Alternative and Augmentative Communication (AAC): Complete Guide
The Alternative and Augmentative Communication (AAC) encompasses all means of communication other than speech that allow individuals with difficulties expressing themselves orally to communicate. Pictograms, gestures, applications... This guide presents the various AAC tools, their indications, and their implementation.
📋 In this article
What is AAC?
The Alternative and Augmentative Communication (AAC in French, AAC in English) refers to all means, techniques, and tools that complement or replace speech when it is absent or insufficient for effective communication.
- Alternative: replaces speech when it is absent
- Augmentative: complements insufficient or unintelligible speech
AAC is not a single method but a set of strategies that can be combined according to the needs and abilities of each person. It can be used temporarily (during language acquisition) or permanently.
🔬 Why AAC is essential
Communication is a fundamental need. Research shows that early access to AAC not only improves communication but also cognitive, social, and emotional development. The absence of means of communication leads to frustration, behavioral issues, and isolation. Everyone has something to say, AAC provides the means to do so.
Who is it for?
AAC can benefit anyone with difficulties expressing themselves orally, regardless of age:
| Population | Examples of AAC use |
|---|---|
| ASD (autism) | Pictograms, PECS, applications, to express needs and choices |
| Language delay | Temporary support during speech acquisition |
| Down syndrome | Makaton (signs + pictograms) in support of speech |
| Motor disability | Voice synthesis, switches, eye gaze to communicate |
| Aphasia (stroke) | Communication binders, applications |
| Neurodegenerative diseases | Tools adapted to evolution (ALS, etc.) |
| Multiple disabilities | AAC adapted to abilities (eye gaze, switch, simplified pictograms) |
Misconceptions to combat
❌ "AAC prevents the emergence of speech"
FALSE. All studies show the opposite: AAC promotes the development of oral language. By reducing frustration and allowing communication, it creates favorable conditions for the emergence of speech. It does not replace speech, it supports it.
❌ "You have to wait until you are sure that speech will not come"
FALSE. Waiting means losing precious time. AAC should be offered early, as soon as communication difficulties are identified. It can always be withdrawn if speech develops sufficiently (which is often favored by AAC itself).
❌ "AAC is for people with severe intellectual disabilities"
FALSE. AAC is for anyone who has a gap between what they understand/thought and what they can express. People with normal or even superior intelligence use AAC (e.g., ALS, cerebral palsy with motor impairment but preserved cognition).
Types of AAC tools
AAC without technical aid (unaided)
- Natural gestures: pointing, nodding, facial expressions
- Sign language (LSF): complete language with its own grammar
- Simplified signs: Makaton, Coghamo, baby signs
AAC with non-electronic technical aid (low-tech)
- Real or miniature objects: the child shows the object they want
- Photos: photos of familiar objects, people, places
- Pictograms: standardized symbolic images
- Communication boards: pictograms organized by themes
- Communication binders: like PODD, thematic binders
AAC with electronic technical aid (high-tech)
- Tablet applications: GoTalk NOW, Proloquo2Go, TD Snap...
- Voice synthesis: the device "speaks" when pictograms are touched
- Eye control: for people who cannot use their hands
- Switches: adapted buttons for selection
How to choose a tool?
The choice of AAC tool depends on many factors and should be made with a trained professional (speech therapist, occupational therapist). Here are the criteria to consider:
| Criterion | Questions to ask |
|---|---|
| Motor abilities | Can they point? Use their hands? Eye control? |
| Visual abilities | Do they see well? Size of pictograms needed? |
| Cognitive abilities | Level of symbolization? Photos or abstract pictograms? |
| Contexts of use | Home, school, outdoors? Durability needed? |
| Interlocutors | Who needs to understand the tool? Training needed? |
| Scalability | Can the tool evolve with the person's progress? |
Implementing AAC
Essential principles
- Modeling: the environment uses AAC WHILE SPEAKING to set an example
- Accessibility: the tool must be available everywhere, all the time
- Multimodality: combine several tools according to situations
- Patience: learning takes time (months, years)
- Training: all partners must be trained
Common mistakes to avoid
- Testing the person instead of modeling
- Withdrawing the tool when it is "not used" (it takes time!)
- Limiting the tool to certain contexts or certain people
- Using AAC only for requests (you can also comment, refuse, tell stories...)
- Not evolving the vocabulary according to needs
Our tools to download
🖼️ Communication Pictograms
Bank of pictograms to create personalized communication boards. Classified by categories (actions, objects, emotions...).
Download📋 Communication Boards
Thematic boards ready to use: meals, hygiene, school, games. Several levels of complexity.
Download🔘 Choice Cards
Cards to offer visual choices: activities, foods, objects. First step towards communication.
Download📅 Visual Schedule
Support to structure the day with pictograms. Helps with predictability and reduces anxiety.
DownloadFrequently Asked Questions
No, it is never too early. AAC can be introduced as soon as communication difficulties are identified, even in very young children. You can start with simple gestures, photos of familiar objects, and then progress to more abstract pictograms. Early introduction promotes overall development.
Not necessarily. AAC can remain a useful support even when speech emerges: during moments of fatigue, stress, for complex concepts. It is the individual who will gradually choose the most effective mode of communication according to the situations. Do not remove a tool that works!
The use of AAC at school can be included in the PPS (Personalized School Project). The speech therapist and/or occupational therapist can intervene to train the educational team and adapt the tools to the school context. The AESH can be trained in the use of AAC.
The choice depends on the needs and abilities of the person. The main French-speaking applications are GoTalk NOW, Proloquo2Go, TD Snap, Avaz. Consult a speech therapist trained in AAC for personalized advice. Many offer free trial versions.
💬 Ready to implement AAC?
Discover all our free tools to promote communication for everyone.
Discover all tools →Article written by the DYNSEO team in collaboration with speech therapists specialized in AAC. Last updated: December 2024.
