – increasing the likelihood that a listener can “catch” the meaning of the unintelligible utterance by providing a visual referent.
  • AAC can also be a practice tool by providing an imitation cue or model for the child to practice speech or verbal output independently.


Will AAC cause my child to not want to talk?

AAC will stop my child from talking or reduce his/her motivation to improve speech. While multiple research studies have been conducted since this was initially proposed back in the 1980’s, no one has been able to provide any evidence to support the decrease in speech production or willingness of a child to talk when using AAC. Children, as well as adults, will gravitate to the fastest and easiest means of communicating. AAC is not a faster communication system. It is however a multi-dimensional system that provides an additional way to communicate if speech is hard. Much like you and I will use our phone to take a picture of information rather than write it down or type it into our phone – we look and learn to use the quickest route. If a child can talk, they will. They are not talking because they are not motivated or acting out. AAC helps bridge the gap and helps reduce frustration.


Where do I start?

  1. The first step is to get an AAC Evaluation from a Speech-Language Pathologist, with specialized training in AAC. The SLP should evaluate what your child understands (receptive language ability) and what is currently communicated (verbal and nonverbal communication methods) as well as symbol knowledge, visual discrimination abilities, and fine and gross motor abilities. If your child has other diagnoses besides CAS, then other disciplines as well as other areas might be evaluated. The SLP should look at low and high tech AAC options and should demonstrate a variety of systems. The SLP should have a background in AAC, preferably with ties to ASHA and USSAAC. They might also have an ATP Certification from RESNA.
  2. Talk with your child’s SLP about using a picture board or other type of low tech AAC to trial the effectiveness of AAC before spending money to purchase a system.
  3. Trialing a variety of high tech AAC systems (Communication Apps, speech generating devices and tablets) leads to a match between your child’s communication and language abilities and needs and product. You wouldn’t purchase a car without a test-drive, why do you trust your child’s communication to a social media post? Check out your state AT Program (every state has one!) Some have lending programs to allow you to try before purchasing through private funding or insurance.
  4. Check out vendor websites for more detailed information about Apps/software or AAC. Many companies have very detailed information about their program features. Each language system has particular features that stand out – you should be able to compare products and determine which one is the most appropriate to you and your child BEFORE you purchase. Seek professional help. You are not expected to know this! Vendors include (but are not limited to) PRC-Saltillo, Tobii Dynavox, Forbes AAC, Assistiveware, and Avaz.


How can I help my child use their AAC device?

My child has an AAC system but he/she just doesn’t use it. AAC is a tool to improve communication. If your AAC User doesn’t understand how to use the tool then it is not useful and will be abandoned. Look at what is going on in the environment. Do you use it with your child or is the burden of use on the child? How often do you model use of the AAC system? How are you modeling use? Is the AAC system (low or high tech) used with only a focus on getting something? Communication is more than asking for a cookie. Lead by example. Inspire. Help your child and demonstrate your support by using the AAC system yourself in front of your child and showing them how to use this tool. There are plenty of programs outlining how to be a better communication partner to your AAC User (SMORRES, MASTER PAL, Project CORE, ImPAACT Program).

Articles to check out for more information:

Romski, M.A., Sevcik, R.A., Barton-Hulsey, A., & Whitmore, A.S. (2015) Early intervention and AAC: What a difference 30 years makes. Augmentative and Alternative Communication, 31, 181-202. doi: 10.3109/07434618.2015.1064163
Smith, A, Barton-Hulsey, A, Nwosu, N. (2016) AAC and Families: Dispelling Myths and Empowering Parents. Perspectives Sig 12, Vol 1, Issue 12.
Binger, A. (2007) Aided AAC Intervention for Children With Suspected Childhood Apraxia of Speech. Perspectives on Augmentative Alternative Communication, Vol 16, 1.
Oommen, E. & McCarthy, J. (2014). Natural Speech and AAC Intervention in Childhood Motor Speech Disorders: Not an Either/Or Situation. Perspectives on Augmentative and Alternative Communication. Vol 23, Issue 3.

Top Websites for Parents and Professionals to check for additional information

By Anne Kuhlmeier