Unlocking Communication: A Caregiver’s Guide to Augmentative and Alternative Communication Systems
June 09, 2025
Contents
- What are Augmentative and Alternative Communication Systems?
- Unaided AAC
- Aided AAC (No-Tech)
- Aided AAC (High-Tech)
- Combined / Hybrid AAC
- Why combine AAC Systems?
- What are the important things to know about AAC?
What are Augmentative and Alternative Communication Systems?
Augmentative and Alternative Communication (AAC) refers to a range of communication methods that can support those with verbal communication difficulties. AAC systems are for everyone who needs them; there is no exclusion criterion for using AAC. If it is beneficial, then it can be used! A method that can support communication is incredibly important, and the right system can make a huge difference.
AAC does not replace speech; they are designed to complement and enhance it. Many AAC systems are designed to be used alongside spoken language, further enhancing communication. For example, a popular AAC method called Makaton combines speech with signs and symbols. This will be discussed later in the article. Research has shown that AAC can actually support speech development, rather than hindering or replacing it.
AAC systems are generally divided into two categories:
- Unaided: these rely on body movement, such as gestures or sign language
- Aided: which involves equipment or technology
Whether you are a caregiver, family member, educator, or simply curious, exploring AAC options can open up new possibilities for effective communication. This article aims to explore different AAC systems, offering insights on how they can facilitate communication and offer practical tips.
Unaided AAC
Unaided AAC involves communication methods that do not require external tools or devices. These systems work well for those who are able to move easily but struggle with their speech. Below are some common types of unaided AAC systems:
Sign language
This is a fully developed, structured language to communicate. It can present complex ideas and functions as a complete language with its own grammar and syntax. It allows people to express detailed thoughts and ideas using signs. Sign languages, such as British Sign Language (BSL), provide a complete form of communication.
Gestures and body movements
Some actions, such as nodding or shaking the head to indicate “yes” or “no”, or pointing to something, can be effective ways of expressing needs or emotions. These non-verbal cues can also be used alongside speech or other forms of communication to clarify meaning. For example, the user may point to a game and then to you, signalling they want to play the game with you.
Facial expressions
From smiles to frowns, these facial expressions can convey an individual’s thoughts or feelings. Paying attention to these non-verbal cues can help develop a better understanding of an individual’s needs.
Aided AAC (No-Tech)
No-tech aided AAC involves tools that do not require electricity or batteries. Below are some common types of no-tech AAC systems:
Communication Books and Charts
These are books that act as a visual method for communication. They have pictorial symbols or words that the user can point to in order to communicate. They can include a range of images that represent objects, actions, emotions, or concepts, allowing users to express their wants, needs, and thoughts.
This AAC system can vary in complexity; some have just a few pictorial symbols, such as “hungry” or “toilet”, while others can have up to a hundred or more pictorial symbols for communicating a wider range of needs and wants.
The pictorial symbols or words can also be organised into a chart for specific scenarios. For example, there could be a communication chart for going to a park, and another for being in a classroom. The user can also combine these symbols to create a sentence such as “I want to eat later” or “I feel poorly”.
Picture Exchange Communication System (PECS)
These are a similar AAC system to Picture Communication Boards. However, with this system, the user gives the pictorial symbol to someone to communicate what they want. For example, the user may give the symbol for food to indicate they are hungry and would like to eat.
Choice Boards
These are similar to many of the aided systems discussed. This system uses a board that has several options for the user to choose from. For example, if asked what they would like to do next, there could be the choices of swings, water play, reading, and relaxing. Some caregivers may then point at each of the pictures and say what it is, and then the user can point to their choice.
Aided (High-Tech)
High-tech aided AAC involves tools that require electricity or batteries. Below are some common types of high-tech AAC systems:
AAC Apps
These are apps on electronic devices which allow the user to tap on symbols or words which the app can turn into speech. Some apps can be customised for phrases or pictures more commonly used by the user.
Eye-Tracking Systems
For those with limited physical movement who may find unaided systems or apps difficult to use, eye-tracking systems track the eye movement of the user so they are able to use their eyes to choose words or symbols on a screen. The system then generates this into speech.
Switch-Activated AAC Devices
These are devices that can be programmed with pre-recorded messages, such as “I am hungry”, and when the switch is pressed by the user, the message plays to communicate a want, need, or thought to the people they are with.
Combined / Hybrid AAC
Combining different systems can sometimes make communication easier and more flexible. This is often referred to as a combined or hybrid AAC. Other times, it is not clear which AAC category a system may fall into; one system may not meet all of the individual’s communication needs, or some systems can work better when used together.
Makaton
Makaton is a common form of AAC, used by over 100,000 children and adults. It is a multi-modal form of communication which uses a combination of signs (based on British Sign Language), symbols, and speech. The signs focus on key everyday words, and the pictorial symbols can be hand-drawn, computer-generated, or printed.
Makaton is one of the systems that can be difficult to place into a single category. Using Makaton signs and speech can be considered unaided, and using the symbols can be considered aided.
Why combine AAC Systems?
AAC systems should not be considered a one-size-fits-all; otherwise, you may be doing yourself a huge disservice. Everyone is different and has different needs and abilities, so it is crucial to find an AAC system that fits the user in order to maximise its effectiveness. Combining different types of systems can be beneficial, allowing for individualisation and flexibility based on the user's preferences and communicative abilities.
For example, a user may use a combination of PECS and Communication Charts, such as:
- The user gives a picture of spaghetti to their caregiver to request it
- The user is constructing a full sentence, such as “I want spaghetti tonight”
By combining these systems, the person has more ways to express themselves. They have the option of quick and simple requests, whilst also being able to express more detailed thoughts. This means that the user's needs can be met effectively no matter the context or situation of communication.
What are the important things to know about AAC?
Learning a new method of communication is not an overnight task, and you will exhaust yourself if you try to make it one! Be patient with yourself and the learner; it can take a lot of time, and it is important to acknowledge that and celebrate any success and progress.
The learning process may feel overwhelming at times. Don’t hesitate to lean on people such as family, friends, and support groups to provide support if you are struggling along the journey.
Consistency is key
For AAC systems to be effective, they should be used consistently and integrated into everyday life. Just like learning any new skill, frequent practice is essential and will help the system become a natural part of life. Part of this is making sure core vocabulary is used consistently to help build fluency and reinforce communication skills.
Set realistic goals and celebrate progress
Setting yourself realistic goals and celebrating progress helps maintain motivation. You may benefit from selecting a few words or phrases you want to learn first and setting goals based on these. For example, using a sign for “more” and “please” when asking for more food at dinner time is great progress and worth celebrating.
Model communication and keep materials close
You can encourage the use of AAC systems by modelling the communication to the user. For example, if you are using Picture Communication Boards, you may point to the picture when you say it. This reinforces the connection between the pictorial symbol and its meaning.
In order to make sure communication is regularly modelled and reinforced, it is important to make sure the resources needed are near you. This encourages use and ensures communication remains accessible, helping the user feel more confident across different environments. This also includes making sure all electronic devices are charged or have batteries in them to ensure they can be used.
Augmentative and Alternative Communication (AAC) systems support those who struggle with verbal communication. These systems offer more accessible, flexible methods of communication and can be used across a wide range of ages and abilities.
The range of systems can seem overwhelming at first, but understanding the differences is key to finding which system works best. If you are unsure where to start, you can reach out to a professional who can guide you. They may be able to support you in making a decision or incorporating it into everyday life.
Mindsum also offers free initial consultations with therapists who can support you on the AAC learning journey. If you are experiencing overwhelm or burnout, or want some extra support when beginning an AAC system, you may find them helpful.
Remember, every step in making communication accessible is important, and every bit of progress is a victory!