Menu

Augmentative Communication (AAC)

Background

Augmentative and Alternative Communication (AAC) describes ways to support, add to, or augment the communication of people who are not verbal communicators. AAC includes low-tech systems, such as:
  • sign language
  • picture boards
  • letter boards
  • communication notebooks
And high-tech systems, such as:
  • voice output communication devices
  • tablets
  • cell phones
  • smart watches
Since the birth of the iPad and the Android tablet, access to communication is much more available to children and adults with disabilities. Applications in both Mac and Android platforms are available for communication, learning, socialization and fun. Many people may use both a low-tech approach and a high-tech tool to communicate across different settings. Communication occurs when the needs or intent of one person is understood by another. The form of communication is less vital than the success of communication.
Children with various conditions may benefit from the use of augmentative communication:
  • cerebral palsy
  • cognitive impairment
  • brain injury
  • autism
  • neuromuscular disease
  • non-verbal speech impairment
  • medical conditions (tracheostomy, vocal cord impairment)
Early intervention with AAC helps with language development for children who are at risk for severe speech impairment. Intervention starts by showing picture symbols and sign language to infants. As children grow, they may shift to high-tech devices. Many studies have shown that use of augmentative communication does not interfere with natural speech, and can in fact aid in language growth if the child has the ability of speech .

Assessment and Evaluation

While many children will use augmentative communication, no one device or approach is right for everyone. An evaluation by a speech pathologist working with a team of other expert is important when choosing a device.
The evaluation includes consideration of the child’s:
  • communication needs
  • motor skills
  • hearing
  • vision
  • cognitive abilities
  • functional setting
The evaluation team decides the input method, vocabulary model, and output method which meet the child’s needs. The needs of the child are then matched to the available technology. Supports should be available to maintain and update the system or device. Some school districts may have an AAC team. Ask your special education teacher for more information on an evaluation by the AAC team. Most states have Centers for Assistive Technology and Augmentative Communication; to find a center in your state, go to the National Assistive Technology Act Technical Assistance and Training (AT3) Center.

iPad use

Use and Care of AAC Devices and Equipment

Many AAC devices are technology-based, while others are books or some other low-tech type. More about input, output, and other features can be found on the Basic Augmentative and Alternative Communication (AAC) Device Characteristics page.

ACC equipment should:
  • make it easier to communicate
  • be comfortable to use
  • not cause any other health concerns
New equipment may take some time to learn to use. With new patterns of use and the weight of equipment, the primary care doctor may need to check for pressure sores, added or decreased use of limbs and muscles, and accidental injuries. Input devices may need to be moved for placement or sensitivity to help functioning. For children who use a wheelchair, a mounting gadget will need to be kept in mind when buying the device.
Proloquo2Go software on Apple's iPad
Tobii C12 augmentative communication device
Proloquo2Go communication software app on
the iPad.

Image courtesy of AssistiveWare and Apple
Tobii C12 augmentative communication device

Image courtesy of Tobii Technology

Costs and Funding

Costs for AAC technology vary widely, from signing and picture notebook systems which are very low cost, to high-tech eye gaze computers which cost much more. Simple communication devices, and tablets or cell phones with applications can be purchased for under $1000. A dedicated device is one that is only used for the child's communication needs and generally are from high tech AAC companies like Tobii Dynavox. Current costs are available on manufacturer websites.
At the time of this writing, insurance companies generally will pay only for a dedicated communication system, but some families are have found success by appealing and presenting the insurance company with a package that is much lower cost - a tablet (iPad, Android or similar) and a communication application (app) that total less than $1000 (sometimes considered "non-dedicated") compared to up to $15,000 for a dedicated communication system.
The funding process requires a prescription, a letter of medical necessity (see Writing Letters of Medical Necessity), and evaluation documenting the need for the chosen device. Most medical insurance providers will consider replacing a communication device every five years. Other funding sources include government agencies such as Independent Living and Vocational Rehabilitation, and foundations that provide grants for iPads and tablets for children with speech impairments. School districts may not fund devices for a child’s personal use, though technology may be provided for the child’s use at school. Some states have Financial Loan Programs for Augmentative Communication to help with the cost.

Resources

Information & Support

In addition to informational links, below we provide a few links to commercial sites offering AAC products that may help you understand the range of technology available.

For Parents and Patients

AAC-RERC
The Rehabilitation Engineering Research Center on Communication Enhancement provides information on the newest developments in augmentative and alternative communication.

Family Center on Technology and Disability Family Portal
Offers information for families and individuals with disabilities by providing information and resources on using technology to improve education. Includes subjects like “how to implement technology in the IEP.” Site is supported by the US Department of Education.

AbleNet
A commercial site offering products and curricula, as well as information and assistance in choosing and funding AT devices.

Adaptivation
A commercial company with information and assistance to make adaptations to assistive technology; this can help families see different options for use of devices.

Tobii Dynavox
Commercial site offering augmentative and alternative communication devices and solutions.

Origin Instruments
Commercial site offering augmentative and alternative communication devices including accessories for popular technogy such as iPads and Kindles.

Prentke Romich Company
A commercial site offering augmentative and alternative communication devices; teaching materials, switches, and more.

AssistiveWare
Commercial site offering assistive communication software for popular devices such as iPods, iPhones, and iPads, including Proloquo2Go.

RJ Cooper & Associates
Commercial site: iPad & computer accessories and gadgets for people with disabilities. Includes reviews, tips, and personal experience with equipment.

Saltillo
A commercial site dedicated to making personal communication possible to individuals who are unable to use their natural voice.

Tools

Autism Speaks - Autism Apps
This website has a comprehensive list of apps for children with Autism; the apps are listed by category, platform and age recommendation, and rated by research and effectiveness.

Bridging Apps – Easter Seals of Greater Houston
Bridging the gap between technology and people and disabilities. Focuses on apps that have been designed to address a particular need or have been creatively adapted by users to meet specific needs. Autism Speaks

Tap to Talk
Commercial site for application - AAC for autism, Down syndrome, apraxia, cerebral palsy, aphasia, any non-verbal condition - All languages, all ages, and across iPad, android, nook, kindle, nabi, windows, smartboard, Nintendo ds, pc and mac platforms.

iHelp for Special Needs
Commercial site with communication and learning apps for children with special needs.

Services in Rhode Island

Select services for a different state: ID, MT, NM, NV, UT
The service category below will include a variety of assistive technology providers, many of which will offer augmentative communication services and tools.

Assistive Technology Equipment

See all Assistive Technology Equipment services providers (4) in our database.

For other services related to this condition, browse our Services categories or search our database.

Authors & Reviewers

Last update/revision: February 2019; initial publication: January 2009
Current Authors and Reviewers:
Authors: Tina Persels
Laura Barnett, MCSD/CCC