AAC stands for “Augmentative and Alternative Communication.” It includes anything we do - other than speech - to supplement spoken language. It can include simple, low-tech solutions like sign language, drawing to communicate, or pointing to pictures in a menu to order food. It can also include higher-tech modes of communication like text-to-speech, buttons that speak when pressed, and communication apps that contain thousands of symbols.

AAC can be a short-term solution or a long-term support depending on what the individual needs.

Definitely not!

Research consistently shows the opposite: that having access to AAC makes children more likely to speak and does not interfere with language development. Below are several research articles that address this question.

• The Impact of Augmentative and Alternative Communication Intervention on the Speech Production of Individuals With Developmental Disabilities: A Research Review

• Augmentative and Early Communication Myths and Realities

• Effects of Augmentative and Alternative Communication Intervention on Speech Production in Children With Autism: A Systematic Review

• Spoken Vocabulary Outcomes of Toddlers With Developmental Delay After Parent-Implemented Augmented Language Intervention

It depends.

Some older children do well with a $25 text-based system on a phone. Other children end up needing an $8000 device that mounts to their wheelchair and can be controlled using eye movements. For most families, there are a number of in-between options that make sense.

Many insurance companies will cover an AAC system as long as it is recommended by an SLP and prescribed by your doctor. If you don’t have insurance or if your insurance does not cover AAC, we can explore alternative funding options together, such as local and national charities, relying on school resources, and community fundraising.

Any good AAC system needs the following:

• Lots of built in vocabulary - 1000 words is a good start; 4000 is better! And it should include all kinds of words - objects, people, place, actions, feelings, question words, and descriptive words like “sparkly” or “cold”

• Organization - it should be easy to find the words, you’re looking for and the way they’re organized should make sense

• Words that don’t move - words on your AAC device should stay in one place as much as possible so that finding them can become automatic.

• A way to combine words into sentences or phrases - combining words is what makes language powerful. If a child can only select from phrases we’ve pre-programmed, how will we know what they really want to say?

• A way to spell

• Grammar

Some AAC systems meet these requirements, while some do not. The following is a list of commonly-used communication apps that have all these features, but others exist and some are currently in development.

Robust AAC systems include:

• CoughDrop

• TouchChat

• LAMP

• TD Snap

• Grid

• Avaz

• Proloquo2Go

• Speech Assistant

• Proloquo4Text

There are no prerequisites for AAC. Insurance companies will not pay for a speech-generating device unless your child demonstrates certain skills, but sometimes the best way to learn those skills is by using AAC.

I follow an “Access First” approach. This means that I do my best to provide AAC access long before children “prove” they can use it. Nobody wakes up one day knowing how to drive a car - someone has to teach them! AAC is no different.