October is AAC Awareness Month, which makes it a good time to address the single biggest worry parents bring up when a speech-language pathologist suggests a communication device or picture system: “If we give him a way to point instead of talk, won’t he stop trying to talk?”
It’s an understandable fear. It’s also one of the most thoroughly studied questions in the field, and the answer is no.
What AAC is
AAC stands for augmentative and alternative communication. It’s any method of communicating that supplements or replaces speech. That includes:
- No-tech: sign language, gestures, facial expressions
- Low-tech: picture cards, communication boards, PECS books
- High-tech: tablet apps and dedicated speech-generating devices where a child taps a symbol and the device says the word
“Augmentative” is the key word. For most kids, AAC is used alongside speech, not instead of it. The goal is to give a child a reliable way to communicate right now, while speech continues to develop.
What the research says
A widely cited review of AAC studies found that introducing AAC did not decrease speech in any of the children studied. Most children showed gains in spoken language after AAC was introduced, and the rest stayed the same. That finding has been replicated repeatedly over the last two decades.
This makes sense when you think about how language develops. Kids learn to talk by communicating successfully and getting a response. A child who can’t make himself understood has fewer of those successful exchanges. Give him a way to say “more,” “help,” “all done,” and “go” reliably, and he’s suddenly having dozens of successful communication exchanges a day. Each one is a language-learning opportunity. Many of those children start using the spoken word alongside the symbol, and then drop the symbol.
Who AAC is for
AAC is not only for children who are “nonverbal.” It’s often used for:
- Toddlers and preschoolers with significant speech delays who are frustrated
- Children with childhood apraxia of speech, where the motor planning for speech is difficult
- Autistic children, including those who are speaking but not yet using speech to communicate needs
- Children with Down syndrome, cerebral palsy, or other conditions that affect speech
- Children who are minimally verbal in some settings (for example, at school but not at home)
- Kids recovering from a medical event that affected speech
Speech-language pathologists also use AAC strategies temporarily with kids who are simply hard to understand, to reduce frustration while articulation therapy works.
What AAC looks like in practice
It’s less formal than most parents imagine. A therapist might start by modeling a few core words on a picture board during play: pointing to “go” every time the car goes, “more” every time the bubbles come out. Nobody makes the child point. The adult just models it, the same way you’d model spoken words to a baby who isn’t talking yet.
Over weeks, the child starts to reach for the board. Then the vocabulary grows. If the child benefits from a high-tech device, the SLP helps the family trial options and, if appropriate, supports the paperwork to get one funded through insurance or Medicaid.
The most important part isn’t the device. It’s that the adults around the child use it consistently, all day, not just in therapy. That’s why parent coaching matters so much.
Common myths, briefly
- “It’s a last resort.” It isn’t. It’s often most effective when introduced early.
- “My child is too young.” There is no minimum age. Signs and pictures are introduced to toddlers routinely.
- “My child isn’t smart enough to use it.” There are no cognitive prerequisites for starting AAC.
- “It’s giving up on speech.” Speech therapy continues. AAC supports it.
Signs your child might benefit
- They’re 2 or older and have fewer than a handful of words you can understand
- They’re frustrated or melting down because they can’t communicate
- They have a lot to say but their speech is very hard to understand
- A teacher or therapist has mentioned a device or picture system
How Stoa can help
Stoa Therapy’s speech-language pathologists work with children ages 1 to 18 across Virginia, Colorado, and Louisiana, with Illinois joining soon, including children who use or may benefit from AAC. We accept Medicaid in all three states and most major insurance plans, and we coach parents on using AAC at home so it becomes part of everyday communication, not just therapy.
If you’ve been wondering whether AAC is right for your child, or you’ve been hesitant about it, reach out. We’re happy to talk it through.