AAC & Communication

Overview: What is AAC?

Augmentative and alternative communication (AAC) refers to the tools, strategies, and supports that help people communicate when speech alone does not meet their needs. AAC can supplement existing speech ("augmentative") or serve as a person's primary way to communicate ("alternative"). It includes both unaided methods, such as gestures and sign, and aided methods, such as symbol boards, communication books, and speech-generating devices and apps. AAC supports expression, comprehension, participation, and social connection across home, school, work, and the community.

Who May Benefit

People of any age may benefit from AAC, including individuals with developmental disabilities, autism, cerebral palsy, Down syndrome, and intellectual disability; individuals with acquired conditions such as stroke, traumatic brain injury, or ALS; and individuals with temporary communication needs. AAC is appropriate whenever a person's communication does not fully meet their daily needs. There are no prerequisites for AAC, and use of AAC does not prevent or slow the development of speech.

Common Access Barriers

Barriers can include limited availability of appropriate tools, gaps in assessment, insufficient training for the person and their communication partners, physical or motor access challenges, cost and funding hurdles, limited vocabulary or customization, and low expectations from those around the AAC user. Environments that do not model or accept AAC can also limit successful communication.

Assistive Technology & Strategies

Approaches range from no-tech and light-tech (gestures, sign, symbol boards, communication books) to high-tech (speech-generating devices and communication apps on tablets). Strategies include aided language modeling, core and fringe vocabulary, robust language systems, partner-assisted scanning, and access methods such as direct selection, eye gaze, and switch scanning. The right combination depends on the individual and is typically identified through assessment.

Autonomy and User Preference

AAC systems and vocabulary work best when they reflect the preferences of the person using them. Involving the AAC user in decisions about vocabulary, device features, and how supports are introduced can strengthen engagement and long term use. Preferences may differ across communication partners and settings, and revisiting these choices as the person's comfort and skills grow is a normal part of the process.

Implementation Considerations

Successful AAC depends on more than a device. Consider vocabulary organization and growth, positioning and access, consistent modeling by communication partners, availability across all environments, backup or low-tech options, and ongoing customization as skills change. Implementation is a team effort involving the AAC user, family, educators, and clinicians.

Funding / Acquisition Options

Depending on the situation, AAC may be funded through health insurance or Medicaid (often as durable medical equipment or a speech-generating device), school systems for education-related needs, vocational rehabilitation, private pay, loan or trial programs, and charitable or nonprofit assistance. Requirements and processes vary; documentation from a qualified evaluation is often needed.

Literacy and AAC

AAC use and literacy development are connected rather than competing goals. Exposure to language rich environments, core vocabulary, and consistent modeling from communication partners can support both expressive communication and literacy skills over time. AAC does not need to wait until other skills are demonstrated first, and literacy instruction can be adapted alongside AAC use rather than treated as a separate track.

Monitoring Whether AAC Supports Are Working

Regularly reviewing whether an AAC system is meeting a person's communication needs helps identify what is working well and what may need to change. Signs that a support may not be working as intended can include limited use across settings, reliance on only a small part of the system, or communication partners speaking for the AAC user instead of waiting for a response. Reduced use of a system is worth exploring rather than assuming it reflects the user's ability or motivation. It may point to a mismatch between the system, the environment, or the training and support available, and often calls for a fresh look rather than abandoning AAC altogether.

Changing Communication Needs Over Time

Communication needs can shift as a person grows, gains new skills, or encounters new environments and demands. An AAC system that works well at one point may need updated vocabulary, added features, or a different device as circumstances change. Periodic review with the people who support the AAC user, including family members and educators, can help ensure the system continues to match current needs rather than remaining fixed to an earlier stage.

Training & Education

Training helps AAC users and their communication partners use tools effectively. This can include learning device features, vocabulary and language modeling, partner strategies, and integration into daily routines. See the Professional Learning section for related educational activities.

Research / Evidence

A body of research supports the use of AAC to improve communication and participation. This page summarizes general, publicly available information for educational purposes and does not report original research findings from Accessibility Clinic. Individuals should consult qualified professionals for guidance specific to their situation. For speech-language and clinical guidance specific to AAC, the American Speech-Language-Hearing Association (ASHA) is a recognized professional resource.

Questions to Consider When Exploring AAC

Families, educators, and adults exploring AAC options may find it helpful to consider questions such as: What communication does the person want or need to do across daily environments? Which communication partners will need training alongside the AAC user? How will the system be introduced, and who will monitor whether it is meeting the person's needs over time? What backup or low tech options are available if a device is unavailable or malfunctions? A qualified professional familiar with AAC can help work through these questions for a specific individual's situation.

Related Resources

For additional educational background on AAC and other assistive technology topics, see AssistiveTechnology.org's Assistive Technology 101 overview (an Accessibility Clinic resource). For formal AAC evaluation information, see AssistiveTechnologyEvaluations.org (an Accessibility Clinic resource).

Related Products or Technologies

A range of AAC applications and speech-generating devices are available from various manufacturers. Product information here is educational and not an endorsement.

Reviewed for educational and assistive technology content by Jeffrey Davis, Ph.D., ATP.