What Is Augmentative and Alternative Communication (AAC)?

Augmentative and alternative communication (AAC) refers to methods that supplement or replace speech for individuals who have difficulty communicating verbally. According to ASHA, AAC includes unaided forms such as gestures, facial expressions and manual signs, and aided forms such as communication boards, picture exchange systems and speech‑generating devices. More than two million people use AAC to communicate because of conditions like autism, cerebral palsy, Down syndrome, apraxia of speech and degenerative diseases.

AAC systems vary from low‑tech to high‑tech. Low‑tech options like picture boards or communication books are lightweight, inexpensive and do not require batteries. They often use symbols or photos to represent words and can be customised to match the user’s vocabulary. Mid‑tech devices include simple speech‑output devices that play recorded messages when buttons are pressed. High‑tech systems include dynamic display tablets and dedicated speech‑generating devices that can store large vocabularies, generate synthetic speech and integrate with other technology.

Selecting an AAC system requires a team approach. Speech‑language pathologists evaluate the individual’s motor skills, vision, hearing, cognitive abilities and communication needs. Occupational therapists, teachers and family members provide insights into daily routines and environments. There are no prerequisites for using AAC; even very young children or individuals with limited cognitive abilities can benefit. Starting AAC early can prevent frustration and support language development.

AAC often uses a multimodal approach. A person might combine gestures, eye gaze and verbal speech with a communication device. For example, a child could point to a picture of “juice” while verbally approximating the word or using a sign. Using multiple modes ensures that communication partners understand the message and encourages speech development.

Families might worry that introducing AAC will stop a child from speaking. Research shows the opposite; AAC can enhance speech by providing consistent models, reducing pressure to speak and allowing children to practise language at their own pace. When choosing a system, consider portability, durability, vocabulary size and the user’s interest in technology.

Learning AAC takes time. Parents and caregivers should model using the device, create opportunities for the child to use AAC in daily routines and celebrate attempts at communication. Working closely with a speech‑language pathologist ensures that the system remains appropriate as the child’s skills grow.