What Is AAC? Augmentative and Alternative Communication

AAC stands for augmentative and alternative communication: all the ways a person can communicate besides, or as well as, spoken words. It includes gestures and signing, picture and symbol boards, letter boards, and devices that generate speech when a button or screen is touched. AAC is for children and adults of any age whose speech, on its own, does not yet meet all of their communication needs.

If you have come across the term AAC for the first time, it can sound technical. In practice it is not: most families already use parts of AAC every day — waving goodbye, pointing at a menu, giving a thumbs up. This guide explains what AAC is, the main types, who it can help, and the myths that worry families most. It also explains how people get started, through an assessment with a speech and language therapist.

Key Takeaways

AAC means augmentative and alternative communication — every way of communicating besides, or as well as, speech.
Unaided AAC uses the body alone: gestures, facial expressions, pointing and signing. Aided AAC uses something outside the body, such as a picture board or a speech-generating device.
AAC is described by type, not by brand — the right match depends on the person.
AAC can help children and adults — anyone whose speech does not currently carry everything they need to say.
AAC supports communication; it does not prevent speech from developing. Speech, gestures and AAC can grow side by side.

What does AAC mean?

The abbreviation AAC stands for two linked ideas:

Augmentative means adding to speech — building on the speech a person already has, helping them say more, be understood more easily, or communicate while speech is still developing.
Alternative means another way to communicate when speech alone is not enough for a person’s needs right now.

So AAC is not one product or one technique. It is an umbrella term covering a wide range of methods, from a baby pointing at a biscuit tin to an adult using a device that speaks typed or selected messages aloud.

One idea matters more than any other in this guide: communication is the goal, and speech is only one of the ways of reaching it. A message shared by pointing, signing or pressing a symbol is a real message, and deserves the same warm, interested response as a spoken word.

AAC also is not an all-or-nothing choice. Most people who use AAC use several methods together, choosing whatever works best in the moment: a gesture with a familiar person, a board at school, a device with someone new. The aim is always the same — more messages understood, by more people, in more places.

The two main groups: unaided and aided AAC

AAC is usually divided into two groups, and most people use a mixture of both.

Unaided AAC

Unaided AAC uses only the person’s own body. It needs no equipment, so it is always available — at the swimming pool, in the bath, in the middle of the night.

Gestures and body language: waving, pointing, nodding, shaking the head, shrugging, reaching towards something, or pushing it away.
Facial expressions: smiles, frowns and looks that share feelings without any words at all.
Signing: using the hands to make signs for words and ideas, from a few simple signs for everyday words, used alongside speech, to a full sign language with its own grammar.
Vocalisations: sounds, hums and word attempts that familiar people learn to understand.

Unaided AAC is powerful because it is instant and portable. Its limits are that gestures can be misunderstood by strangers, and signing needs partners who understand signs too.

Aided AAC

Aided AAC uses something outside the body to help share a message — anything from a printed sheet of pictures to an electronic device that speaks.

Pictures, photographs and symbols that the person points to, looks at or touches.
Boards and books that organise those pictures and words so messages can be built.
Letter boards for people who can spell, pointing to letters to build words.
Speech-generating devices that produce spoken words when the person selects symbols, letters or whole messages.

Aided AAC has one great strength: the message stays visible or audible for the partner, so even someone meeting the person for the first time can often understand it.

Types of aided AAC

Aided AAC is sometimes described as “low-tech” (paper-based, no battery) or “high-tech” (electronic). Neither is better in itself — the best system is the one the person can and will use throughout the day. AAC is always described here by type only, because what matters is the kind of support, not any particular make or product.

Picture and symbol boards

A communication board shows pictures, symbols or words that the person points to, looks at or touches to share a message. Boards range from a small choice board for one activity — two snacks, two songs — to a large core word board built around the small words we use constantly, such as more, go, stop, help, want and finished. Our guide to AAC communication boards for children explains board types in more detail.

A mother and her young daughter sitting together at a kitchen table, smiling as the child points to a picture symbol board

Boards can also be gathered into a portable communication book, with extra pages for topics, people and places. A related idea is a communication passport — a short booklet, written from the person’s point of view, explaining how they communicate and what helps them.

Letter boards and spelling

For people who can read and spell, a simple alphabet board can be surprisingly powerful. The person points to letters to spell words, either independently or with a partner who says each letter aloud and watches for a “yes” signal. Letter boards need no power, work anywhere, and give access to any word the person can spell.

Speech-generating devices

A speech-generating device produces spoken output. The person selects symbols, words or letters — by touching a screen, pressing buttons, or, for some people, by looking at the screen with their eyes — and the device speaks the message aloud. Devices range from a single button that plays one recorded message to full systems with large vocabularies that can grow with the person.

An adult man tapping a speech-generating device on a table while talking with a therapist in a bright room

Whatever the type, two practical points apply to every aided system. First, it only works if it is there: within reach throughout the day, not stored in a cupboard. Secondly, partners need to use it too — pointing to words as they talk and responding to every message.

Who can AAC help?

AAC is not for one diagnosis or one age group. It is for anyone whose speech does not currently carry everything they need it to carry.

Young children whose speech is delayed or unclear

Some children are late to talk, or talk in ways that are very hard for others to understand. AAC can give them a way to share messages now — asking, choosing, refusing, commenting — while their speech and language continue to develop. For a young child, that might be a handful of signs or a simple choice board. Our guide to how to support a non-speaking child explores everyday support in more depth.

Autistic children and adults, and people with learning differences

Some autistic people speak very little, or find spoken language hard to use even when they understand a great deal. Others speak fluently at times and lose speech when tired, anxious or overwhelmed. AAC offers a reliable route to communication that does not depend on speech being available in that moment. People with developmental or learning differences may use AAC in similar ways — sometimes for a period of learning, sometimes as a long-term main method. Both are entirely valid. As children grow into teenagers, AAC grows with them: larger vocabularies and letter-based systems for those who can spell.

A teacher and a young child signing to each other and smiling in a bright classroom

Adults after stroke, brain injury or illness

Adults can need AAC too. After a stroke or brain injury, some people know exactly what they want to say but cannot find or form the words — a difficulty called aphasia — or their speech is too weak or unclear to carry the message. A letter board, a communication book with personal pages, or a speech-generating device can restore a way to take part in conversation while speech recovers, and for some it remains a valued backup on tired days. AAC can also help when a health condition gradually affects speech: introduced early, while speech is still strong, it gives the person time to learn calmly. And it is not always long-term — a person may use it briefly after surgery or during a hospital stay.

Common myths about AAC

AAC attracts a handful of persistent myths. Each deserves a careful answer.

Myth: “AAC will stop speech from developing”

This is the worry almost every family raises, and the one therapists are asked about most. The answer is reassuring: using AAC does not prevent speech from developing, and families are never asked to choose between AAC and talking.

Think of it this way. AAC takes the pressure off. A person who can share a message — any message — experiences being understood, and that success encourages more communication of every kind, including sounds, word attempts and speech. AAC also surrounds the person with spoken language: every time a partner points to a symbol for more, they say “more” aloud, so the person hears and sees the word together. Speech and AAC are not rivals; they grow side by side.

Progress varies from person to person, and no honest professional can promise that any approach will lead to a particular outcome. What AAC offers is communication now, rather than waiting for speech that may take time.

Myth: “AAC is only for people who will never talk”

No. Many people use AAC alongside speech that is developing, hard to understand, or that comes and goes. Some use it briefly; some use it for life. All of these patterns are normal.

Myth: “You should wait until other approaches have failed”

Waiting is rarely helpful. Communication matters today — for learning, friendships, safety and self-respect. Introducing AAC early does not close any doors; it opens one that was needed.

Myth: “High-tech is always better than low-tech”

A paper board used confidently all day serves a person far better than a sophisticated device that stays in its bag. Vocabulary, ease of use, the person’s movement and vision, and the support around them all matter as much as technology.

Myth: “AAC is just for children”

Adults use AAC after strokes and injuries, with voice difficulties, and with conditions that change over time. The principles are identical across the lifespan; only the vocabulary, situations and style change.

An older man pointing to letters on a simple board at home while his wife sits beside him smiling

How people get started with AAC

Getting started is a process, not a purchase. It usually begins with an assessment and unfolds in small steps. General information is also available from the American Speech-Language-Hearing Association (ASHA).

Step 1: An AAC assessment

A speech and language therapist carries out the assessment, which generally involves getting to know the person: how they communicate now, what they understand, how they point, look or move, and where communication is hardest. For a child, this includes the family and often their school or nursery; for an adult, the people and situations that matter most in daily life.

Step 2: Choosing a starting system

The therapist matches a starting system to the person — the type of AAC, the symbols or letters, the layout and the first vocabulary. It is a starting point, not a final answer: chosen to be useful quickly, and expected to change as everyone learns what works.

Step 3: Learning together

People learn AAC by using it, so families and partners are part of the process from the start. The central skill is modelling: partners talk and point to the words on the board or device at the same time, a few key words at a time, without pressure. Nobody is tested and nobody is corrected. Over time, the person begins to use the system themselves — usually after a quiet period of watching, which is normal.

Step 4: Reviewing and growing the system

As skills, interests and life change, the system should change too: new words, new pages, perhaps a different type of AAC altogether. Review is a normal part of the process.

When to seek help

It is worth seeking professional advice about AAC if:

Someone has very few reliable ways to share messages — wants, needs, choices, refusals, feelings — and often seems frustrated or withdrawn when trying to communicate.
A child’s communication does not seem to be moving forward: no new words, sounds, gestures or communication skills over time.
An adult’s speech has changed after a stroke, brain injury or illness and everyday conversation has become difficult.
Communication depends entirely on familiar people interpreting guesses, and strangers, teachers or new carers cannot understand.
You simply feel unsure. Asking for an assessment is reasonable in itself; you do not need to be certain AAC is needed first.

One pattern deserves prompt advice at any age: losing skills. If someone stops using words, sounds, gestures or ways of interacting they had before, seek professional advice promptly.

One situation is an emergency. If someone suddenly loses speech, their speech suddenly becomes slurred or very hard to understand, their face suddenly droops on one side, or they develop sudden weakness, choking or difficulty breathing, call your local emergency number immediately.

The usual first step is to talk to a doctor or another health professional, or, for a child, to their teacher, who can point you towards a speech and language therapy assessment. You can also contact a speech and language therapist directly.

Questions to ask a therapist

If you arrange an AAC assessment or a first appointment, these questions can help you feel prepared:

Which type of AAC would suit us best to start with, and why?
Which words and messages should we begin with, and how will the vocabulary grow over time?
How should we model with the system at home, and how often?
How can school, nursery or other family members use the same system, so it stays consistent everywhere?
What signs of progress should we watch for, and when should we review the system together?
What should we use as a simple backup when the main system is not available?

Frequently asked questions

Does using AAC mean someone will never learn to talk?

No. AAC supports communication while speech develops; it does not replace speech or hold it back. Many people use speech, gestures and AAC together, and the balance can change over time.

Can AAC be used alongside speech?

Yes. AAC is designed to work with whatever speech a person has, not instead of it. Many people mix methods freely — speech with familiar people, a board or device when speech is tiring, unclear or not available.

What age can someone start using AAC?

There is no set age. AAC can be introduced whenever someone would benefit from another way to share messages — a toddler, a teenager or an older adult after a stroke. What matters is matching the type of AAC to the person.

Do we need to buy an expensive device to start?

No. Many people start with low-tech AAC: a simple choice board, a few signs, or a paper communication book. Speech-generating devices are one option among several, and an assessment helps work out whether one would help and, if so, what kind. Simple and used well beats sophisticated and left in a bag.

How long does it take to learn AAC?

It varies a great deal. Most people need to see AAC modelled around them for some time before they use it confidently themselves — just as babies listen for a long time before they talk. Steady modelling, patience and responding to every attempt are what build skills.

A gentle next step

AAC is, at heart, a simple and hopeful idea: everyone deserves a way to say what they want to say. Whether that turns out to be a handful of signs, a paper board, or a device with a growing vocabulary, the first step is the same — a conversation about the person and what they need. If you would like to talk it through, you are very welcome to get in touch online. There is no obligation and no pressure.

By Hamayal Adnan, Speech-Language Pathologist

This article is for general educational purposes only and is not medical advice. It does not replace an assessment by a qualified speech and language therapist or other healthcare professional. Every person is different. If you have concerns about speech, language, feeding or swallowing, please seek professional advice. In an emergency, call your local emergency number.