What is AAC?

Augmentative and alternative communication, or more frequently referred to as AAC, includes all forms of communication a person uses (other than verbal speech) to express their wants, needs and desires. Which means we all use AAC all day, every day! 

Understanding Augmentative and Alternative (AAC) Communication

There are two forms of AAC: unaided and aided. 

• Aided AAC consists of any approach that involves external supports such as picture cards, communication boards, and speech generating devices. 
• Unaided AAC consists of any non-spoken communication or natural forms of communication we use with our bodies such as gestures, eye gaze, facial expressions, and sign language. 

Forms of Unaided AAC Used in Speech Therapy

There are a wide variety of unaided communication options which are adapted to each child’s individual needs. Here are some of the most common forms of unaided AAC used by NAPA Center’s speech language pathologists! 

1. Switches

Jellybean switches: 

A wired switch with an activation surface that provides an auditory and tactile feedback to help your child’s awareness.

Step-by-step switch:

A battery-operated button which also provides auditory and tactile feedback as well as voice output! Record 1-3 messages on this switch to pre-program appropriate language for your child to request or engage in activities.

Wobble switch:

A flexible arm that can move 360-degrees and activates with a swiping motion in any direction,

2. Picture cards 

• Picture cards are a great low-technology form of communication to utilize during communication opportunities 

• Picture cards can be placed in front of your child with a ranging number of cards to choose from or can be held up for your child to choose from visually using eye gaze 

3. Speech generating devices

There are a wide variety of high-technology AAC devices for children

• iPads with speech applications such as GoTalkNow, Proloquo2Go, TouchChat, LAMP. These can be adapted with switch access, auditory scanning or touch access.

• Dedicated devices from companies such as PRC or TobiiDynavox. These can offer switch access, auditory scanning, touch access, and eye gaze access.

All forms of AAC can be adapted if your child has a vision impairment, such as CVI.

Augmentative and Alternative Communication FAQ

1. How do I know what is the best fit for my child?

Talk to your speech therapist about trialing different AAC options during your next weekly or intensive speech session. Taking into consideration your child’s motoric abilities, fine motor skills and language skills, you and your therapist can brainstorm the best AAC option. 

If one option doesn’t seem like a good fit, there are so many communication modalities to trial so you can find the perfect fit for your child. 

2. My child has just received their own AAC modality at home! What are my next steps?

One of the most important factors of implementing AAC into your child’s life is using it in as many situations and environments as possible. Use it during mealtimes, play, out at a restaurant, bath time and more. 

Become familiar with your child’s AAC device/system and model away! What is modeling? Modeling is using the communication system while you talk; this shows your child how it can be used. This is so important because learning language requires repetition and exposure. Modeling will help you and your child become a more adequate AAC user! 

Uncovering Myths About AAC

• Myth: Start with an easier to learn system and make changes as the user becomes an adequate communicator with the system. 
  • FACT: It is best practice to start your child with the most robust AAC system that can grow with them. If you change the system on them frequently, your child will have to re-learn the new system which can be frustrating and time consuming. 

• Myth: I shouldn’t program new and less relevant vocabulary into the system, or I should make separate communication boards for different activities. 
  • FACT: New and less familiar vocabulary is great! It allows your AAC user to become familiar with more words and the appropriate context. Use your modeling skills to teach your child ways to use that new word. It is best to have one system to allow your child to have accessibility to a wide variety of language. This encourages initiation and allows you to target a variety of language skills. 

• Myth: AAC will reduce my child’s motivation to use their voice. 
  • FACT: Research has proven that use of AAC actually increases oral language and verbalizations! Through AAC, your child will be exposed to more language while simultaneously reducing the stress and social pressure to use verbal speech to communicate.  

Find Additional Resources in the NAPA Speech Therapy Blog:

• How to Involve Your Child’s Entire Team in AAC
• Total Communication Approach and Other Strategies for Non-Verbal Children
• Pre-Intentional and Prelinguistic Communication
• The Difference Between Receptive and Expressive Language
• Pragmatic Language Skills: 25 Conversation Starters for Kids

About the Author: 

Tate Strack is a pediatric speech language pathologist at NAPA Center Boston. When she’s not in a speech session, you can find her working out, binge watching a wide variety of TV series or eating dessert for dinner.