Augmentative and Alternative Communication (AAC): Complete Guide
Augmentative and Alternative Communication (AAC) encompasses all means of communication other than speech that allow people with difficulties in oral expression to communicate. Pictograms, gestures, applications... This guide presents the different AAC tools, their indications and implementation.
📋 In this article
What is AAC?
Augmentative and Alternative Communication (AAC) refers to all means, techniques and tools that complement or replace speech when it is absent or insufficient to communicate effectively.
- Alternative: replaces speech when it is absent
- Augmentative: supplements insufficient or poorly intelligible speech
AAC is not a single method but a set of strategies that can be combined according to each person's needs and abilities. 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 improves not only communication but also cognitive, social and emotional development. The absence of communication means leads to frustration, behavioral problems and isolation. Everyone has something to say, AAC provides the means to do so.
For whom?
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) supporting speech |
| Motor disability | Speech synthesis, switches, gaze to communicate |
| Aphasia (stroke) | Communication folders, applications |
| Neurodegenerative diseases | Tools adapted to progression (ALS, etc.) |
| Multiple disabilities | AAC adapted to abilities (gaze, switch, simplified pictograms) |
Misconceptions to combat
❌ "AAC prevents speech development"
FALSE. All studies show the opposite: AAC promotes oral language development. By reducing frustration and enabling communication, it creates favorable conditions for speech emergence. It doesn't replace speech, it supports it.
❌ "You have to wait until you're sure speech won't 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 It can always be withdrawn if speech develops sufficiently (which is often facilitated by AAC itself).
❌ "AAC is for people with severe intellectual disabilities"
FALSE. AAC is for anyone with a gap between what they understand/think 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
Unaided AAC
- Natural gestures: pointing, head nods, facial expressions
- Sign language (ASL): complete language with its own grammar
- Simplified signs: Makaton, Coghamo, baby signs
Low-tech aided AAC
- Real objects or miniatures: 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 folders: like PODD, thematic folders
High-tech aided AAC
- Tablet applications: GoTalk NOW, Proloquo2Go, TD Snap...
- Speech synthesis: the device "speaks" when pictograms are touched
- Eye gaze control: for people who cannot use their hands
- Switches: adapted buttons for selection
How to choose a tool?
Choosing an AAC tool depends on many factors and should be done 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? Required pictogram size? |
| Cognitive abilities | Level of symbolization? Photos or abstract pictograms? |
| Contexts of use | Home, school, outdoors? Required robustness? |
| Communication partners | Who will need to understand the tool? Training needed? |
| Scalability | Can the tool evolve with the person's progress? |
AAC implementation
Essential principles
- Modeling: the environment uses AAC WHILE SPEAKING to show the 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
- Removing the tool when it's "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 vocabulary according to needs
Our downloadable tools
🖼️ Communication pictograms
Bank of pictograms to create personalized communication boards. Classified by categories (actions, objects, emotions...).
Download📋 Communication boards
Ready-to-use thematic boards: meals, toileting, school, games. Multiple complexity levels.
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 predictability and reduces anxiety.
DownloadFrequently asked questions
No, it's 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, then evolve towards 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. The person themselves will gradually choose the most effective communication mode according to situations. Don't remove a tool that works!
The use of AAC at school can be included in the IEP (Individualized Education Program). Speech therapists and/or occupational therapists can intervene to train the educational team and adapt tools to the school context. The aide can be trained in AAC use.
The choice depends on the person's needs and abilities. The main 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.
