PediatricDigest: Will an Augmentative and Alternative Communication (AAC) Device Keep My Child From Talking?

Our Speech Therapy team discusses the benefits of an augmentative and alternative communication (AAC) device.

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Will an Augmentative and Alternative Communication (AAC) Device Keep My Child From Talking?

"My child's SLP recommended that we trial an Augmentative and Alternative Communication (AAC) system and I'm worried that this means we are giving up on spoken speech. If my child uses AAC, will it keep him from talking? I'm also worried that he will just want to use the device to watch videos or play games. Is this a good recommendation for my child?"

We hear this concern from parents quite often. But… did you know that the research actually shows that AAC facilitates communication, rather than hindering it? In addition, multiple research studies have shown that providing an alternate means for communication can effectively reduce challenging behaviors and expand language and communication skills. Access to AAC can foster independence, support natural speech development, increase participation in classroom activities, and provide opportunities for social interaction with peers, teachers, and family members. Many of the behaviors we see are related to inability to communicate. Using an AAC system can increase self-advocacy and autonomy, so your child can communicate more effectively to:

- protest an activity or indicate a desire to transition to something new (e.g., "stop," "don't," "no," "I don't want to!" "I don't like this!" "Leave me alone")

- indicate sensory needs (e.g., "loud," "swing," "Give me a push," "It's break time")

- make requests for desired items or activities (e.g., "play," "eat," "swing," "give it to me!" "time to go!" "Let's listen to Super Simple Songs")

- ask for assistance (e.g., "help," "open," "Can you get that," "Help me out here!")

- communicate emotions (e.g., "mad," "lonely," "I'm so happy!")

- share about new experiences (e.g., "go," "worried," "new," "Where are we going?")

- engage socially with others to find common interests and share experiences (e.g., "hi," "mine," "Wanna play?")

- share enjoyment (e.g., "love," "favorite," "so much fun!")

Did you know AAC can also support literacy skills?

AAC provides tools for early literacy experiences, such as recognizing letters, sounds, and words, paired with visual symbols. This early exposure helps build a great foundation for later literacy learning. Also, providing access to AAC can help support shared reading activities and can later expand comprehension, including understanding and interpreting text.

Is your child a gestalt language processor?

We also have many options to customize your child's AAC system to fit their unique learning style. AAC systems can be tailored to an individual's specific needs, preferences, and communication goals, making them highly versatile and effective tools, regardless of their language learning style. We can record programmed words and gestalts with real voices with rich intonation, making it motivating and engaging. We can also add gestalts from your child's favorite media sources using video pop-ups, or by recording the original audio. The options for customization are truly endless!

Will my child use AAC long-term?

Some children do use AAC long-term and prefer it as their primary method of communication, while some need it only temporarily while their spoken skills are expanding. We all use various forms of AAC (e.g., texting, email, written messages) in daily life, so having a "back-up" option for communication can be helpful, even for speaking people. It is also common for neurodivergent individuals to experience situational mutism, or moments where they can't access spoken speech. In these cases, AAC is vital.

But what if my child exits the AAC app and wants to play games or scroll videos?

We look at each case individually, but there are settings available to guide your child to stay in the communication app. We also individualize the language system to be highly motivating for your child and our goal is to get their "buy-in" so they will want to use the device to communicate with others. Also, devices funded by insurance and Medicaid are designed to be solely for communication, and will not have other apps accessible.

Speaking from clinical experience, in my 15 years of working as an SLP, I haven't seen a single case where AAC prevented a child from talking. It consistently enhances communication and increases access and learning. Also, in our high-tech world, most kids are highly motivated by technology. AAC provides a great opportunity for us to utilize technology in a positive way! AAC has been shown to consistently improve communication outcomes, so don't be afraid to give it a try!

References:
Kasari et al. (2014): "Communication Interventions for Minimally Verbal Children With Autism: Sequential Multiple Assignment Randomized Trial."

Millar, Light, & Schlosser (2006): "The Impact of Augmentative and Alternative Communication Intervention on the Speech Production of Individuals With Developmental Disabilities: A Research Review."

Sedey Rosin & Miller (1991): "Augmentative Communication and Early Intervention: Myths and Realities." Carr & Durand (1985): "Reducing behavior problems through functional communication training."

Drager Light & Mcnaughton (2010): "Effects of AAC interventions on communication and language for young children with complex communication needs." Robinson & Owens (1995): "Functional augmentative communication and behavioral change.