Better Care

Facts about AAC

AAC stands for Augmentative and Alternative Communication. It is the term used to describe the different types of communication we use alongside or in place of natural speech.

Facial expression, body language, pointing, gestures and signs are all forms of AAC. These are known as unaided communication as they do not require any additional aids. Writing and showing objects or pictures are also forms of AAC. These involve additional aids, such as a pen and paper or photographs, and are known as aided communication. Some people may use more formal systems of aided communication, such as symbol cards, communication boards and communication books. Some people may also use high tech electronic aids that can speak out messages (called voice output communication aids).

Some children and young people find spoken communication difficult and they may need to use AAC most of the time to help express themselves. Some children and young people also find it difficult to understand what people say to them. 

They may need others to use AAC to them to help them to understand, for example, a gesture to say ‘come with me’ or being shown a coat to say it is time to go out.

Speaking difficulties can be due to many factors including:

  1.  speech sound difficulties
  2. learning difficulties
  3. physical difficulties, such as cerebral palsy
  4. Autistic Spectrum Disorder (ASD)
  5. brain injury as a result of accident or illness

Potential effects of AAC on communication development: 

AAC has been shown to reduce frustration for children and young people with communication difficulties and increase participation in life at home and at school. Communication is about people exchanging messages. Having a reliable and effective way of communicating, whether it is with speech or with AAC, can improve quality of life and bring more opportunities for education, work, relationships and independence (The Scottish Government 2012).

Intervention offered:

You or your therapist may feel that your child would benefit from AAC. Your therapist can discuss this with you and with your child’s school or nursery during your child’s appointment. As part of your child’s package of care, the therapist may recommend and show you strategies that can be used at home or at school or nursery. It is important that these strategies are carried out across all environments to help your child to develop their skills.

Strategies may include:


Additional support

  • Makaton   
  • Communication Matters - voluntary organisation promoting AAC) 
  • One Voice - charity supporting people who use AAC and their and families 
  • ACT 
  • ACE Centre - an AAC assessment and training service – their website provides lots of free symbol resources.
  • Autism West Midlands - a charity supporting people with autism – their website has lots of symbol resources. 
  • The Communication Trust - a group of organisations supporting people with communication needs. 
  • Talking Point - information to help understand and support children and young people’s speech, language and communication.

  1. Makaton: Makaton uses signs, symbols and spoken language to help people to communicate. Your therapist may recommended a Makaton Parent Beginners Workshop. Your child’s nursery or school may also want to arrange Makaton training for their setting or staff may wish to attend a Makaton Professionals Foundation Workshop.
    For more information on booking Makaton training, please click here.
  1.  Objects of Reference: These are objects that are used to represent something else, for example a cup can represent a drink, a swimming costume can represent going swimming. These objects give the child information about what is going to happen next or can be used to help your child make choices. The objects you choose will be very personal to your child. Your therapist can help you to choose the right objects and will tell you how to introduce them.
  1.  Photographs or symbols: Photographs and symbols can be used to help your child understand what is said and what is happening next. Your therapist may suggest keyring cards or visual timetables to help with this. Your therapist may also recommend using photograph or symbol cards to help your child make choices.
  1. Communication boards and books: Communication books consist of a number of pages containing words and symbols that have been grouped together into topics such as toys, bath time and meals. This needs careful planning and the therapist can help you to think about what to include in the book and how your child can point to the pictures (e.g. with their hand or eyes).
  1.  Communication aids that speak: Your therapist may recommend a voice output communication aid. This could be a small battery operated aid that you can record single or multiple messages onto. These aids can help your child to get attention, greet others with a voice and join in with social activities. Other complex aids can be used by people to form their own messages, using text or symbols, with synthesised speech. If your child would benefit from a complex communication aid the therapist may refer your child to a specialist NHS service called Access to Communication and Technology (ACT).

The most effective way to support your child’s communication is to value all forms of communication. Using AAC to your child will show your child that you value what they say, not how they say it. The more you use AAC, the more likely your child is to understand and use it themselves. Parents and education staff play a key role in this.