Introduction
AAC (Augmentative and Alternative Communication) includes all the ways people can communicate when talking is difficult, such as gestures, pictures, signs and communication devices. AAC supports people of all ages to express their needs, thoughts, and feelings, reducing frustration and supporting participation at home, school, work, and in the community.
With so many AAC options available, it’s common for families to feel overwhelmed. Broadly speaking, AAC can be grouped into two main categories: unaided AAC and aided AAC.
Unaided AAC
Unaided AAC uses the body to communicate, with no additional tools required.
Common examples include:
- Gestures (e.g., pointing, reaching, waving)
- Sign language
- Facial expressions (e.g., smiling, frowning)
- Body language
Unaided AAC is often the earliest form of communication and is always available. However, it can be limited by a person’s motor abilities and how easily others can understand the message.
Aided AAC
Aided AAC involves the use of additional tools or materials to support communication. These can be further categorised into light-tech and high-tech AAC.
Light-tech AAC
Light-tech AAC systems are typically paper-based and do not require batteries or charging.
Common examples include:
- Communication boards or books with symbols, words or pictures that users can point to, such as:
- Choice boards
- Topic boards (words related to a specific activity, e.g., mealtimes, art, play)
- Core boards (high-frequency ‘core’ words, with some activity-specific ‘fringe’ words)
- Print-outs of displays from AAC apps
- Pragmatic Organisation Dynamic Display (PODD), where vocabulary is organised to support communication for different functions (e.g., commenting, expressing preferences)
- Alphabet boards
- Picture Exchange Communication System (PECS), where a user hands a picture to a communication partner to convey a message (commonly used for requesting)
Light-tech AAC can be a helpful starting point and is often used alongside high-tech AAC as a backup system. Some light-tech AAC systems, such as PODD books, are also robust enough to support communication, without the need for additional high-tech AACs.
High-tech AAC
High-tech AAC systems are electronic and require charging. These are often called speech-generating devices (SGDs).
Common examples include:
- Dedicated communication devices (e.g., GoTalk)
- Symbol-based AAC apps (e.g., TouchChat, Prologuo2Go, LAMP Words for Life, simPODD), which are often highly customisable
- Text-based AAC apps
High-tech AAC often offer access to more vocabulary and spoken output, supporting more flexible communication.
Access methods
How someone uses an AAC system depends on their physical abilities.
- Direct access: touching the icon directly (e.g. using fingers or a stylus).
- Alternative access: when direct touch is physically difficult, alternative access methods may be used, including:
- Switch scanning
- Eye-gaze technology
- Partner-assisted scanning, where a communication partner offers choices and the user indicates their selection
- Head pointing
Light-Tech vs High-Tech AAC: A Quick Comparison
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Light-tech
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High-tech
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Cost
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More affordable and accessible
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More expensive to purchase and maintain
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Power required
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No charging or batteries needed
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Must be charged regularly
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Vocabulary
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Vocabulary may be limited by space constraints
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Dynamic display allows for large vocabulary storage
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Customisation
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More effortful, not easily changed on the go
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Can be customised quickly
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Use across environments
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Can be used anywhere and as a backup if devices fail
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May be limited in certain environments (e.g. swimming pool, messy activities)
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Ideally, anyone using high-tech AAC should also have a light-tech backup, so they can continue communicating effectively in different environments or if technology fails.
Which Type of AAC Is Best?
There is no one-size-fits-all AAC system. The best system is the one that works for the individual in their everyday life. When selecting an AAC system, there are some important considerations.
A Robust AAC system
It is recommended that a robust system is introduced early, even while communication skills are still developing.
A robust AAC system supports:
1. Multiple communication functions
We communicate for a wide range of reasons, such as commenting, asking questions, sharing opinions, and talking about past events. Some AAC systems (like PECS or choice boards) focus primarily on requesting and may need additional support to expand communication functions.
2. Rich vocabulary access
A robust AAC system provides access to:
- Core words: high-frequency words used across many situations (e.g., I, go, help, like, up, good)
- Fringe words: context-specific or interest-based words (e.g., animals, toys, places)
- Prestored messages: commonly used phrases (e.g., “I don’t know”, “Wait a minute”)
Systems with limited vocabulary, such as topic boards, can be helpful in certain situations, especially when the full AAC system is not available. However, when used on their own, they can limit:
- Language opportunities: AAC users can only learn and say what is available on the board
- Motor planning: words may appear in different locations across boards, making it harder to develop consistent motor patterns
- Generalisation of language: when words are tied to specific activities, it becomes harder to use them across different situations. For example, if “open” only appears on a snack board, how can someone talk about opening a door, opening a present, or opening a book?
3. Alphabet access
Even before reading or writing, access to letters supports future literacy and language development.
4. Spontaneous Novel Utterance Generation (SNUG) (Hill, 2006)
The ultimate goal of AAC is to help people say what they want, when they want, to whomever they want, wherever they want.
AAC systems that support SNUG provide access to individual words that can be combined freely, allowing users to create new messages. This does not necessarily mean complex language, but that the individual can express what they are thinking, supporting more meaningful, flexible and interactive communication.
Conclusion:
AAC is not about choosing the “perfect” system, it’s about giving individuals their voice and ensuring that they are empowered to express themselves confidently and participate fully in the world around them.
If you or your family might require AAC, reach out to a speech therapist! They can assess communication needs, recommend appropriate AAC systems, and guide you through the process.
References
Hartmann, A. (n.d.). 4 things every AAC system needs. AssistiveWare.
https://www.assistiveware.com/learn-aac/4-things-every-robust-aac-has
Hartmann, A. (n.d.). Don’t limit communication with topic boards: Use your AAC. AssistiveWare.
https://www.assistiveware.com/learn-aac/topic-boards-vs-robust-aac
Hill, Katya. (2006). Augmentative and Alternative Communication (AAC) Research and Development: The Challenge of Evidence-based Practice. International Journal of Computer Processing of Languages, 19(4), 249-262. https://doi.org/10.1142/S0219427906001505
