By Beth Fleming, M.S., CCC-SLP
Pediatric Speech-Language Pathologist & Owner, Chatterbox Pediatric Therapy
Imagine having something important to say but not having a reliable way to say it.
You know which snack you want.
You know that you don’t want to go somewhere.
You want to tell someone about something exciting that happened.
Something hurts.
You have a joke to share.
You want to say, “I love you.”
But the people around you can’t understand what you’re trying to tell them.
For many people who use Augmentative and Alternative Communication, or AAC, communication tools provide access to something most of us take for granted every day:
the ability to be heard.
October is AAC Awareness Month, making it a perfect time to talk about what AAC really is—and some of the misconceptions that can keep families from exploring it.
What is AAC?
AAC stands for Augmentative and Alternative Communication.
AAC includes ways of communicating other than spoken words alone.
You probably use forms of AAC yourself without realizing it.
You point.
You gesture.
You make facial expressions.
You send emojis.
You write something down when someone can’t hear you.
AAC builds on that same idea: communication doesn’t have to happen in only one way.
For someone with significant communication needs, AAC might include:
- gestures or manual signs;
- pictures;
- communication boards or books;
- written words;
- a tablet with a communication application; or
- a dedicated speech-generating device.
Some AAC systems are very simple. Others contain thousands of words and allow someone to create complex, completely original messages.
Who uses AAC?
There is no single “type” of AAC user.
A toddler with a developmental delay may use AAC while spoken language is emerging.
A child with autism may use a communication device alongside speech.
A child with cerebral palsy may understand everything being said around them but need another way to express their thoughts.
Someone with childhood apraxia of speech may use AAC when their motor speech abilities make spoken communication difficult.
A teenager may communicate using a combination of speech, gestures, typing, and a device.
An adult may begin using AAC after a stroke, traumatic brain injury, or progressive neurological condition affects their ability to speak.
AAC isn’t defined by a diagnosis.
It’s about whether someone’s current communication is sufficient to allow them to say what they want to say.
AAC doesn’t mean we’ve given up on speech.
This misconception is incredibly common.
Parents sometimes worry that introducing a communication device will make their child “lazy” or eliminate their motivation to learn to talk.
But communication doesn’t work that way.
Research does not support withholding AAC because of fear that it will prevent speech development.
In research involving toddlers with significant developmental delays, children who received AAC intervention using speech-generating devices produced significantly more spoken target vocabulary words than children who participated in a spoken-language intervention. Researchers also found no statistically significant differences in speech-sound errors between the groups.
Earlier research summarized in that same study also found that the majority of AAC intervention studies reported speech gains, while none demonstrated decreases in speech development.
That doesn’t mean AAC guarantees that a child will eventually communicate primarily through speech.
It means something much more important:
We don’t have to choose between giving a child access to communication today and supporting the development of spoken language tomorrow.
We can do both.
AAC is more than requesting.
One of my favorite things about AAC is seeing communication expand beyond “I want ___.”
Of course, asking for what you want is important.
But think about everything you communicate during an ordinary day.
You protest.
You ask questions.
You tell stories.
You complain.
You joke.
You greet people.
You give opinions.
You say something is gross.
You tell someone they’re wrong.
You say you’re scared.
You tell someone to leave you alone.
You say “I love you.”
You talk about something that happened yesterday and something you’re excited about tomorrow.
An AAC user deserves access to all of that, too.
Communication is about connection, not compliance.
A robust AAC system should give someone opportunities to express much more than what other people want them to say.
Learning AAC takes time.
Imagine someone handed you a tablet containing thousands of unfamiliar symbols and said:
“Okay, communicate.”
You probably wouldn’t immediately know where everything was.
AAC users are learning a language system, and that takes time, exposure, practice, and good communication partners.
One of the most valuable things parents, teachers, therapists, and caregivers can do is model AAC.
That means we use the person’s communication system while we talk.
If you’re saying, “Let’s GO outside,” you might select GO on the device.
If you say, “That is SO funny,” you might model FUNNY.
If a child clearly doesn’t want something, you might model NO or STOP without requiring them to copy you.
We show children how their communication system works in the same way that we show young children how spoken language works: by using it with them.
And please don’t make someone “prove” they can use AAC before giving them access to it.
We sometimes hear versions of:
“They don’t understand enough yet.”
“They aren’t ready for a device.”
“They just push buttons.”
“They need to learn pictures first.”
Or:
“Let’s wait and see if they start talking.”
But communication development doesn’t require us to sit quietly and wait.
The toddlers in the research study provided with this article were only 24–36 months old when recruited and had significant developmental delays and fewer than 10 intelligible spoken words.
AAC can be part of early language intervention, not merely something introduced after years of unsuccessful therapy.
Communication belongs everywhere.
An AAC device isn’t just a therapy tool.
If it is someone’s voice, it needs to go where that person goes.
To school.
To the playground.
To Grandma’s house.
To the grocery store.
To restaurants.
To doctor’s appointments.
On vacation.
Into the car.
And yes—even onto the playground where we are worried something might happen to the expensive device.
We can protect communication systems physically without limiting a person’s access to communication.
Imagine if someone took your voice away every time you left the house because they were afraid you might damage it.
That’s why we encourage families to think of AAC differently:
It isn’t an activity. It’s communication access.
The best communication may be multimodal.
Many AAC users don’t communicate in one single way.
They may speak some words, use their device for others, gesture, point, make facial expressions, sign, type, or combine several methods within the same conversation.
That’s called multimodal communication.
And that’s okay.
The goal isn’t to make every message come from a device.
The goal isn’t to make every message spoken.
The goal is for the person to have effective, authentic ways to communicate what they want to communicate.
This AAC Awareness Month, let’s change the question.
Instead of asking:
“Will AAC stop my child from talking?”
Perhaps we can begin by asking:
“Does my child have a reliable way to communicate everything they want to say right now?”
If the answer is no, it’s worth having a conversation with a speech-language pathologist who understands AAC.
Providing another way to communicate isn’t giving up on your child’s voice.
It’s making sure they have one.
And every person deserves that opportunity.
Need Support? We’re Here to Help.
Every child develops at their own pace, but if you have concerns about your child’s speech, language, feeding, social communication, sensory processing, motor skills, or overall development, you don’t have to navigate those questions alone.
The team at Chatterbox Pediatric Therapy is here to provide compassionate guidance, evidence-based evaluations, and personalized therapy services that help children build confidence and reach their full potential. Whether you’re looking for answers, wondering if your child would benefit from an evaluation, or simply need a trusted professional to talk with, we’re here to help.
Contact Chatterbox Pediatric Therapy today to learn more about our pediatric speech therapy, occupational therapy, physical therapy, and feeding therapy services. Early support can make a meaningful difference, and we’re honored to partner with families every step of the way.
About the Author
Beth Fleming, M.S., CCC-SLP, is a Pediatric Speech-Language Pathologist and the Owner of Chatterbox Pediatric Therapy. With more than 20 years of experience serving children and adolescents with developmental differences and communication challenges, Beth is passionate about helping families better understand their child’s development through practical, evidence-based information.
Throughout her career, Beth has worked with children with a wide range of communication, feeding, learning, sensory, and developmental needs. She believes that empowering parents with trusted knowledge is one of the most important parts of supporting a child’s success.
The articles on the Chatterbox Pediatric Therapy blog are written to educate, encourage, and equip families with reliable information grounded in clinical expertise and real-world experience. While this content is intended for educational purposes and should not replace individualized medical or therapeutic advice, Beth hopes each article helps parents feel more confident in supporting their child’s growth and knowing when to seek professional guidance.
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