Aided Communication

icon for Aided Communication

Aided communication (aided comm) can be simple or complex. It might be as simple as writing with a pencil. It might be as complicated as an eye gaze activated computer. Both the “speaker” and the “listener” need to understand the communication aid. All partners need to understand the system used to communicate.

Aided Comm has 4 integrated parts.

Symbols, Aids, Selection Methods, and Strategies


What are the symbols that everyone involved can understand? In many cases, the symbols are visual and/or graphics. Examples of symbols include pictures, photographs or line drawings. Other symbol sets are Bliss symbols or icons. Printed words are kind of symbol.

Aids or Tools

The aids (tools) are the manner in which the symbols are ‘delivered’? Maybe a board, book, key-ring, tablet or computer. Comm boards or books don’t have speech output. Computers or hand-held devices might have speech output. Speech output can be a recorded, natural voice or a synthesized voice.

Selection Methods

Selection methods are the ways a user chooses the symbols. This might be direct or indirect. Pointing is direct. Scanning is indirect.


The strategies are the action plans in place to encourage success. Word prediction like what text messaging has is a strategy. Systematic symbol location is a strategy. Usually, aided communication is slower than natural communication. We use strategies to help speed up the process. It might only take a few seconds more to create a message on a speech generating device. Those moments feel extremely slow to the listener. People used to natural communication expect speed. Writing is slower than talking. These seconds might even result in forgetting the topic or question. One of the things that aided communication can teach us is to go slower and relax.

These aids use a variety of brain resources, depending on the symbol system and equipment. Pictures and photographs are easier for most people to understand than written words or icons. A user of aided communication needs to be able to understand how to use any tool they use.

Pros and cons of aided communication

  • Tools with pictures or icons are easy to understand by most partners. The user needs to be able to identify, locate and select the pictures or icons. Problems occur if the pictures get misplaced or lost. If printed pictures don’t have a stable location, the user might get confused.
  • Tools that generate speech in place of the user’s voice are easy to understand. This assumes that all partners will understand the language of the device. These speech generating devices (SGDs) can be picture, icon, or text-based. The user needs to know how to activate the device. The user should know how to maintain the device.
  • Tools that use technology are popular. Technology breaks. We should consider having low-tech options and a backup plan.

Aided communication systems require the use of tools or equipment in addition to the user’s body. Aided communication methods can range from paper and pencil to communication books or boards to devices that produce voice output (speech generating devices or SGDs) and/or written output. Electronic communication aids allow the user to use picture symbols, letters, and/or words and phrases to create messages. Some devices can be programmed to produce different spoken languages.  USSAAC 


Print Materials

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Related Videos

This video provides a concise and easily understood description of Aided Communication - specifically AAC.

Deepen Your Understanding

Aided Communication is communication in which the expression of the intended message relies in part at least, on some physical form external to the communicator, such as a communication aid, a graphic symbol, a picture, or an object.

Measures of pre-communicative cognitive ability may be invalid for some populations, and research suggests that impaired cognition does not preclude communication (Kangas & Lloyd, 1988; Zangari & Kangas, 1997). Development of language skills can lead to functional cognitive gains (Goossens’, 1989).

AAC intervention for children with complex communication needs helps develop functional communication skills, promotes cognitive development, provides a foundation for literacy development, and improves social communication (Drager et al., 2010).

Incidence and Prevalence

It is difficult to estimate the prevalence of AAC users due to wide variability across this population in terms of diagnosis, age, location, communication modality, and extent of AAC use. However, it is commonly accepted that the number of AAC users is growing, most likely as a result of increases in access to technology and AAC awareness and increases in the number of individuals with complex communication needs (Light & McNaughton, 2012; Ratcliff, Koul, & Lloyd, 2008).

Beukelman and Mirenda (2013) estimated that approximately 1.3% of people (or roughly 4 million Americans) are unable to reliably communicate using natural speech to accomplish daily communication needs.
Enderby, Judge, Creer, and John (2013) estimated that 0.5% of the U.K. population requires the use of AAC. Based on the prevalence of conditions associated with use of AAC (in the United Kingdom), Enderby et al. (2013) estimated that the largest populations of individuals who could benefit from AAC had diagnoses of dementia (23.2%), Parkinson’s disease (22.7%), ASD (18.9%), learning disabilities (13.3%), and stroke (9.9%).

According to the National Survey of Children With Special Health Care Needs (2005–2006), the estimated prevalence of children with special health care needs who have a speech difficulty is 2.9% among all U.S. children. Of these children, 7.6% were estimated to require a communication aid or device; however, an estimated 2% did not receive one (Kenney & Kogan, 2011).

Binger and Light (2006) reported that approximately 12% of preschoolers who were enrolled in special education services in Pennsylvania required AAC, and the authors cautioned that this was almost certainly an underestimate. The majority of children in this study had a primary diagnosis of developmental delay, autism, or pervasive developmental disorder (PDD). It was reported that students used a variety of different types of AAC systems (often, more than one), including gestures (62%), sign language (35%), objects (31%), pictures (63%), and high-tech devices or SGDs (15%).

Roles and Responsibilities

SLPs play a central role in the screening, assessment, diagnosis, and treatment of persons requiring AAC intervention. The professional roles and activities in speech-language pathology include clinical/educational services (diagnosis, assessment, planning, and treatment), advocacy, education, administration, and research.