Understanding Augmentative and Alternative Communication
Assistive Technology (AT)
Assistive Technology, or AT, is a broad category for any tool that aids daily living. Assessments for AT focus on how you interact with your environment. AT equipment, tools and strategies cover anything that can support learning, mobility, communication, sensory needs and/or independent living. Examples include:
- Educational learning aids like visual guides including schedules, planners and checklists, reminders apps, timers, note-taking supports and graphic organizers.
- Hearing and vision aids like hearing aids, glasses, screen readers, captioning tools and screen-zoom features on devices.
- Mobility tools like mobilized wheelchairs, scooters and adaptive seating.
- Sensory tools like adaptive utensils, weighted blanket, noise-canceling headphones and fidgets.
- Daily living aids like dressing aids and smart home reminders including alarm clocks for cooking, medication or appointments.
Augmentative and Alternative Communication (AAC)
Augmentative and Alternative Communication, or AAC, is a specific type of AT. Augmentative means to add to someone’s speech. Alternative means to be used instead of speech. The American Speech-Language-Hearing Association (ASHA), the credentialing body of the nation’s audiologists and speech-language specialists, specifically defines AAC as all the ways that someone communicates besides talking. This includes gestures, facial expressions, writing and sign language, among others.
Types of AAC
AAC includes many tools and strategies that support or replace speech. You can think about them with these three questions:
- Does it use only the person’s body, or does it require a tool?
- If it uses a tool, is it electronic?
- Will the person mainly use pictures/symbols or text/typing?
Body-based vs Tool-based
Body-based, or Unaided AAC, does not use any external tools. It relies only on the person’s body to communicate. Examples: natural gestures, facial expressions, body language, eye gaze and sign languages like ASL.
Tool-based, or Aided AAC, use an external tool. This can be as simple as a paper board or as complex as a speech generating device (SGD), tablet app or eye gaze system.
Non-Electronic vs Electronic
No-Tech AAC uses a person’s body or simple, everyday tools without any special equipment.
Examples: Nodding up and down, shaking head "no" side to side, thumbs up or thumbs down, waving and pointing with a finger. Drawing or writing with a standard pen or pencil is also no-tech.
Light-Tech AAC uses physical tools that do not need batteries or electricity. These are often used in structured or predictable situations.
Examples: Picture or emoji cards, picture books, flip books, choice boards, communication boards and core boards.
Note: Picture Exchange Communication System (PECS) and associated Pyramid training are a light-tech AAC rooted in Applied Behavior Analysis (ABA). Some autism and neurodiversity advocates express concerns that PECS may be overly compliance-based, limited in communication functions.
Light-Tech Resources
The following third-party resources are provided for informational purposes only and are not endorsements.
Video Tutorial: Step-by-Step Guide to Doing a Full Model Using a PODD Book
Mid-Tech AAC tools are simple, battery-operated devices that play back recorded messages. They have limited vocabulary but are usually easy to set up and use.
Examples: Single message buttons, multi-level static display devices and talking photo albums.
Mid-Tech Resources
The following third-party resources are provided for informational purposes only and are not endorsements.
High-Tech AAC includes advanced electronic devices and software. These systems often provide digital message storage, customizable vocabulary, text to speech, and word prediction and are usually paired with symbol- or text-based apps.
Examples: Tablets, computers and dedicated SGDs that use synthesized or digitized speech.
High-Tech Resources
The following third-party resources are provided for informational purposes only and are not endorsements.
Pictures vs Text
Symbol/image-based systems use pictures, icons, or symbols to represent words or phrases. Symbols may be photos or line drawings which appear in many AAC apps and classroom materials. These systems are often used when literacy is still developing or when quick visual recognition is helpful.
Text-based systems rely on letters and words. Examples include alphabet boards, keyboards with text to speech and lists of words or phrases. These systems require at least emerging literacy.
