AAC – Augmentative & Alternative Communication

Tablet with a speech bubble

Assistive Technology for Communication includes many tools and technology. These may be used to help with hearing, speaking, reading, & writing. A big part of AT for Communication is Augmentative and Alternative Communication (AAC). AAC includes all of the ways we share our thoughts and ideas without talking.

AAC may be any tool, light tech to high tech, that is used to help someone communicate.

Some light tech systems may be made of paper and fit onto a single page. There may be multiple pages that fit into a binder. These systems can include picture symbols, photos, or written words. The choice of a symbol system is individual and depends on the needs and abilities of the user. Light tech AAC doesn’t speak out loud. The user points to the picture to indicate what they want to say. Their partner needs to be looking in order to “hear” their message.

Some mid-tech AAC devices include buttons that are pressed to play a message. These devices might have one big button or many. They usually run on batteries and the messages are recorded. The user can only say what someone has recorded into their device.

High tech devices can be accessed in different ways. Depending on the person, they may touch the screen, press a switch, or use their eyes to speak their message. The speech that comes out of these devices is generated by a computer. This type of speech generating device may contain thousands of words. These words can be combined in many ways. This means that the person can speak words, phrases, and sentences. They can express new and novel thoughts.

Why is it called augmentative and alternative communication? The term augmentative is used when AAC is needed to augment or support someone who speaks. This person may have trouble being understood by unfamiliar partners. They use AAC when they need to repair communication or speak in a novel setting. AAC is an alternative when it takes the place of speech. It can be an option for someone who is not able to speak at all. This may be due to lifelong disability, or an illness that has robbed them of their speech.

The type of AAC that works best depends on the abilities of the user. That is why there are so many choices. As with all assistive technology, there is no “one size fits all”.

Choosing AAC is an individualized decision. First, we need to know about the person’s abilities. This may include knowing about their motor skills, vision, and hearing. Are they able to push a button, or will they need another means of access? We then match that person’s abilities to the tools we think will suit their needs. If the device is not accessible to the person, it is more likely to be abandoned.

We may need to try out several different AAC tools. We keep trying until we find the one that works for that person. We can also provide them with opportunities to make choices. We can set the stage so they have something meaningful to talk about. Learning a new system of communication is like learning a new language. It takes time to gain mastery.

We will know what tool works best for the person when we see them choose to use it. One size does not fit all.


Print Materials

Alt image for concept handout

Related Videos

These AAC users with complex needs are demonstrating insight and thoughtfulness. - It is also a great example of assisted scanning.

Deepen Your Understanding

What is AAC?

Augmentative and Alternative Communication (AAC) is the term used to describe various methods of communication that can ‘add-on’ to speech and are used to get around problems with ordinary speech.

AAC includes simple systems such as pictures, gestures and pointing, as well as more complex techniques involving powerful computer technology.

Some kinds of AAC are actually part of everyone’s communication, for example: waving goodbye; giving a ‘thumbs up’ instead of speaking; pointing to a picture or gesturing in a foreign country. However, some people have to rely on AAC most of the time.

Different types of AAC

No-tech communication does not involve any additional equipment – hence it is sometimes referred to as ‘unaided communication’. Examples are body language, gestures, pointing, eye pointing, facial expressions, vocalizations, signing.

Low-tech communication systems do not need a battery to function and include: pen and paper to write messages or draw; alphabet and word boards; communication charts or books with pictures, photos and symbols; particular objects used to stand for what the person needs to understand or say. This is sometimes referred to as ‘aided communication’ because additional equipment is required.

High-tech communication systems need power from a battery or mains. Most of them speak and/or produce text. They range from simple buttons or pages that speak when touched, to very sophisticated systems. Some high-tech communication systems are based on familiar equipment such as mobile devices, tablets and laptops, others use equipment specially designed to support communication. This is sometimes referred to as ‘aided communication’ because additional equipment is required.

Frequently asked questions

What reading and spelling skills are needed?
Some people use spelling to create messages, but good reading and spelling skills are not essential for AAC because there are powerful systems based on using symbols, pictures, photos or objects instead.

What is the best kind of AAC system to use?
There is no ‘best’ type of AAC system. Each system has its own pros and cons; the most suitable one for an individual will depend on their abilities, needs and personal preferences. Many people have more than one AAC method, and choose which to use depending on the listener and the particular situation.

What about people who can’t press keys?
There are lots of solutions for people who would have difficulty physically operating a piece of equipment. Accessibility options include a keyguard, a pointer, a switch to control a scanning system or even an eye gaze controller. For more details, see Access methods: switches, keyboards, and eye-gaze.

How do people get the AAC system that they need?
There are many options so it is a good idea to get specialist advice in order to identify the most appropriate AAC system or systems. The starting point is usually to contact the local speech and language therapy service.