Augmentative and Alternative Communication (AAC): What to know

What is AAC?

Augmentative and Alternative Communication (AAC) is any type of non-spoken communication. Augmentative means adding to someone’s speech. Alternative means that it will be used instead of speech. When you use something other than spoken words to express a thought, feeling, or idea, you’re using AAC! All humans use AAC every day — think about things like gestures, drawing pictures, writing, or facial expressions.

Why is AAC important for autistic kids?

We all have different ways we communicate best. For example, the person writing this article prefers written communication for some things and speaking for other things.

Speech may be difficult for autistic kids for many reasons. AAC gives all people an alternative way to communicate that doesn’t require speech. Autism is a dynamic disability, which means your child’s needs and abilities may fluctuate from day to day or moment to moment. Even neurotypical people sometimes have days when they feel drained and don’t feel up to talking. It is crucial to your child’s safety that they always have a way to communicate.

Types of AAC

Augmentative and Alternative Communication (AAC) can come in many forms. Your child may use AAC for a little while, for their whole lives, or only sometimes. The type of AAC your child uses and the frequency will depend on their unique needs and preferences. Let’s explore the different types of AAC.

AAC can be aided or unaided. Aided AAC requires help from someone or something else, like holding a letter board. Unaided AAC means your child doesn’t need anything but their own body to use it, like sign language.

AAC can also be low-tech or high-tech. Low tech would be options like picture boards. High-tech can be things like speech-generating devices.

• Gestures. This can include pointing, pulling you toward something, making shapes or expressions with their hands or body. Your child may grab your hand and pull you toward the door when they want to go outside, or put the remote in your hand when they want you to turn the TV on. All of these gestures are one way your child communicates.
• Facial expressions. Sad faces, happy faces, all the faces! Facial expressions are often a way to express feelings. Keep in mind, autistic kids may interpret facial expressions differently than neurotypical people. Their own facial expressions may not match what you’d typically expect. For example, you may think your child looks angry, when really they are sad or disappointed.
• Writing and/or typing. Many nonspeaking autistic people prefer to communicate through writing or typing. Even some speaking neurodivergent people prefer written communication. Writing is a less stressful way to communicate because it allows our brains time to process information and create a thoughtful reply. Spoken communication can feel overwhelming, and has a lot of nuance and social cues we may not pick up on. Reading something might make sense when hearing or listening to something doesn’t. But with writing/typing, we can express ourselves at a pace and in a way that feels more intuitive to us. Some autistic children will learn to read or write very young (hyperlexia).
• Drawing. Art can be a powerful tool of communication. Your child may find that they express themselves better sometimes through drawing or creating art than through speech or writing. Many autistic people, like author and scientist Temple Grandin, are visual thinkers. This means the person thinks and learns best in pictures. (Think engineers, artists, and designers.) For an example of this, check out Viktor, a teenage autistic boy who doesn’t speak but communicates through his stunning art.
• Spelling words by pointing to letters. This AAC uses a letter board and the person’s pointing finger or object (like a pencil) to point to the letter the person wants as they spell out words to form sentences. This can be a great option for children with autism who don’t have the fine motor skills to write or type. One example of this communication system is Spelling 2 Communicate (S2C). There is some disagreement about S2C and programs like it. It’s a complex debate, but Not An Autism Mom breaks it down here.
• Pointing to photos, pictures, or written words. One common system used in ABA is PECS (Picture Exchange Communication System). It’s a very rigid system that mostly focuses on requests (“I want”, “I need”, etc.). PCES isn’t a good long term communication solution. Not all picture communication systems are PECS. Visual aids can be extremely helpful for autistic kids, whether they talk a little or a lot. You can use pictures in a variety of ways to help your child communicate. Pictures are a great part of a communication system. Autistic children need more robust communication systems.
• Using an app on an iPad or tablet to communicate. This is one type of high-tech AAC device. Many kinds of AAC devices exist, ranging in cost and complexity. You can purchase some devices online, or you can get them through your child’s insurance provider. There are some PECS-style apps for tablets, but there are also more advanced systems. For many nonverbal adults and kids, their AAC device is a lifeline.
• Using a computer device that “speaks” for them. This is sometimes called a “speech-generating device.” The high-tech device allows the user to input text or select a preset option, and the device will say the word or phrase for them. You may be familiar with the speech-generating device that Dr. Stephen Hawking famously used throughout his career. Speech-generating devices can offer flexibility, opportunity, and robust communication. While there is a slight delay in creating the speech and the computer speaking it, this AAC allows the user to converse with others in real time.

Will using AAC stop my child from talking?

No! In fact, AAC can actually help your child speak more! Your child will continue to develop language and speech. AAC is a tool to support your child’s communication. Children will naturally use speech when they are able. AAC is there to enhance your child’s abilities.

How can I use AAC for my child?

Whether your child is verbal or nonspeaking, autistic or even neurotypical, there are so many ways you can incorporate AAC into your child’s life! Here are some tips:

• Work with an SLP (Speech Language Pathologist) who knows their stuff. We highly recommend working with a qualified and knowledgeable speech therapist. They can help you develop a robust, appropriate communication system for your child. Your child’s personalized communication system should be unique to them. For example, it may look like a combination of pictures, an AAC device, gestures (like sign language), and more. Find a speech therapist who understands and will work with the way your child processes language.
• Create an environment that respects their communication style. It’s important to understand that speakers overtake nonspeakers in conversation and everyday interactions. Society as a whole is biased toward speaking people. This means the burden will likely fall to your child to make themselves heard — which is a big task, especially for a child. It’s vital that you create an environment where your child’s communication style is respected. That means providing space and time for them to listen to and understand what others are saying. Then time for them to think, create, and share a response. It also means acknowledging ALL their communication as valid and important (including behavior).
• Focus on connection and autonomy. The whole point of communication is so your child can express their needs, assert their independence, form connections with people, and have meaningful social interactions. Your child’s AAC should add value to all these areas of their lives. Learning or using AAC should never be about drilling, correction, or getting it right. The focus should be on your child’s strengths, promoting their autonomy, and adding support wherever your child needs it. When adding AAC to your child’s life, always prioritize connection over correction.

How do I get my child an AAC device?

You can get your child an AAC device a few ways.

• Add it to your child’s IEP. If your child has an IEP, you can request that an AAC device be made part of it, and that they always have access to it in school. (Some schools will allow you to take the device home, too.)
• Ask your child’s doctor. You can request an evaluation for an AAC device through your child’s doctor. This requires an evaluation, and your child’s insurance should cover part (or all) of the costs.
• Buy one yourself. Many AAC devices are just apps installed on regular iPads or a tablet. They can be a bit pricey, but getting insurance to pay for AAC devices can take a long time.

Not An Autism Mom’s guide to getting your child an AAC device explains each of those options in more detail. Remember, a speech therapist can help you figure out which AAC device is best for your child and teach them how to use it.

All communication is valid

Unfortunately, many kids are not offered AAC or are denied access to AAC by educators or therapists. Sometimes the adults in a nonverbal child’s life will insist they speak, even if that is not what is most comfortable for them. This can cause a lot of stress on the child, and denies them their right to communication. Jordyn Zimmerman is a nonspeaking autistic person who was denied AAC as a child, but thrived once she had access to it. She’s now on the board of Communication First, a member of President Biden’s committee, and holds a Master’s degree.

Whatever way your child communicates best is worthy of respect. No one should be forcing your child to speak, or denying them access to AAC.

Your child has something to say

We must always presume our children have something to say, even if they cannot speak. The same applies for AAC. We should always presume competence when thinking about AAC. There’s no special training or requirements for a child to learn AAC. Your child doesn’t even have to be a certain age! Assume that your child has something to say and can learn how to share it. Check out AssistiveWare’s guide to presuming competence about AAC for more information.

Conclusion

Whether your child is verbal or nonverbal, understanding and respecting autistic communication is important. AAC can be life-changing, and all people deserve access to it. Using AAC doesn’t make anyone less smart, less worthy, or less capable than anyone else. We all use AAC every day without even realizing it! All ways of communicating are valid and should be respected. For information, check out the deep dives below.