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Augmentative and Alternative Communication (AAC)

Augmentative and Alternative Communication (AAC)

Children who have significant limitations communicating verbally may be evaluated by medical professionals such as a speech-language pathologist, an occupational therapist, rehabilitation professional and/or physical therapist to see if further intervention is needed.

A speech language pathologist or another one of these experts may recommend that the child be given an adaptive communication device (properly known as an ‘augmentative or alternative communication,’ or AAC) to help them compensate for limitations in the production or comprehension of verbal speech. These devices can range from very simple (a picture board or flip-book the child can choose images from) to complex and technological (such as eye-tracking software for individuals with limited mobility).  

Augmentative and alternative communication is a broad category of communication methods, which include the use of gestures, sign language, facial expressions, symbols, pictures, communication boards,  and technological means in order to convey thoughts, needs and desires. It’s important to remember that AACs don’t necessarily replace speech, though in some circumstances it can. Sometimes speech-language pathologists (SLPS) teach children to use alternative or augmentative forms of communication as a bridge to verbal speech when possible.

Low-tech vs. high tech AACs

AACS are often subdivided into categories as ‘unaided’ or ‘aided’ AAC systems. Unaided AACs rely exclusively on a child’s body language, and can include sign language, gesturing and physical cues; AACs that rely on external objects (such as flipbooks, eye-tracking systems, or smartphone apps) are considered ‘aided’ systems.

AACs also tend to fall into two broad categories: low-tech and high-tech. Low-tech AACs do not use batteries or electricity and thus are always usable. These can take the form of charts, flipbooks and other paper- or image-based systems. High-tech systems (such as voice synthesizers, speech generation systems, or eye tracking systems are electronic and may need batteries or charging to operate. It is often suggested that individuals have backup systems for high-tech AACs in case batteries run out or systems fail. One of the latest developments in accessibility is the proliferation of app-based AACs that can often supercede the need for bulkier standalone systems.

Will insurance cover my child’s AAC device?

As AACs can sometimes be expensive, it can be useful to see if insurance will cover the cost of purchase. Certain organizations (such as United Cerebral Palsy) have local Assistive Technology Centers that can help you locate AAC systems for rental and borrowing. Individual states often have assistive technology centers and lending libraries, though resource availability may vary significantly. As children grow, their needs and abilities may change, which may result in the need to re-evaluate AAC type periodically to ensure the child’s needs are being met.

Augmentative and Alternative Communication (AAC) Mobile Apps

It is also worth noting that there has recently been a proliferation of mobile device-based AACs as well, allowing individuals to using existing mobile phones and tablet devices as adaptive equipment. Some of these apps are free or very low cost, while others have additional features and can be significantly more expensive. Browse through examples of available augmentative and alternative communication systems here:

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