*** A guide to teaching AAC for parents and teachers can be found here: https://www.speechandlanguagekids.com/teach-your-child-to-use-an-aac-device/

What is Augmentative/Alternative Communication (AAC)?

AAC is the term used to describe any form of communication that a person can use that is not speech.  This may include pointing to pictures of what the person wants, using sign language, or using a device that will speak a message when a specific button is pushed.

When Should AAC be Considered for a Child?

AAC should be considered for any child when his/her speech output is not adequate to communicate everything that the child wants/needs to communicate.

Things to consider:

  • Child’s frustration levels
  • Adult frustration levels
  • Access to school curriculum
  • Participation in classroom activities
  • Ability to demonstrate knowledge to teachers
  • Access to home and community environment
  • Ability to interact appropriately with family and peers
  • Independence in developmentally-appropriate daily activities

What Prerequisite Skills Does a Child Need Before Trying AAC?

In short, there are no skills that a child MUST have before AAC can be tried.  Though, here are a few of the common misconceptions about this:

These are commonly used as excuses why AAC devices should not be attempted with children but these are WRONG:

  • The child must understand cause and effect (AAC teaches cause and effect quite effectively)
  • The child must understand that a picture represents an object (again, AAC teaches this)
  • Child must have good enough motor skills for AAC (there are lots of alternatives for children who can’t access a device with their hands)
  • Child must understand enough language for AAC use (babies don’t have great language
    before they are introduced to speech)
  • Child must be interested in communicating (even inappropriate behaviors can be shaped into intentional communication)

For more information about these “prerequisites”, click the link: http://www.speechandlanguagekids.com/what-are-the-prerequisites-for-using-an-aac-device-augmentativealternative-communication/

How to Select an AAC System

Options for AAC devices, methods, and systems

  • Gestures/Body Language
  • Sign Language
  • Object Symbols (objects glued to cards)
  • Picture Boards
  • Picture Exchange
  • Written Messages (paper or typed)
  • Single Button Voice-Output Devices
  • Multi-Button Voice-Output Devices
  • Dynamic-Display Voice-Output Devices

Download the free PDF cheat sheet of the different types of AAC here:

Click Here to Download a Free AAC Cheat Sheet

Often the decision of what type of AAC system the child uses is put up to a team of professionals that evaluates the child’s needs and abilities.  These teams are typically called AAC teams and can be found at many larger hospitals across the country.  If you don’t have access to such a team, here are a few things to consider when selecting a method:

  • Child’s mobility and physical limitations
  • Family preferences and limitations
  • Number of different desired communication partners
  • Child’s cognitive level
  • Child’s visual and attention skills
  • Likelihood of long-term AAC use
  • Child/Family’s means of acquiring devices
  • What the child will be using it for
  • How well the child does when using the systems during trials or therapy
  • Past success or failures with AAC systems

If nothing else, just pick something that seems suitable and give it a try with a child.  You won’t know if it will work until you try.  Many states and organizations have lending libraries that will help you decide if a device or system is right for a child.

How to Introduce the System:

Make it as natural as possible.  Think of it as similar to how you would encourage a late talker to talk.

  1. Get Familiar with the Child’s System
  2. Model AAC Use Around the Child
  3. Encourage the Child When he Attempts to Use it and Provide Differential Reinforcement
  4. Have the Device Present at All Times
  5. Set Up Opportunities for the Child to Use the AAC Device (in the classroom, at home, in speech, etc.)
  6. Train Other Adults on How to Set Up Opportunities and Provide Differential Reinforcement

For more info on getting started, click the link: http://www.speechandlanguagekids.com/help-child-use-aac-home-classroom-hint-easier-think/

Writing Goals for AAC Use:

To write a goal for AAC use, think about what goal you would set for the child if he was using speech instead of the device/system.  Write goals for what the child will communicate, not for specific AAC use.


Good Goals:

  • Child will use single words to request foods during snack time, using spoken words, sign language, or an AAC device.
  • Child will answer “who” questions by indicating the correct person using spoken words, sign language, or an AAC device.
  • Child will create three-word utterances using an “I want…” carrier phrase through use of spoken words, sign language, or an AAC device.

Not-So-Good Goals:

  • Child will push buttons on his AAC device to request.
  • Child will use his AAC device during circle time.
  • Child will answer yes/no questions using his AAC device.
  • Child will find buttons on his AAC device when requested by the therapist.
  • Child will hand a picture to the therapist during PECS training.

How to Track Progress on AAC Use:

Once you have a really solid goal, you’ll need to track the child’s progress toward it.  Here are a few ways to measure AAC goals:

  • % of attempts: Track each time the child tries to accomplish a goal (like get something) and mark correct if the child uses language of some kind (ex: Child will use language to request during snack on 80% of attempts – Reaching, grabbing, crying, and grunting count as incorrect while using words, signs, or AAC count as correct)
  • # of times in ___ minutes: Track how many times the child accomplishes the goal during a certain number of minutes (ex: Child will use language to request during snack at least 5 times in 5 minutes – Only AAC or spoken words count as correct)

The method you use will depend on the type of goal you write and how you prefer to collect data, but this can be used to help you easily track if the child is making progress toward that goal.

Download the Cheat Sheet:

Download the free PDF cheat sheet of the different types of AAC here:

Click Here to Download a Free AAC Cheat Sheet

More Resources for Speech-Language Pathologists:

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