Meeting the Needs of Students Who Use Augmentative and Alternative Communication (AAC) Devices
[Image Description: The image shows an Augmentative and Alternative Communication (AAC) electronic device on an iPad with a green protective case. The screen shows a grid-based communication system with many symbols and pictures. There are icons for people and common words like "I", "is", "do", "want", "like", "have", "where", "more", "you", "it", "what", "get", "make", "to", "on", "good", "of", "all done", "that", "stop", "not", "bad", "in", "out", "go", "come", "think", "eat", "help", "see", "some", and "up."]
CONTENT WARNING: I would like to mention that I am not a medical doctor, psychologist, or therapist. All content posted on disability advocate/teacher influencer page is for educational purposes with no intent to provide any professional services. Social media should never be used as a substitute for mental nor medical health care advice. If you suspect that your child is experiencing developmental concerns, it is okay to get help. I highly recommend seeking help from a medical doctor, psychologist, therapist, and/or other professional who is qualified to do so.
AAC stands for Augmentative and Alternative Communication, and it is a type of assistive technology (AT) for people who struggle with communicating through speech and/or language. Augmentative means supplements verbal speech and alternative means instead of verbal speech. It can be used in educational, therapeutic, vocational, and daily living settings. There are different types of AAC, which include no tech, low tech, and high tech. No tech AAC is pointing, gesturing, facial expressions, and sign language. Low tech AAC does not require batteries and may include a textbook or communication book. High tech AAC is any electronic device that requires batteries and permits the storage, retrieval, and generation of messages and speech output. The two most common AAC electronic device apps installed on iPads as communication devices include Proloquo2Go and Avaz AAC. Touch Chat is another common AAC device app. The iPads that these apps are installed on are arranged in an adaptable grid format to represent images and words on buttons, which represents groups of items in folders. Users can tap the buttons to express their wants, needs, feelings, thoughts, and experiences. These apps are designed to assist and empower people with limited to no speech with an alternative way to communicate to express themselves with their peers and anyone in general. The people who benefit from using AAC devices are people who cannot meet their daily needs with spoken language alone. It is not just nonverbal autistic people/people with Autism/Autism Spectrum Disorder (ASD) who need AAC devices. The other populations that can often benefit from using AAC devices include the following:
- People with limited verbal communication
- Children with verbal emerging skills (still developing)
- People who have difficulty with verbal articulation
- People with loss of verbal speech from seizures, Traumatic Brain Injury (TBI), or certain physical illnesses
- People who struggle to verbally communicate due to shutting down when dysregulated
- People in the intellectual and developmental disabilities (IDD) community, especially who have Down Syndrome, which affects the structure of the body which impacts their speech
- Speech language disability community, especially apraxia and slurred or slowed speech
- Selective mutism
- Cerebral palsy
- Stroke recovery
- People with certain medical health conditions especially degenerative diseases (e.g. ALS)
Communication is a fundamental human right and research shows that AAC users need at least 200 communication opportunities every day. Everyone in the world communicates and it is part of everyone's basic rights to be able to communicate. So, the best way to supplement their communication is always have access to it. They should always have access to it at all times and everywhere that they go. Their AAC device should be with them ALL days, at ALL times, in ALL environments, &&& charged because it is their voice!!! If you ever think of removing or leaving an AAC device behind, think about what you would do if the person was speaking. Their voice cannot be left behind. If we verbal speakers think about it, we take our voices for granted. We use our voices all of the time, but for AAC users, if they do not have the device, they cannot communicate. Taking away their communication device as discipline for misbehavior is also taking away their voice. In this case, they are being robbed of the inclusive opportunities to learn and be part of the society. So, let them use their devices and make sure that they have them at all times. Model as much as you can and explore the devices when you are working with students who are AAC users. AAC users who are older in age should be asked if they can be shown stuff on their device. Sometimes it seems like people do not always communicate with learners who use communication devices the same way that they would communicate with someone who does not need a communication device; however, we would ask people who do not use communication devices if we could use their pencil instead of just taking it. Talking to them this way provides them with a sense of autonomy. It is especially important focus on communicating things like "I want..." and "I need help" with AAC users since these are extremely important life skills and provide as many ample opportunities as you can.
Just like you would talk to a baby, English Language Learner (ELL), or any verbally articulate person, we need to talk to AAC users in their language, which is on their AAC system!!! That means that you need to use their system to model communication. If you do not know how to use their device, explore it because we need opportunities to practice using it too and you showing them what you are doing is actually helping them as well. Modeling using an AAC device means that a person is using the system while they are talking and showing the person how to use the device. They may need to point to certain categories/folders or icons to guide them through how to use the device. For example, if a teacher is asking a student to identify numbers, they may need to point to the numbers category folder to direct them where to click to get started. Then, the student can try to find and click on the correct numbers independently. Another example is if a student's alphabet skills are being assessed, the teacher could show them a separate written visual of letter G and say, "Is this letter G or C?". The teacher should point to both letter options when asking this question (similar to a word bank or multiple choice) to provide clarity and limit choices. Modeling is also a way that we verbal people communicate too. For example, when there is a child who is learning to communicate, and an adult says "ball" or "sink", typically, they will repeat it verbally. The same goes for AAC users. Typically, by 18 months old, a verbally speaking child has already 4,080 hours of spoken language. So, AAC users need those same hours of language development. If AAC users only get the speech sessions, they are going to take 84 years to be exposed to the same amount of language as a child who verbally speaks.
Core vocabulary is a small set of common words that make up about eighty percent of what we say day to day. So, we use it all of the time and the primary focus should be on core vocabulary words, such as "hello", "goodbye", "yes", "no", "more", "you", "was", "on", "go", and "that." Other functional core vocabulary should especially be added to AAC devices, such as sight words, fluency, ABCs, numbers, colors, shapes, actions, people, foods, animals, weather, days of the week, months of the year, the user's full name, home address, phone numbers, and emergency contact information, everyday objects and activities, and any other words and information that they use in their typical day-to-day lives. We can use it to communicate, write a sentence, or answer questions. Those words are included in the device and teachers, paraeducators, service providers, and families should always put emphasis on teaching and modeling core vocabulary. For example, if a teacher is doing an activity that involves answering questions "yes" or "no," there are simple words that need to be seen by child AAC users so they can continuously practice and learn. We can use words to describe something and those small words to make longer sentences. Vocabulary, phrases, and folders to click on can be customized on AAC devices as well.
Students who are AAC users can use their devices to be engaged through hands-on learning opportunities. These lesson activities include letter, number, color, and shape identification, spelling, counting, following directions, parallel play, and group play. Sometimes creating these lesson activities for AAC users requires using creativity to provide them with the most inclusive, accessible, free, fair, and appropriate education possible. Individualized supports and developmentally appropriate leveled materials enhance both academic and communication skills. Using leveled materials can help students who are AAC users "to challenge them to move forward in their academics and functional communication" (The Autism Helper 2025).
There are four reasons why we communicate, which are to express our wants and needs, build relationships, get or share information, and engage in conversations. Everyone definitely needs a lot of opportunities to practice, build, and improve their communication skills. It could be as simple having a conversation and adding a word. Even making them travel through the device is helping the users and you to become familiar with it. If you get lost, click home and it takes you back to the beginning of the device. If you are concerned that you messed something up on an AAC device, just let the student's Speech Language Therapist know and realizing that AAC devices are automatically backed up should provide relief. How-to videos and asking Speech Language Therapists if they can show you X, Y, and Z about AAC devices seem to be two common helpful ways for other professionals and families who are new to using AAC devices. AAC devices should also be set on guided access, which means that the app cannot be exited out of. To elaborate, AAC devices should not be used for making videos, taking photos, or playing video games. AAC devices should only be used as a communication tool and not played with by the user or other people.
While AAC devices, especially with Proloquo2Go installed on them, are highly successful and many people in the disability community like using them, there are some possible pitfalls that can happen. AAC devices can be difficult for users and other people who are supposed to be part of their support system to navigate and even overwhelming due to the high number of categories. It can be tricky to navigate, especially when just starting out using it because there are so many different categories that can be used. Using the device comes immediately easy to some students while some students find it confusing. It is not used by many students with limited fine motor planning difficulties because it needs to be navigated physically with many buttons to push. It can be hard to build a solid motor plan for those students. In addition, when the device is being taken home and used at school, the teacher and student's family need to have open communication to make sure that the tablet is being charged fully and used. Some families also forget to send it in or refuse to let their child use it, which results in the child spending days without having a voice and forgetting how to use it if they are not using it enough.
Schools are legally required to provide and pay for AT for students who need it. It is more just about convincing the school district that the child would benefit from this AT. Students in the disability community get services through their Individualized Education Program (IEP) under the Individuals with Disabilities Education Act (IDEA). Schools must provide AT services and any other Related Services that the IEP team determines are necessary for individual students to benefit from. The IEP team must provide data and evidence to explain why the student would need it or benefit from it. It can either get approved or disapproved depending on how much data they have. This is why it is important to collect data about the student and why it would benefit for them to have this AT. Proloquo2Go is a $250 downloadable app and implementing it is pretty simple after approval.
As a whole, the IEP team for students who are AAC users typically includes a Speech Language Pathologist (SLP), AT Specialist, parents/guardians, students (if they are at the legal age of participation), the Special Education teacher(s), and general education teachers. Other Related Service providers, such as but not limited to an Occupational Therapist (OT) or Physical Therapist (PT), may also be included. The role of the SLP and AT Specialist is to gather information for the AAC assessment, make recommendations, provide treatment, and identify funding sources for the AAC. Other responsibilities that could fall onto the SLP is to observe and update the AAC, give team members system updates, train staff, and consult ed teams on questions and feedback regarding the AAC. Anyone who is in the IEP team of a student who is an AAC user can put all of the goal writing and data tracking into one document so that they can have constant access to it and see what each other are putting into it. Consulting with each other through meetings can also be helpful. Observing the student while using the device together and while they are using it independently can be helpful to collect data and ensure that the student is not abandoning the AAC and that they are not only using it together. The abandonment can be prevented by making sure that the student is receiving proper training and the school monitoring that it is actually beneficial for them because that is the main goal of the AT.
To learn more about how to support AAC users, visit the following websites:
- National Institute on Deafness and Other Communication Disorders (NIDCD) - www.nidcd.nih.gov
- Practical AAC - www.praacticalaac.org
- The Autism Cafe - www.theautismcafe.com
- The Autism Helper - www.theautismhelper.com
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Citations
1. "Building Academic and Communication Skills with AAC Devices." YouTube. The Autism Helper. (1 Jan. 2025). https://youtu.be/ZwMNLf0kXOQ?si=RqTnB3LUIJT9YeEs
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