AAC: Augmentative and Alternative Communication for Autism

Medically Reviewed by Poonam Sachdev on October 03, 2022
Written by Amber Felton
4 min read

With more and more children, teens, and adults being diagnosed with autism spectrum disorder (ASD), we must learn new ways to communicate and teach. Luckily, techniques and technology have evolved to support autistic individuals, leading to innovations like AAC: augmentative and alternative communication. 

Augmentative and Alternative Communication involves different communication methods that are used by people who can’t rely on their speech. These individuals use AAC by incorporating abilities other than speech to communicate permanently or temporarily. AAC benefits people who have cerebral palsy, intellectual disabilities, brain damage following a stroke or head injury, and more. AAC also helps non-verbal autistic individuals communicate with their peers. 

Augmentative and alternative communication can include both aided and unaided communication. 

Unaided Modes

Unaided modes include using non-verbal communication, including:

  • Facial expressions
  • Hand gestures
  • Vocalizations
  • American Sign Language (ASL)

Unaided communication usually requires that a user have good control of their motor skills and the support of someone who can interpret the meaning of their communication.  

Aided Modes

With aided modes of AAC, individuals communicate with outside systems of support by using devices. 

Low-tech devices include:

  • Communication boards
  • Objects
  • Pictures
  • Visual schedules
  • Writing

High-tech devices include: 

  • Communication applications, text-to-speech apps, and texting through mobile devices and computers
  • Recordable or digitized devices
  • Single-message devices
  • Speech-Generating Devices (SGD)

Some individuals may rely on one or both modes of AAC communication, depending on the circumstances. 

AAC devices generally belong to one or more of the following three categories:

Single-meaning pictures 

A single-meaning picture device allows the user to pick a picture representing one word or message. Sometimes, the user may need to be taught what the pictures mean before using the device.

Alphabet-based systems 

The alphabet-based system device uses spelling and letter codes and requires the user to have a basic literacy level.

Semantic compaction 

Semantic compaction devices combine icons with multiple meanings to form words. They require training before use.

AAC has evolved over the years to encompass several techniques to help children and adults alike learn how to use AAC to communicate effectively. These techniques include: 

  • Visible language: Visible language is the perfect way to help non-verbal children communicate what they want and to teach them routines and skills. Visible language could include visual schedules, demonstrations of a particular pattern or routine, and social stories.
  • Language stimulation: Language stimulation is a monkey-see-monkey-do technique that allows you to teach your child AAC by speaking AAC yourself.
  • Temptations: Using desirable objects to achieve AAC communication is often an effective solution. For example, if your child has a favorite toy or snack, you might consider using that as a temptation to get them to communicate.
  • Repetition: Repeating a task is a great way to adopt it into your daily routine, and the same action can apply to AAC techniques.
  • Structure: Structure is essential, especially for those with ASD. Creating a structure helps build routines and teaches individuals what is expected of them. Structure also helps improve engagement and teamwork.
  • Written choice: Written choice can be beneficial for adults. For written choice, an individual is given specific word choices relating to a topic of conversation. Pictures can be used alongside written words to help users understand the terms.

AAC has many benefits that depend on the specific needs of the user. For example, someone with cerebral palsy will benefit differently than someone with autism. 

For autistic individuals, AAC: 

  • Helps with communication: One of the main benefits of adopting AAC techniques for autistic children is that it helps them communicate. This is especially beneficial in autistic children, or even autistic teens and adults, who are non-verbal. 
  • Helps develop routines: With visual schedules, individuals can learn to develop habits. Visual schedules usually depict a series of photos or videos, breaking down activities into simple, easy-to-follow steps. Individuals can use these schedules to guide themselves through a routine; over time, the routine should become instinctual.
  • Improves skills: Visual schedules and visual stories can also be used to improve skills. Both of these AAC techniques can break down the steps involved in, for instance, self-care routines or riding a bike.
  • Builds on decision-making: Non-verbal people often have difficulty expressing their opinions, making decision-making hard. However, with AAC devices, specifically those that improve communication, people can voice their opinions and make their own decisions without speaking.
  • Provides motivation: AAC can motivate children to accomplish more. Apps that aim to build on communication and develop skills can be fun and engaging, motivating those using the apps.

Some parents and patients have concerns regarding AAC devices and techniques. Common problems include: 

  • Age: Age is something that people often wonder about when considering AAC for their child. Some parents wonder if their child is too young to use AAC properly. However, there is no age limit on AAC devices and techniques, and research suggests that even toddlers younger than three can benefit from AAC. AAC requires no specific age or skills.  
  • Motivation: Another concern for parents is whether AAC hinders a child’s motivation to speak or if AAC will slow down a child’s language development. The opposite is true: AAC has been shown to help speed up language development in children.
  • Movement: A final concern pertains to children or individuals who lack other motor skills, such as the ability to move their hands or arms. While this may affect some AAC methods, many other AAC systems and devices can be used without physical manipulation.