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Augmentative or Alternative Communication Devices and Systems for Kids with Autism

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Some kids with autism are non-verbal or have very limited verbal communication skills. As a result, they may be unable to communicate their wants and needs in a way that others easily understand. 

Augmentative or alternative communication devices or systems help to enhance communication. These devices help autistic kids effectively express themselves and engage with the people around them.

What is Augmentative and Alternative Communication (AAC)?

AAC refers to a range of communication methods and tools that help people with speech or expressive language difficulties. They’re often used by children with autism who face verbal communication challenges. 

AAC can take many forms, from simple picture boards to high-tech devices with speech-generating capabilities.

Types of AAC Systems:

There are many different types of AAC, ranging from no or low-tech to high-tech.

Unaided AAC: 

These methods don’t use any external tools or devices. Someone using unaided AAC uses various parts of their body to aid and enhance verbal communication.

Examples of unaided AAC methods include:

  • sign language
  • gestures (e.g. pointing)
  • facial expressions
  • body movements
  • head movements
  • eye movements & eye gaze
  • vocalizations (i.e. non-speech sounds)

Gestures like waving to say hello or nodding in agreement are universally recognized, and some of the first communication milestones reached. These gestures are effective tools for communication across various social contexts. They can allow for an immediate response from the child rather than finding the picture card or symbol on a board or a device. 

These are beneficial for children with the motor skills and cognitive ability to learn these forms of communication.

Low-tech AAC: 

Low-tech AAC refers to augmentative or alternative communication systems that don’t require technology. Instead, they rely on simple visual symbols or images to assist communication. 

Low-tech AAC is often helpful for children with limited fine motor skills. 

They’re valued for their simplicity, accessibility, and effectiveness in bridging communication gaps.

Examples of low-tech AAC include communication boards, PECS®and communication books. 

Communication Boards:

Communication boards are fundamental low-tech AAC tools. They consist of a physical board or sheet with a grid of symbols, words, or pictures representing various objects, actions, or concepts. 

Symbols can be categorized or organized based on their functions, which makes it easier for children with autism to express themselves by pointing, touching, or indicating their choices. 

You can customize communication boards according to each child’s specific needs and interests, which makes it highly useful for educators, therapists, or caregivers.

Picture Exchange Communication System® (PECS®):

PECS® (Picture Exchange Communication System®is a low-tech AAC system developed by Andy Bondy, PhD, and Lori Frost, MS, CCC-SLP. 

PECS® consists of six phases, allowing for more complex communication as it progresses. In phase I, individuals learn to request desired items/activities by exchanging a single picture with a “communicative partner” who immediately honors the exchange as a request.

The system later teaches discrimination of pictures and how to put them together in sentences. In the more advanced phases, individuals learn to use modifiers, answer questions, and make comments.

Using PECS® is beneficial because it follows a structured approach that helps kids gradually build communication skills. It’s also incredibly flexible, enabling children to communicate in a variety of situations and settings. 

Communication Books:

Communication books are portable and customizable AAC tools that resemble a notebook or binder filled with pages of symbols, pictures, or words. 

Each page is dedicated to a specific category or topic, allowing children to flip through and point to the relevant symbols to express themselves.

These books range from basic to highly advanced, depending on the child’s needs and communication abilities.

A picture of a communication book, ax example of low-tech augmentative or alternative communication devices

Mid-tech AAC Devices

Mid-tech Augmentative and Alternative Communication (AAC) devices bridge the gap between low-tech and high-tech solutions. These devices, such as Speech-Generating Devices (SGDs) and dedicated communication apps, incorporate technology to offer a more versatile means of communication. 

Mid-tech AAC devices work well for autistic children and adults because they provide customizable, interactive, and engaging communication tools. Motor skills and cognitive abilities could pose limitations on mid-tech AAC.

Speech-Generating Devices (SGDs):

Speech-generating devices (SGDs), also known as communication devices or voice-output communication aids (VOCA), are portable electronic devices that help people with limited or no speech capabilities express themselves. This includes popular devices such as AlphaTalker, GoTalk, and DynaWrite.

SGDs generate speech based on the user’s input, which can include selecting symbols, pictures, or words on the device’s touchscreen or interface.

SGDs are customizable and can store an extensive vocabulary beyond what can be kept on a board or in a book. They support language development through visual and auditory feedback and offer a way for children to communicate independently. 

Dedicated Communication Apps:

Dedicated communication apps are software applications for mobile devices like tablets and smartphones. 

These apps offer AAC capabilities and leverage the touchscreen interface to provide an interactive and customizable communication experience. Popular apps include TouchChat and Proloquo2Go.

These apps are widely available, and since most kids are already familiar with using tablets or phones, the touchscreen interactions are often more intuitive.

High-tech AAC: 

High-tech AAC devices, like the Grid Pad, can help individuals with complex communication needs, including children with autism who have more advanced communication skills. 

These sophisticated electronic devices use cutting-edge technology, including text-to-speech synthesis, touchscreen interfaces, and extensive customization options to facilitate effective communication.

Features of High-tech AAC Devices:

  1. Text-to-Speech Technology: High-tech AAC devices have the capability to convert typed or selected text into spoken language. 
  2. Touch Screen Interface: Touch screen displays are intuitive and user-friendly. Children can navigate the device’s interface by tapping symbols, words, or buttons to form sentences or access vocabulary.
  3. Customization: These devices can be highly personalized to meet each child’s individual needs.
  4. Multimodal Communication: Users can choose to communicate using symbols, pictures, text, or a combination of these, depending on their preferences and abilities.
  5. Predictive Text and Symbol-Based Communication: Some devices incorporate predictive text algorithms or symbol-based communication systems, which can help kids communicate more quickly.

Choosing the Right AAC System for Your Child

First of all, there are no prerequisites necessary to start using AAC. 

Communication begins with interaction, someone wanting to interact with another purposefully. So, If your child wants to interact but cannot – AAC may be a solution for them.

The primary goal of any AAC system is to enable the user (your child) to communicate interactively and efficiently across environments. In other words, the goal is to give your child a way to say what they want to say but don’t have the oral language skills to communicate.

When choosing an AAC device, consider the following:

  • Is it operational? – Does your child have the skills (cognitive, motor) required to use the system?
  •  Is it functional? – Does your child have the underlying language skills to use the system or device appropriately?
  • Versatility – Will your child be able to use the AAC system in different environments and during different activities (at home, school, and in the community)?
  • Multimodal or single system approach? – For some kids, a single AAC system can meet all their communication needs, but others may need more than one system. 


Typically, when formally introducing an AAC device or system, your child’s school team and/or an SLP and OT will be involved in the process. 

Any AAC systems implemented should be used both at school and at home.

Parents, educators, and anyone else who spends a significant amount of time with a child plays a pivotal role in implementing AAC systems successfully. 

It’s important for educators to understand the AAC systems in place and provide opportunities for interactive communication, supporting the child’s communication efforts.

Augmentative and Alternative Communication devices and systems are invaluable tools for autistic children, enhancing their communication ability. 

By carefully considering the child’s unique needs, the environment, and the tasks they need to perform, parents, educators, and specialists can choose a suitable AAC device and set the stage for improved communication. 

Remember, AAC is not a one-size-fits-all solution, and ongoing support and adjustments are essential for success.


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