AAC Overview

Augmentative and Alternative Communication (AAC)

Brief 10.02

Overview for paraprofessionals supporting students with complex communication needs

Why this brief

Augmentative and Alternative Communication is the umbrella term for the tools and strategies used by students who can't rely fully on speech to communicate. Some are minimally speaking; some have unintelligible speech; some have unreliable speech (autism, apraxia, certain medical conditions); some have no speech and use AAC as their primary mode. Paraprofessionals are often the adults closest to AAC users in school — using the device, modeling, troubleshooting, and helping the student be communicative across settings.

This brief covers what AAC is, why "presuming competence" is the central frame, the basic types of systems, what aided language stimulation looks like in practice, and the most common implementation pitfalls. It is an overview; brief 10.07 goes deeper on modeling AAC, brief 10.03 covers PECS specifically, and brief 10.06 covers visual supports.

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| The core principleEvery person — including every student you support — has the right to communicate. The AAC user's communication is real communication, not a stage on the way to "real" speech. Paras who internalize this respond to AAC differently: with the same conversational engagement, the same wait time, the same respect for what's being said as they would for spoken communication. |

1\. Fundamentals

1.1 Communication is more than speech

Communication includes any way one person sends a message to another — words, gestures, facial expressions, eye gaze, written notes, signs, symbols, photos, body language, behavior. AAC widens the channel. Any AAC system is supposed to do for the user what spoken language does for typically-speaking people: express needs, share information, ask questions, decline, joke, comment, build relationships.

1.2 Presume competence

"Presume competence" is the foundational stance in modern AAC practice (Donnellan; Biklen; later writers). It means assuming the student understands more than they currently produce, and behaving accordingly: addressing them at age-appropriate levels, explaining what's happening around them, expecting them to participate, and waiting longer than feels comfortable for their response.

The opposite — under-estimating the AAC user's understanding — is one of the most damaging adult patterns in special education. Students who are not spoken to as if they understand do not get the input they need to develop language; the gap widens; the under-estimation becomes self-confirming.

1.3 AAC and speech are not in competition

Decades of research (Romski, Sevcik, Schlosser & Wendt) have shown that introducing AAC does not slow speech development; if anything, AAC use is associated with increased speech for many users. The fear that AAC will keep a student from "learning to talk" — once common, still encountered — has been empirically retired. AAC is added; it doesn't replace anything that's already working.

2\. The AAC continuum

AAC is usually described along a no-tech to high-tech continuum. Most students who use AAC use multiple systems — a high-tech device for everyday communication, a low-tech backup for noisy or device-down situations, and natural communication (gestures, facial expression, vocalizations) layered throughout.

| Tier | Examples | When typically used |

| :-: | :-: | :-: |

| No-tech / unaided | Gestures, facial expression, body language, vocalizations, sign language. | Always available; the student carries them. Critical for redundancy. |

| Low-tech / aided | Picture cards, communication books, choice boards, partner-assisted scanning, alphabet boards. | Quick access, no battery, works in water and noise. Essential as backup; primary system for some users. |

| Mid-tech | Single-message and multi-level voice-output devices (BIGmack, GoTalk). | Specific communicative purposes, beginning AAC users, environmental control. |

| High-tech / SGD | Dedicated speech-generating devices and apps on tablets — Proloquo2Go, TouchChat, LAMP Words for Life, Snap Core First, Avaz, CoughDrop. | Primary system for many users. Robust vocabulary, customizable, voice output, sometimes eye-gaze access. |

"Speech-generating device" (SGD) is the term most often used in IEPs and insurance documentation. The choice of system is made by an SLP, often through a formal AAC evaluation. The para's role is implementation, not selection.

3\. Aided language stimulation

The single most-evidenced AAC strategy is for adults to use the AAC system themselves while talking with the user — pointing to or activating the same words/symbols on the device as they speak. This is called aided language stimulation, aided language input, or aided AAC modeling, and it parallels how typically-developing children learn spoken language: by hearing it modeled by adults thousands of times before they're expected to produce it.

3.1 What it looks like

You are reading a book with a student who uses an AAC tablet. Instead of just reading aloud, you read aloud and tap the corresponding words on the device — "the \[tap MORE\] more \[tap MORE\] cookies \[tap COOKIE\]." You are not requiring the student to do anything. You are showing them what the device can do, in context, at a pace they can absorb.

3.2 Why it works

Vocabulary has to be encountered many times before it is produced. AAC users need the same exposure that typically-speaking children get from hearing language.

Modeling without expectation reduces pressure and increases attention. "You don't have to do anything; I'm just showing you" is a low-stakes invitation.

Modeling on the device shows where words live, motor patterns build, and the student starts to map symbols to meaning.

3.3 How much modeling

More than feels enough. The literature suggests AAC users may need 200+ exposures to a target word before producing it consistently. This is why ALS is something you do constantly — across activities, settings, and partners.

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| If you're new to ALSStart small. Pick five words you'll model on the device this week (often: MORE, STOP, GO, HELP, DIFFERENT — high-frequency "core" words; see brief 10.08). Use them in real moments, on the device, while talking. Build from there. |

4\. Core vs. fringe vocabulary

AAC vocabulary is often divided into:

Core vocabulary — about 300–400 words that account for 80%+ of what we say in everyday speech. Pronouns, common verbs, common adjectives, prepositions, function words. "Want, like, more, stop, help, this, that, go, get, give, do, no, yes, here, there."

Fringe vocabulary — content-specific words. Items, names, places, foods, activities. "Pizza, dog, slide, math, Mrs. Garcia."

Most beginner AAC programs over-emphasize fringe ("point to the picture of the apple") and under-emphasize core ("want — more — different — stop"). The result is that students can name many things but struggle to comment, request, or express opinions — the higher-leverage uses of language. Modern best practice is to emphasize core early and add fringe in context.

5\. Access methods

How does the user activate symbols on the system? Different students need different access methods, prescribed by an SLP, OT, and AAC team.

| Access method | Notes |

| :-: | :-: |

| Direct selection — finger touch | Most common. The user taps a button on a screen or paper system. |

| Stylus or pointer | When fine motor makes finger touch unreliable. |

| Eye gaze | The user looks at a button to select it, with calibrated eye-tracking technology. Often used by users with significant motor impairments. |

| Switch scanning | Symbols highlight in sequence; user activates a switch to select. For users with limited motor access. |

| Partner-assisted scanning | Adult names items in a structured order; user signals (eye blink, vocalization) when their target is named. No tech required. |

| Head pointer or mouth stick | Physical pointer worn or held; useful with limited limb mobility. |

Setup, fitting, and adjustment are clinical decisions made by the team. The para's role is to use the system as set up — and to flag issues (calibration drift, broken parts, too-small targets) to the SLP or AAC specialist.

6\. AAC in daily classroom life

6.1 When the device should be available

All the time. The AAC user has the right to communicate at all times — at the desk, at recess, in the bathroom, at lunch, on the bus, on field trips. Devices should not be put away because they're "distracting" or "easier without." If a device is hard to bring somewhere, that's a problem to solve, not a reason to leave it behind.

6.2 When to model

During shared book reading.

During play and snack.

During transitions ("It's time to \[tap GO\] go.").

During greetings.

During academic instruction (math vocabulary, science vocabulary).

During conflict resolution and emotional moments — modeling the words you wish the student had right now.

Whenever you would say something to a typically-speaking peer.

6.3 Wait time

AAC users typically need substantially longer to formulate and produce a response than speaking peers — sometimes 10–30 seconds. The single most common adult error is filling that silence with another question or by answering for the student. Wait. Count to ten silently. Wait again. Most students have something to say if they have the time to say it.

6.4 Don't withhold the device as discipline

Removing AAC because of behavior is removing the student's voice. There is no behavioral situation where this is justified. If the device is being used in a way that's a problem (e.g., pressed in a perseverative loop), the response is to teach an alternative use, not to take communication away.

7\. Responding to AAC communication

How adults respond to AAC use shapes whether the student keeps using it. Some practical orientations:

Treat what the student communicates as real communication. "I want" said via AAC is the same as said with the voice; respond accordingly.

Honor partial messages. If the student types or selects "want" and stops, ask, "What do you want?" — don't fill in the blank.

Don't quiz. "Where's the apple? Where's MORE? Show me HELP." — this turns communication into a test. Communication should be functional.

Honor refusals. If the student selects NO, accept it the way you would accept a spoken no. Don't overrule because "they didn't really mean it."

Don't "correct" grammar mid-utterance. AAC users frequently produce telegraphic messages ("more cookie"); respond to the meaning, not the form.

Don't talk about the AAC user as if they aren't there. Adults around AAC users routinely have over-the-head conversations the student can hear and understand. Stop.

8\. Practical troubleshooting

8.1 Device problems

Battery dying — chargers should travel with the student. Have a backup low-tech system ready.

Software glitch — close and reopen the app. If persistent, route to the AAC specialist or SLP.

Cracked screen, broken case, lost stylus — flag to the team and family immediately. The device is the student's voice; replacement and repair are urgent.

Symbols moved or missing — likely customization in progress; check with SLP before changing anything.

8.2 Behavior issues

Student perseverating on a single page or symbol — model variety, redirect to functional use.

Student using device for entertainment (e.g., listening to the same word repeatedly) — sometimes appropriate (rest), sometimes a sign the device is the only stimulating thing in the moment. Look at the broader environment.

Student rejecting the device — talk to SLP. Could be motor pain, a setting that's frustrating, or a request for a system change.

8.3 Communication breakdowns

If you can't understand the message, say so honestly. "I'm not sure what you mean — can you show me again?"

Try yes/no questions to narrow down.

Try open-ended modeling on the device of likely topics.

Don't pretend to understand — students notice and lose trust in the channel.

9\. Collaboration with the AAC team

Successful AAC implementation is a team activity. The student's AAC team typically includes the SLP, often an OT, the supervising teacher, the para, the family, and sometimes an AAC specialist. The para is usually the team member with the most daily contact.

Ask for SLP modeling. "Can you show me what good ALS looks like during a 15-minute session, and let me try?" Most SLPs welcome this.

Bring observations to team meetings. "Marcus is using STOP across settings now but only with me — not with peers." Patterns are valuable.

Flag changes early — new behavior, new vocabulary used, system frustrations, family questions.

Coordinate with the family. AAC must be used at home and at school for full development. Cross-setting consistency matters.

10\. Common pitfalls

Speaking for the student.

Pre-loading the answer or restricting choices to make conversations "easier."

Treating AAC as a step on the way to speech rather than a legitimate communication channel.

Using AAC only for requests ("want" + item) and not for commenting, refusing, asking, joking, complaining.

Modeling rarely or only when the student is expected to respond.

Putting the device away during transitions, recess, lunch, or behavior incidents.

Withholding the device as a behavioral consequence.

Not waiting long enough.

Quizzing — "Where's MORE?" instead of using MORE in real moments.

Over-emphasizing fringe vocabulary at the expense of core.

Ignoring nonverbal communication. AAC users communicate constantly through eye gaze, body, and behavior; the device is one channel among many.

Assuming silence means the student has nothing to say.

11\. Resources

Practice and PD

PrAACtical AAC — praacticalaac.org — Possibly the best free practitioner blog on AAC.

AAC Language Lab (PRC) — aaclanguagelab.com — Free educator resources from a major AAC manufacturer.

AssistiveWare — assistiveware.com — Maker of Proloquo2Go; free training and core-word resources.

ATIA (Assistive Technology Industry Association) — atia.org — Conferences and PD.

ASHA Practice Portal — Augmentative and Alternative Communication — asha.org — Speech-language pathology professional guidance.

Foundational documents

Communication Bill of Rights (NJC) — asha.org — Foundational document for communication access.

Beukelman & Light — Augmentative and Alternative Communication — Brookes Publishing — Standard textbook in the field.

Cross-references

Brief 10.01 — Communication Bill of Rights — this library

Brief 10.03 — PECS and Picture Exchange — this library

Brief 10.06 — Visual Supports — this library

Brief 10.07 — Modeling AAC — this library

Brief 10.08 — Core Vocabulary — this library

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