AAC, or augmentative and alternative communication, is a range of ways to communicate when speech alone is not reliable or sufficient. It includes gestures and signs as well as communication boards, printed words, computers, and speech-generating apps. An app is one possible tool—not the definition of AAC—and people may combine methods or use different ones in different settings.
What AAC means
AAC stands for augmentative and alternative communication. “Augmentative” communication supplements speech; “alternative” communication provides another way to express a message when speech is unavailable or does not work well enough. AAC can be temporary or long-term, and it can include more than one method. ASHA’s AAC Practice Portal describes aided and unaided approaches.
Unaided communication
Unaided AAC uses the person’s body, without an external tool. Examples include gestures and manual signs.
Aided communication
Aided AAC uses an external support, ranging from a printed communication board to a computer, handheld device, or tablet. The right approach depends on the person and situation; a screen-based system is not automatically better or sufficient on its own.
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How a speech-generating app works
A speech-generating app is a form of high-tech aided AAC. The person creates a message by selecting items in an on-screen display, and the system produces speech output. Depending on the system, the display may use symbols or pictures, letters and words, or a combination. Speech can be synthesized or recorded natural speech. Alphabet-based systems may offer word or phrase prediction to reduce the number of selections, but features and interfaces differ between systems. ASHA’s overview of AAC features explains that systems vary.
For example, a symbol-based display may let someone select a picture or symbol to communicate an idea. An alphabet-based display lets the person build a message from letters and words; prediction, when available, can suggest completions or phrases. The selected content is then voiced by the system. These are broad patterns, not a guarantee that every app offers the same vocabulary, layout, voice, or prediction tools.
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Who can use AAC?
A person does not need to be entirely without speech to use AAC. It may supplement speech that unfamiliar listeners have difficulty understanding, or provide another way to communicate in demanding situations. The National Joint Committee for the Communication Needs of Persons With Severe Disabilities, in an overview hosted by ASHA, says AAC should also be considered for people who have some speech or speech that is unintelligible to unfamiliar listeners.
There is no threshold of age, cognition, language, or motor ability that someone must meet before AAC can be considered. The National Joint Committee overview says there are no specific prerequisites and that no individual should go without communication. ASHA likewise states: “There are no prerequisites for AAC intervention, and a variety of strategies and techniques should be implemented in order to determine the most effective means of communication for the individual.”
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- Enhanced Communication: The AbleNet iTalk4 is a portable AAC (Augmentative and Alternative Communication) device that enables individuals to express themselves more effectively using four message buttons.
- Clear Voice Output: With its built-in speaker, the iTalk4 provides clear and audible voice output, ensuring messages are communicated clearly and distinctly.
- Easy Message Customization: Users can easily record and personalize messages on each of the four message buttons, allowing for individualized communication tailored to specific needs and preferences.
- Compact and Portable Design: The iTalk4's compact and lightweight design makes it highly portable, allowing individuals to carry it wherever they go and communicate on-the-go.
- Versatile Communication Aid: Suitable for non-verbal individuals or those with speech impairments, the iTalk4 serves as a versatile communication aid for various settings, including school, home, therapy sessions, and community interactions.
How to choose an AAC app or device
There is no universal best app or device. Selection is a feature-matching process: identify what the person needs to express, how they can access a system, and where and with whom they communicate. ASHA and the National Joint Committee recommend considering the person’s profile and communication contexts, with the individual, family, and relevant professionals involved when possible.
- Language representation: Would symbols, alphabet-based text, or a mix best support the person’s communication?
- Access and motor needs: Can the person reliably select items by direct touch, or might indirect access such as a switch be appropriate?
- Vision, hearing, and sensory-motor needs: Is the display and method of access usable for the person?
- Speech output: Does the system’s synthesized or recorded speech, voice, and volume suit the person and their communication settings?
- Positioning and portability: Can the system be positioned accessibly and taken to the places it is needed? A mount or switch may help when feature matching identifies a need; neither is a default purchase.
- Vocabulary and adaptability: Can the system’s vocabulary and features be adjusted as communication needs change?
- Partners and support: Who will communicate with the person and help make the system available and usable across settings?
- Preference and practical fit: Does the person prefer the system, and are its cost and maintenance manageable?
Assessment and trials can take time; an initial assessment may not make it clear which specific system will work best. Involving the person who will use AAC, their family, and professionals can help evaluate options in real communication contexts.
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- Enhanced Communication: The AbleNet iTalk2 is a portable AAC (Augmentative and Alternative Communication) device that enables individuals to express themselves more effectively using twomessage buttons.
- Clear Voice Output: With its built-in speaker, the iTalk2 provides clear and audible voice output, ensuring messages are communicated clearly and distinctly.
- Easy Message Customization: Users can easily record and personalize messages on each of the two message buttons, allowing for individualized communication tailored to specific needs and preferences.
- Compact and Portable Design: The iTalk2's compact and lightweight design makes it highly portable, allowing individuals to carry it wherever they go and communicate on-the-go.
- Versatile Communication Aid: Suitable for non-verbal individuals or those with speech impairments, the iTalk2 serves as a versatile communication aid for various settings, including school, home, therapy sessions, and community interactions.
A speech-generating app or a dedicated device?
An app running on a tablet is one possible setup, while dedicated speech-generating devices are another. The choice should be made around the person’s access, communication, portability, positioning, and support needs—not on the assumption that one category is always better. Compatibility and accessibility matter when considering a tablet and app, and the person’s preference should be part of the decision.
Whichever system is selected, access matters: a person who uses AAC should have their communication tools available. AAC may also combine an app or device with unaided methods such as gestures or signs, rather than replacing those methods.
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What prevalence figures do—and do not—tell you
ASHA’s Practice Portal summarizes a 2018 national survey of special educators across all 50 U.S. states: 18.2% of students needing support when communicating used some form of AAC. The reported forms were gestural modes (6.9%), pictorial supports (6.5%), and speech-generating devices (4.8%). These figures describe that survey population; they are not a current prevalence estimate for all children or all AAC users. ASHA’s AAC Practice Portal provides the summary.
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