Augmentative and Alternative Communication: A Caregiver’s Guide

Oct 5

7 min read

October is Augmentative and Alternative Communication (AAC) Awareness Month. As a speech-language pathologist (SLP), my role is often to introduce parents and caregivers to this new world of communication opportunities.

As a parent, you want to know what your child is thinking, feeling, and trying to tell you. You want to hear about their favorite things, understand when something is wrong, and give them a way to share their personality with the world. So what happens when speaking is difficult for your child?

Maybe you’ve heard the term augmentative and alternative communication, or AAC, from a speech-language pathologist, your child’s school, or another parent. Maybe you've seen a child using a tablet to communicate and wondered what it is and how it works.

AAC can be a powerful tool for children who have difficulty communicating through speech. And despite some common misconceptions, AAC isn't just for children who don't speak at all. Let's take a closer look at what AAC is, who can benefit from it, and how it can help children communicate in ways that work for them.

A speech language pathologist demonstrates the use of an AAC device for a child.

What Is AAC?

AAC stands for augmentative and alternative communication. Augmentative communication helps to supplement or support a person’s existing speech when speaking alone is not enough to effectively communicate a message. Alternative communication is another way to communicate when speech is not functional or available.

AAC includes a wide range of tools and strategies. It doesn't have to involve technology, and it doesn't look the same for every child.

Some examples of AAC could include:

Gestures and signs: Pointing, waving, using meaningful gestures, or using sign language.
Picture communication: Pointing to photographs, picture symbols, or words on a communication board.
Speech-generating devices: Using a dedicated communication device or an app on a tablet that speaks aloud when a child selects a picture, symbol, or word.
Written communication: Typing or writing words to express thoughts and needs.

Some children use one form of AAC, while others use several. A child might use gestures and spoken words at home, a picture board during a difficult activity, and a speech-generating device throughout the day. The goal of AAC is not to get a child to use a particular device. The goal is to give them reliable means of communication.

Who Can Benefit From AAC?

AAC can benefit children with a wide variety of communication needs. A child does not have to be completely nonspeaking to be a candidate, and AAC is not limited to one diagnosis. The following are some common examples of who could benefit from AAC.

1. Autistic children who are nonspeaking or minimally speakingAAC can give autistic children another way to express wants, needs, ideas, feelings, and social messages - whether they use few spoken words, no spoken words, or find speech difficult to access consistently.

2. Children with motor speech disordersChildren with conditions such as childhood apraxia of speech may know exactly what they want to say but have difficulty planning and coordinating the movements needed for speech. AAC can provide a reliable way to communicate while they continue developing their speech skills.

3. Children with significant speech or language difficultiesChildren who are difficult to understand or who have trouble expressing their thoughts and ideas may use AAC to supplement their speech and reduce communication breakdowns. AAC can also provide visual support for children with receptive or expressive language difficulties.

4. Children who need communication support in certain situationsAAC isn't necessarily an all-or-nothing system. Some children who speak may benefit from pictures, written words, communication boards, or a speech-generating device when they're overwhelmed, having difficulty finding words, or need additional support to communicate.

Will AAC Prevent My Child From Talking?

This is one of the most common concerns parents have, and it is an understandable question. Research reviews have found that AAC does not impede speech development and may support spoken language development for some children. It is important to note that AAC is not “giving up” on speech. It is giving a child another avenue to build the neural pathways that help support language development.

Some children who use AAC develop more spoken language over time. Others continue to rely on AAC as their primary means of communication. Many use a combination of speech, gestures, and AAC throughout their lives. There is no single communication outcome that every child must achieve. The priority is meaningful, effective communication.

Does My Child Need to Be a Certain Age or Have Certain Skills Before Starting AAC?

No. There is no minimum age for AAC, and a child does not need to demonstrate that they understand every picture, follow directions, imitate words, or point accurately before AAC can be considered. Children learn to communicate through access, experience, and interaction. They do not have to master a set of prerequisite skills before being given opportunities to communicate.

A colleague once said to me, “You can’t learn to ride a bike without a bike,” and I just love how perfectly this illustrates how we can approach AAC as an option. We can't expect a child to learn how to use AAC if they aren't given the opportunity to access it. AAC selection and support should be individualized. A speech-language pathologist can help families explore options that fit a child's communication, language, sensory, and motor needs.

It's also important to remember that children do not have to use AAC perfectly for it to be valuable. Learning a communication system takes time, modeling, and meaningful opportunities to use it.

How Do Children Learn to Use AAC?

AAC is not simply a device that a child is handed and expected to figure out independently. Children benefit from communication partners who show them how to use it in everyday life. One important strategy is aided language modeling. This means that adults use the child's AAC system while speaking naturally, showing the child how words and messages can be communicated.

For example, while playing with bubbles, a parent might say “Ready, set, go!” while selecting the corresponding words on the child's device. During snack time, the parent might model “want more,” “open,” or “all done.” The adult doesn't need to turn every interaction into a lesson or expect the child to imitate every message. Instead, AAC becomes part of shared activities, play, routines, and conversations.

Children also need access to their communication systems throughout the day, not just during speech therapy sessions. Parents, caregivers, teachers, and other important communication partners all have a role in supporting communication. And perhaps most importantly, AAC should give children a voice and not become another way to test, pressure, or control them.

What If My Child Doesn't Use the Device Right Away?

It's normal for parents to hope that a new communication tool will immediately make a difference. But learning AAC is a process. I often compare learning AAC to learning a second language, or even to the way typically developing children acquire spoken language. We don't expect babies to come into the world talking. They spend months listening to the language around them, experimenting with sounds, babbling, and eventually using their first words. Over time, those words grow into phrases and sentences.

AAC is no different. Children need time to learn what the system means, how to use it, and most importantly that it is a meaningful way to communicate. A child might look at the device, explore the buttons, touch a symbol without an obvious communicative purpose, or show little interest at first. These experiences don't necessarily mean AAC isn't appropriate. Children need time, modeling, and repeated opportunities to discover how AAC can help them communicate.

Adults can support this process by modeling language without demanding imitation, following the child's interests, honoring all forms of communication, and making sure the child has consistent access to their system. AAC should never be withheld as a consequence or made contingent on a child completing a task, demonstrating a particular behavior, or attempting to speak. The purpose of AAC is to give a child a voice, which includes the ability to say “no,” “stop,” “break,” or “I don't want that.”

How Can a Speech-Language Pathologist Help?

A speech-language pathologist (SLP) can help determine whether AAC may be beneficial, explore appropriate communication options, and support the child and family as they learn to use the system.

This may include:

Exploring low-tech and high-tech AAC options.
Considering the child's communication, language, sensory, and motor needs.
Identifying meaningful words and messages for everyday routines.
Modeling AAC during play and natural interactions.
Coaching parents and caregivers to support communication throughout the day.
Collaborating with teachers, occupational therapists, and other members of the child's team when appropriate.

AAC is not a one-size-fits-all solution. A system that works well for one child may not meet another child's needs, and communication tools may need to evolve as a child grows.

Families should also know that they do not necessarily have to wait for a formal device evaluation to begin exploring ways to support communication. A speech-language pathologist can help identify appropriate starting points while determining whether a more comprehensive AAC assessment is needed.

A speech pathologist demonstrates an AAC device with a mother and her toddler.

Every Child Deserves a Way to Communicate

Communication is about so much more than asking for things. It is about sharing ideas, expressing emotions, building relationships, making decisions, developing independence, and being understood. AAC can help children communicate when spoken language alone isn't meeting their needs. It doesn't have to replace speech, and it doesn't require a child to fit a particular diagnosis or profile.

If you're wondering whether AAC could benefit your child, consider reaching out to a speech-language pathologist who has experience with AAC and can help you explore the options. Your child has things to say. They deserve the opportunity to say them in a way that works for them.

f you're a parent in Columbus or Central Ohio and wondering whether AAC might be a good fit for your child, you don't have to figure it out on your own. An AAC evaluation can help determine whether AAC may support your child's communication and what type of system or supports might be appropriate.

At Small Talk Speech Therapy, we can help you explore whether AAC is right for your child and guide you through the process. Whether your child is nonspeaking, minimally speaking, difficult to understand, or simply needs additional support to communicate, we're here to help.

Ready to explore your options? Contact us to schedule an evaluation.