One of the most common questions I hear from parents is…
Will my child ever talk? 
I hear the pain and desperation in their voices.
I see the heartache on their faces.
I sense the dreams deferred in their hearts.
Then I do my best to offer them some HOPE.
For even if your child is not yet speaking or not using words, there are still options for them to communicate.
While speaking is, no doubt, the fastest and most effective means of communicating with others, it’s not the only option. Just to name a few…
- Sign language
- Picture Exchange Communication System (PECS)
- Gestures
- Written/typed communication
- Voice-output devices
- Eye-gaze boards
- Sentence strips
- Choice boards
All of these are examples of what we call Alternative/Augmentative Communication (AAC).
What does that fancy term mean, you ask?
Well, AAC refers to any communication method that supplement or replace speech or writing.
Now before I go any further, I have to dispel a common misunderstanding.
You see, one of the next most common questions I hear is “Won’t using signs/pictures/xxx stop my child from actually learning to talk?”
And without a doubt I can confidently say…. NO!
Based on both my own experience using AAC with tons of children as well as published research articles, utilizing AAC systems do NOT stop or delay children from speaking. In fact, using AAC can improve communication skills, enhance relationships, and children have made gains in their speech as a result.
So how do you know if your child could benefit from using AAC?
Well, I’m so glad you asked 😉
In my opinion, using some form of AAC can be helpful for any child who has difficulty with communication. Using visual/picture icons or gestures are common practices for any child I treat. These are called low-tech forms of AAC.
On the other end of the spectrum, the most common thing people think of when they hear about AAC systems are voice-output devices (aka speech-generating devices or SGDs). Picture the machine that Stephen Hawking uses to communicate. These are called high-tech AAC and can be very useful for children who are nonverbal or minimally verbal.
In fact, if you really get down to it, everyone uses some form of AAC everyday. When you wave to a stranger, nod in affirmation, or give someone a high-five in praise, you are using gestures to augment your speech to communicate a message or use an alternative form of communication other than speech.
Ok, Jessica, I have a child who has a speech delay who I think would benefit from an AAC system… now what do I do???
Here are some ACTION STEPS to take depending on your situation:
>>>Well, if your child is already receiving speech therapy services, your first step should be to talk with your speech-language pathologist (SLP) about it. He or she may have some recommendations around what that could look like for your child’s treatment plan. Whether your child is receiving speech therapy in the school or through a private practice (or BOTH!), AAC is always an option.
>>>If your child is only receiving speech therapy services through your local school district, you can request an assessment from an AAC specialist. Eligibility for that assessment and those services will need to be discussed and agreed upon by the IEP team (of which you are a HUGE part and must agree to), as those services must be related back to how your child accesses curriculum and performs in the educational setting.
>>>If your child receives private speech therapy, but your SLP is not specialized in AAC or does not have experience with it, seek another SLP’s opinion who has more knowledge in that area. I’m not gonna lie, it may take some digging. While most SLPs have some education in the area of AAC, there are not as many who specialize in that field. Check out the directory for those who are LAMP certified or just run a Google Search of “AAC Specialist near me” or “AAC Specialist name of your city” (e.g. “AAC Specialist Tacoma WA”).
Once you’ve found an SLP with knowledge and experience with AAC, s/he should conduct an assessment. This will help determine your child’s strengths, challenges, and needs. Sometimes, depending on the setting and needs of the 
child, this assessment could also involve other related service providers, including vision specialists, occupational therapists, physical therapists, and/or audiologists.
This assessment process tends to be more detailed than a typical speech evaluation, as it considers the following areas (described in more detail on the ASHA website):
- Any physical impairments, including underlying strengths and weaknesses in speech sound production and verbal/nonverbal communication
- Any diagnoses, such as apraxia of speech, dysarthria, Autism Spectrum Disorder, and intellectual disability
- Limitations in activity and participation, such as the ability to function in daily activities, interpersonal interactions, and learning potential
- Environmental and personal factors that serve as barriers to, or facilitators of, successful communication and life participation
- Impact of communication impairments on quality of life
- Symbols, vocabulary, icon size, format/layout
- How the individual uses and interacts with the system
- Long-term plan for success with the system