What Is AAC?

If your child’s speech is not consistently meeting all of their communication needs, you may hear a speech-language pathologist bring up AAC.

AAC stands for Augmentative and Alternative Communication. It is a broad term for tools and systems that can support communication when someone cannot rely on speech alone.

The word augmentative means adding to someone’s existing speech. For example, a child who uses some spoken words might also use a communication board or speech-generating device when they need another way to express themselves.

Alternative means using another way to communicate when speech is not available or accessible. For some children, AAC may become one of their primary ways of communicating.

The goal of AAC is not to get a child to communicate in one particular way. The goal is to make sure they have access to communication.

What Can AAC Look Like?

When people hear the term AAC, they often picture a tablet that speaks when someone selects a button. Speech-generating devices are one type of AAC, but there are many different options.

AAC may include:

• Picture-based communication systems

• Communication boards or books

• Written words or keyboards

• Speech-generating devices

• Communication apps on tablets or other devices

Some AAC systems are very simple. Others may contain hundreds or thousands of words that a child can use to build messages.

A child may also use different systems in different situations. A speech-generating device may be their primary AAC system, while a simple communication board might be useful in another setting.

AAC Is Part of Multimodal Communication

At Play & Thrive, we talk frequently about multimodal communication.

Multimodal communication simply means that we do not expect a child to communicate in only one way.

A child might speak, point, gesture, use signs, select a picture, use a speech-generating device, or, for some children, read and write. They may use several of these forms of communication within the same interaction.

The way a child communicates can also change from moment to moment. A child may be able to say a word easily in one situation but need another way to communicate that same message at another time.

Rather than deciding that one form of communication is better than another, we focus on whether the child has a way to successfully share their message.

Who Can Benefit From AAC?

As speech-language pathologists, we may consider AAC or other forms of multimodal communication for children with many different communication profiles.

Some children have speech sound difficulties that make it very hard for other people to understand what they are saying. AAC can give them another way to clarify words or messages they are already trying to communicate verbally.

Some children with selective mutism may have difficulty using their voice in certain settings or with certain people. Having access to other ways of communicating can give them a way to express their wants, needs, and ideas during times when speech is not accessible to them.

For many of the children we see at Play & Thrive, we may not yet know why they are not consistently communicating through speech. We do not need to wait until we have all of those answers before giving them additional ways to communicate.

Access to multimodal communication can give a child more opportunities to share what they want, need, think, and feel while we continue learning more about their individual communication needs.

Does Using AAC Mean We’re Giving Up on Speech?

The short answer is no.

The slightly longer answer is that there is no evidence that giving children access to AAC has a negative impact on the development of speech.

Introducing AAC does not mean that we stop talking to a child or stop supporting their spoken language. AAC gives them another way to communicate alongside speech.

We discuss this question, including what the research tells us and why this concern is so common, in our article Will AAC Delay My Child’s Speech?

How Is an AAC System Chosen?

There is not one communication system that is going to work best for every child.

When we work with children with emerging or complex communication needs, we begin by giving them access to a variety of ways to communicate. That may include spoken language, signs, low-tech AAC, and speech-generating devices.

We model these different options during natural interactions and pay attention to how the child responds. Which forms of communication are they noticing? Which ones are they beginning to use? When are they most successful at getting their message across? Those interactions help guide our decision-making.

Our goal is not to teach a child to use a particular device simply because it is available. We want to identify communication options that give that individual child meaningful and reliable ways to express themselves.

What AAC Looks Like at Play & Thrive

At Play & Thrive, we have clinic speech-generating devices with AAC apps as well as low-tech communication boards that we can use during therapy.

With parent or caregiver consent, we will often begin by introducing AAC during sessions and seeing how a child responds before helping a family explore options for obtaining a dedicated system of their own.

During therapy, our biggest focus remains multimodal communication. We support and honor speech, gestures, signs, AAC, and other forms of communication rather than requiring a child to use one particular mode.

We also care deeply about intentionality and bodily autonomy. We model how AAC can be used and make communication systems accessible, but we do not physically prompt a child to select a particular message.

We want children to learn that communication is something they can use to share their own ideas, wants, needs, and experiences.

The Bottom Line

AAC is one way we can make communication more accessible.

For some children, it may be something they use occasionally alongside speech. For others, it may become an important or primary way of communicating.

Either way, our focus is not on which method a child uses. It is on making sure they have meaningful, reliable ways to communicate and that the people around them recognize and respond to those messages.