Augmentative and Alternative Communication (AAC)

Common Myths about AAC

  • Cognition – His cognition is too low to learn AAC
  • Behavior – His behaviors have to be under control first
  • Proof of desire – I don’t think he wants to communicate
  • Hierarchy – First we need to master signs, pictures, objects, cause and effect, etc. OR we need to try verbal intervention for X years first
  • Motor skills – He can only access bigger buttons or he wouldn’t be able to use an AAC device at all with his motor skills
  • Age – He is too young for AAC
  • Verbal speech – He can already talk, even if people don’t understand him or it’s very scripted
  • Symbol representation – He must understand the picture system before he can use an AAC device
  • Hinder speech – If I give him a device, he won’t try to talk anymore

AAC Myths and Realities

There are many common myths that can potentially affect an individual's or family member's willingness and motivation to use AAC. However, available research does not support these myths (Romski & Sevcik, 2005).

Myth 1: Introducing AAC will reduce an individual's motivation to improve natural speech and will hinder language development (including the development of social communication skills). AAC should be introduced only after the ability to use natural speech has been completely ruled out.

Research Findings

The use of AAC does not affect motivation to use natural speech and can, in fact, help improve natural speech when therapy focuses simultaneously on natural speech development and use of AAC in a multimodal approach (Millar, Light, & Schlosser, 2006; Sedey, Rosin, & Miller, 1991).

Intervention for minimally verbal school-age children with ASD that included use of an SGD increased spontaneous output and use of novel utterances compared with the same interventions that did not include use of an SGD (Kasari et al., 2014).

AAC can help decrease the frequency of challenging behaviors that may arise from frustration or communication breakdowns (Carr & Durand, 1985; Drager, Light, & McNaughton, 2010; Mirenda, 1997; Robinson & Owens, 1995).

Myth 2: Young children are not ready for AAC and will not require AAC until they reach school age.

Research Findings

Early implementation of AAC can aid in the development of natural speech and language (Lüke, 2014; Romski et al., 2010; Wright, Kaiser, Reikowsky, & Roberts, 2013) and can increase vocabulary for children ages 3 years and younger (Romski, Sevcik, Barton-Hulsey, & Whitmore, 2015).

AAC use with preschool-age children has been associated with increased use of multisymbol utterances and development of grammar (Binger & Light, 2007; L. Harris, Doyle, & Haff, 1996; see Romski et al. [2015] for a review).

AAC use can lead to increases in receptive vocabulary in young children (Brady, 2000; Drager et al., 2006).

Myth 3: Prerequisite skills such as understanding of cause and effect and showing communicative intent must be demonstrated before AAC should be considered; individuals with cognitive deficits are not able to learn to use AAC.

Research Findings

Measures of pre-communicative cognitive ability may be invalid for some populations, and research suggests that impaired cognition does not preclude communication (Kangas & Lloyd, 1988; Zangari & Kangas, 1997). Development of language skills can lead to functional cognitive gains (Goossens', 1989).
AAC intervention for children with complex communication needs helps develop functional communication skills, promotes cognitive development, provides a foundation for literacy development, and improves social communication (Drager et al., 2010).

Speech-Generating Devices (SGDs)

  • Can be funded by Medicare, Medicaid and some private insurance companies.
  • Considered Durable Medical Equipment (DME)


Prentke Romich Company (PRC)

Accent 1000 (models 800 and 1400 also available)

Accent 1400 with NuEye® Tracking System
(allows the eyes to control the movement of the cursor on the screen)

Saltillo Corporation

NOVA Chat 8 (also available in 5” and 10” and 12” models)

Chat Fusion 10 with optional headpointing

Tobii DynaVox

Indi with Communicator 5
Portable and lightweight

I-110 with Snap + Core First
Ultra-rugged and durable with Gorilla Glass

Tobii DynaVox

I-15 with Communicator 5 (also available in 12” model)
Large screen, eye-controlled device