An Augmentative and Alternative Communication device (AAC) is a tool used by individuals who struggle to communicate using speech. AAC tools can take different forms, such as picture exchange systems or electronic devices, and are individualized to meet the needs of the user.
AAC devices matter for autistic children, especially non-speaking or minimally verbal kids. Without having a functional way to communicate, children may begin engaging in challenging behaviors to have their needs met. Having an AAC device is crucial to help them have a voice and be able to advocate for themselves.
A common concern is that introducing an AAC device will hinder speech development. However, research repeatedly shows that giving a child an AAC device encourages speech production.
What Is Augmentative and Alternative Communication
In an AAC device, the augmentative part refers to the enhancement of a person’s communication. An AAC should improve and support a person’s speech, helping to clarify what a person is trying to communicate. The alternative component of an AAC device refers to using a different mode of communication. For example, if a person is not able to produce vocal speech, they may use a speech-generating device.
AAC devices can and should be used with anyone who has struggles with speech or communication. They can be long-term or short-term supports and used with people with speech impairments, physical limitations, cognitive or developmental disabilities and people who may temporarily be unable to communicate due to surgeries, etc.
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Types of AAC Systems
An unaided AAC does not require any external tools; it relies entirely on the user’s body for communication. This includes methods like sign language, gestures, facial expressions, and body movements. It is always available and doesn’t require equipment, but it depends on the communication partner’s ability to understand the signs or gestures, and it may be challenging for individuals with motor difficulties.
A low-tech AAC refers to non-electronic tools that support communication. Examples include picture cards, PECS (Picture Exchange Communication System), communication boards or books, and alphabet boards. These systems are often simple, inexpensive, and easy to use, but they offer limited vocabulary, require physical manipulation, and lack voice output, which may reduce their effectiveness in some social settings.
High-tech AAC involves electronic devices that produce speech or text. This category includes speech-generating devices (SGDs), tablets with AAC apps such as Proloquo2Go or LAMP Words for Life, eye-tracking systems, and other text-to-speech technologies. High-tech AAC offers extensive vocabulary options, customizable interfaces, and voice output, enhancing communication and social interaction. However, these systems can be expensive, require regular charging or updates, and may not always be practical in outdoor or fast-moving environments.
How AAC Supports Autistic Children
Why Some Autistic Children Struggle With Speech
One of the most pervasive characteristics of autism is difficulties with communication, including speech production. Commonly, children with ASD experience delays in their speech and communication, speaking later than their peers. To help autistic children communicate, targeted intervention is usually required, with early intervention being the most effective.
There are key differences between the terms “non-speaking” and “non-communicative”. Specifically, non-speaking refers to individuals who use different types of communicative modalities, apart from speech. Another term commonly used would be “non-vocal” communicators. In contrast, non-communicative refers to a broader set of communication challenges, which may include difficulties with receptive language, social interaction, as well as expressive communication.
Benefits of AAC
Having an AAC device can greatly improve an individual’s quality of life. For example, an AAC device means a person can finally be understood and have their needs met, which will reduce frustration and meltdowns.
Using an AAC device can be a helpful tool to support speech and language development. Contrary to some beliefs that AAC devices will slow down or impede language development, AACs help with building communication skills.
Having an AAC device also helps confidence and independence, as children can find their voice and advocate for themselves. Rather than waiting for other people to pre-empt or try to guess their needs, they now have a way of initiating and communicating to get their needs met.
Having an AAC can often lead to an improved relationship with family, teachers, and peers. Children finally have a functional way of communicating, which is both reinforcing and positive for themselves as well as for those around them. Instead of relying on less appropriate ways of communication, such as grabbing, aggression, avoidance, etc., children can now clearly communicate their needs, creating calmer and more positive relationships.
Common AAC Devices and Tools
Popular High-Tech Options
High-tech AAC tools are essential for individuals who need support with expressive communication. These devices and apps offer voice output, customizable vocabulary, and access options that meet a wide range of user needs.
One of the most popular programs is called Proloquo2Go and can be used on iPads and iPhones, making it a popular choice. It offers a symbol-based interface, customizable layouts, and voice output, making it a flexible option for many users.
TouchChat is another powerful AAC app for iOS devices. It supports both symbol-based and text-based communication and includes a wide variety of vocabulary sets. Its voice output and visual display are designed to support users of all ages and ability levels.
Based on motor planning principles, LAMP Words for Life is often used with individuals on the autism spectrum. It provides consistent icon locations and a structured layout, which helps users build language through repetition and predictable movement patterns.
In addition to tablets and apps, there are dedicated speech-generating devices (SGDs) designed specifically as an AAC device. PRC-Saltillo and Tobii Dynavox offer robust, durable devices with advanced features such as eye-tracking, switch access, and powerful customization tools. These devices are often used when a more specialized or rugged system is needed for consistent and reliable communication.
Low-Tech Alternatives
Low-tech alternatives are non-electronic options for communication. These can often be used or taught in conjunction with high-tech options, as a secondary option when a device might be broken or out of battery. These can also be useful tools if a child struggles with fine motor skills or behavioral issues around electronic devices.
PECS is a structured, evidence-based communication system where individuals learn to exchange pictures for items or actions they want. It begins with simple exchanges and gradually builds toward sentence formation. PECS supports the development of intentional communication and functional language.
Communication boards display symbols, pictures, or words that a user can point to to express themselves. These boards can be customized to different topics (e.g., emotions, daily routines, school activities) and are ideal for individuals who need support expressing needs, wants, or choices in various settings.
Core vocabulary boards focus on high-frequency words that are useful across multiple situations (e.g., go, want, more, stop). These boards are especially powerful because they support sentence building and spontaneous communication. They’re often used alongside modeling strategies to teach language in context.
Choosing the Right AAC for Your Child
What to Consider
When considering an AAC device, there are a few key points to consider. For example, if a child is currently communicating mainly with gestures or sounds, PECS or picture boards may be more appropriate. For more advanced communicators, a transition to an AAC app or speech-generating device could help to develop their communication further.
For high-tech AAC devices, a degree of fine motor ability is needed. Specifically, the user will need to be able to unlock their device, swipe, select the app, and select the icons they want to communicate. If a child is currently unable to complete those tasks, a low-tech option may be a better fit.
Learning style will also influence what type of AAC will suit your child. For example, a child who benefits from visual structure and repetition may do well with a system like LAMP Words for Life, while a child who can read may be ready for text-based tools. Some children engage more with interactive screens, while others do better with simple picture cards.
Finally, consider where and with whom your child will be using the AAC system. Will teachers, caregivers, and peers be trained and supportive? Will the device or materials be easy to carry and maintain across settings? A successful AAC system works best when everyone in the child’s environment is involved in modeling and supporting its use.
Professional Involvement
Working with professionals is a key part of choosing and successfully using an AAC system. A speech-language pathologist (SLP) plays a central role in assessing your child’s communication needs, recommending appropriate AAC tools, and helping your child learn to use them effectively.
If your child also works with a Board Certified Behavior Analyst (BCBA), they can support AAC use by building communication skills into daily routines and behavior plans. An important first step is getting a formal AAC evaluation, usually done by an SLP with AAC experience. This assessment looks at your child’s current skills, motor abilities, and environments to help choose the most suitable communication system.
Will AAC Prevent My Child From Speaking?
Debunking the Myth
Numerous studies have found that AAC can increase verbal speech in children, with the best results when introduced early and consistently. Millar, Light, and Schlosser (2006) found that in 89% of cases reviewed, speech either increased or remained unchanged after AAC was introduced.
Schlosser & Wendt (2008) conducted a meta-analysis confirming that SGDs can support speech development, especially when paired with modeling and verbal encouragement. Romski et al. (2010) showed that toddlers with developmental delays who used AAC apps and speech-generating devices developed more spoken words over time than peers who only received speech therapy without AAC.
A parent shared that their son began speech therapy at 23 months and was already using some sign language. They introduced an AAC device to support his communication, which helped significantly. With the combination of signs and AAC, he was able to express himself more easily, leading to less frustration and better engagement. After about six months of AAC use, he began speaking more and eventually graduated from speech therapy in under a year. The parent believes that having a way to communicate early on helped him focus on building language, not just getting his needs met. Their SLP reassured them that for children who are ready to develop speech, AAC won’t get in the way—it can actually help.
Funding and Access to AAC
How to Get an AAC Device
Getting an AAC device can feel overwhelming, but there are several ways to access support. Many families get devices through insurance, especially when a speech-language pathologist provides a formal AAC evaluation and documentation of need. School districts may also provide AAC tools as part of a child’s IEP (Individualized Education Program) if it’s needed for communication in the classroom. Additionally, some families qualify for Medicaid or apply for grants from non-profits that help cover the cost of AAC devices. An SLP or school team can often help guide you through the process.
What to Expect From the Process
The AAC process usually starts with a comprehensive assessment by an SLP, who looks at your child’s communication skills, physical abilities, and daily needs. After that, your child may go through one or more device trials to see which AAC system works best for them. Once a device is selected, the team will help submit paperwork for insurance or school approval. After approval, you’ll receive the device and begin training, both for your child and for family or school staff, so everyone knows how to support its use in daily life.
Supporting AAC Use at Home
Creating a Communication-Rich Environment
To help your child succeed with AAC, it’s important to create a communication-rich environment at home. One of the most effective strategies is modeling AAC, also known as Aided Language Input. This means using your child’s AAC system yourself as you talk, showing them how to communicate with it naturally.
Try to make AAC a part of daily routines like meals, playtime, getting dressed, and going out, so your child sees it as a normal way to express themselves. Also, collaborate with your child’s therapists to stay consistent with goals and strategies, and to get ideas for using AAC in fun, practical ways. The more they see AAC being used, the more likely they are to use it themselves.
Resources for Parents
There are many great resources for parents looking to support their child’s AAC journey.
Online support groups and AAC communities can be incredibly encouraging — for example, you can join the AAC for Families Facebook Group or explore discussions on Reddit’s r/AAC.
For guidance at home, websites like PrAACtical AAC offer video tutorials, tips, and parent guides, while AssistiveWare’s Parent Resources are perfect for families using apps like Proloquo2Go.
You can also explore AAC-friendly books and apps, such as Toca Boca apps for fun, language-rich play, or books from The All Done Monkey Bookstore featuring diverse and inclusive AAC users.
These tools can help you build confidence, stay informed, and make AAC a natural part of your child’s life.
What to Expect: A Parent’s Perspective
Realistic Timelines
Every child is different, and no two AAC journeys will look the same. Being realistic and celebrating each small step is important, as some children will take a few days to start using their AAC independently, while others will take weeks or months.
Learning to use an AAC device is not a race, and being consistent and patient will lead to the highest likelihood of success. Be aware that it will take time and adjustment, but commit to following through and learning this new way to communicate with your child.
Common Challenges and Solutions
As with changes and new routines, you are likely to experience some small hiccups along the way. A common challenge is device rejection or resistance. This is expected, as your child will be accustomed to communicating their needs with you in a certain way and they are now being taught a whole new way. Change can be difficult, but keeping consistent is the best tool to help them realise the power of their device and decrease confusion between different communication modalities.
Another challenge is managing device access, making sure the device is charged, nearby, and safely stored when not in use. Children can often swipe off their communication app and open leisure apps such as YouTube or games. Using the guided access feature will ensure your child stays on the AAC app and can also provide opportunities for communication, as they can request videos or games.
As mentioned, consistency is key, so syncing strategies between school and home is paramount. Regular meetings between your child’s therapeutic team, such as BCBA and SLPs, and the school can help with agreement and sameness between environments.
Conclusion
Introducing an AAC device into your child’s life is an exciting first step to helping your child find their voice. Every child can communicate, but not every child communicates in the same way. Using an AAC device will allow you and your child to better understand each other, as both of you will be able to communicate more effectively.
Above all, it’s important to remember that AAC is a bridge to communication—not a barrier to speech. It gives children a way to express themselves while their verbal language is still developing. Using AAC doesn’t mean giving up on speech—it means supporting your child’s ability to connect, be understood, and feel confident.
If you feel you are open to exploring and learning more about AACs, speak with your BCBA or SLP about options that they feel would fit with your child.
