Authors: Julie Maro and Lori Tufte
An introduction to augmentative and alternative communication (AAC)
for students 5-10 years old is addressed in this module.
Designing quality programs for students who have AAC needs involves
engineering communication environments, organizing and training
team members, and developing appropriate lessons and materials.
Strategies for achieving these goals will be presented.
Using speech and language principles to develop appropriate
goals and objectives for AAC students helps practitioners
incorporate speech, semantics, syntax, and pragmatics
objectives into their lessons.
Communication is a process.
A team approach is critical when assessing and teaching
students how to use AAC systems.
In representing vocabulary for students who do not read, one
must look at pictures through the eyes of a non-reader.
Picture symbols can be used to create visual systems and aids.
Learning to functionally use an augmentative communication
system requires a significant investment of time.
Where to Begin
Getting the Team on Board Engineering the Environment
Communication is a Process - Not a Product
The success of any student's augmentative/alternative communication
program is greatly increased when all staff involved embed it's use
within everyday programming. Augmentative/ alternative
communication implementation should not be viewed as separate from
the learning program. Rather, as the educational plan is developed for
each student, opportunities for AAC use should be infused into the
curriculum. This gives the student real reasons to practice and apply
their AAC skills.
Professionals often indicate that a particular student's main challenge is
their inability to communicate. While this may be true, we must then ask
"Communicate about what?". This question allows us to identify the
tasks and situations which need to be set up or "engineered" for
So, where do you begin?
Getting the team on board
Begin engineering the environment
Consider picture representation from the student's perspective
Getting the Team on Board
For AAC implementation to be successful, we need to have all people
that interact with the student aware of and able to facilitate the use of
AAC systems and strategies. This is an incredibly challenging process
but can be accomplished with careful planning and a large amount of
communication between team members. The days when the speech
pathologist created the AAC boards/systems down in 'their room' and
then handed them to parents and staff have given way to joint
ownership of AAC system maintenance and development by wide array
of people. How is this accomplished?
Routine collaboration meetings with all staff involved in
programming for the students with AAC need to be set up and
supported by building principals as well as administration at the
central office at least monthly. Some of the best AAC ideas and
strategies come from the most unexpected sources. Meeting
regularly pools our resources and provides a wealth of ideas
Staff need to be trained on a variety of communication
systems and strategies. This can be accomplished by the
school speech pathologist, the district assistive technologyteam,
and/or by attending conferences/workshops as a team.
If the speech pathologist can team teach with a teacher in a
classroom or resource room to engineer the environment and
jointly develop lessons incorporating AAC strategies, then
hands-on training ensues. One year the speech pathologist
might schedule their time in the resource room working closely
with that teacher, another year the speech pathologist could
split their time between music and art bringing AAC strategies
into these environments. AAC needs to modeled and promoted
across all settings and what better way than directly working
with staff on their lessons.
Staff need to be trained on and provided with the software to
support their independent development of lessons and
symbols/boards incorporating AAC vocabulary and concepts
to support their lessons.
A wide variety of resources should be available to staff to
promote their independence in learning about and incorporating
AAC. District resources should be made known to all staff, an
AAC library of resources in the building should be created, low
tech devices should be made available to the classrooms and a
method of sharing AAC resources found on the web should be
Engineering the Environment
The idea of "engineering the environment" comes from the monumental
work of Carol Goossens', Ph.D., CCC-SLP, Sharon Sapp Crain, M.S.,
CCC-SLP and Pamela S. Elder, M.A., CCC-SLP.
These authors present a systematic approach to planning where, when
and how to get student's communicating in various environments.
Identify and prioritize communication activities that occur
throughout the day.
Develop message sets for each activity.
Depict message sets on communication boardsappropriate
for the target student.
Place communication boards in the environments where
they will be used.
Implement a systematic approach to cueing and teaching the
students to use the boards.
The initial implementation phase includes an intensive period of
modeling communication board use by the teachers, aides, parents,
therapists and other individuals who have significant contact with the
students. This approach encompasses using the communication boards
both expressively and receptively throughout the day.
For additional information and resources, please see the following
Engineering the Preschool Environment for Interactive,
Communication Displays for Engineered Preschool
Environments Books I and III
These resources can be found in many local assistive technology
Speech & Language Development Common Myths Resources
When considering the use of an AAC system for a student we need to
take into account normal speech and language development as well as
some of the common myths about AAC use.
Speech & Language Development
Any child whose speech and language skills are not developing
normally or who has a condition making normal speech development
unlikely may be a candidate for an augmentative/alternative
communication system. It is critical to note that introducing AAC does
NOT mean we are "giving up on speech".This common misperception
will be addressed in more detail later.
As practitioners consider the use of augmentative/alternative
communication (AAC) strategies it is important to remember that AAC is
a form of communication that all children use as they develop speech
and language skills. For example, pointing to desired objects, gesturing,
and using non-speech vocalizations. Using speech and language
principles to develop appropriate goals and objectives for AAC students
helps practitioners incorporate speech, semantics, syntax, and
pragmatics objectives into their lessons.
The American Speech-Language-Hearing Association websiteprovides
guidelines for normal speech and language development in children. If
you have concerns in any of these areas, please seek the advice of a
certified speech-language pathologist.
Another site that provides information on normal speech and language
development is KidSource where you can find answers to questions
What is Language?
What is Speech?
How do you know that a child's language and speech are what
they should be for a particular age?
The Barkley Memorial Augmentative Alternative Communication
website created by the University of Nebraska at Lincoln also includes a
section: AAC Connecting Young Kids - YAACK. This section includes
another excellent description of normal speech and language
development. If children are not achieving these developmental
milestones, it may be time to consider using AAC.
Common Myths About Using AAC
"If a child is given a communication system it will hinder their
"If my child gets an AAC system, they will get lazy and give up
on using speech."
Reality: Research and clinical practice has shown that AAC systems do
not interfere with speech development. In fact, many children
demonstrate an increase in language, speech and communication skills
once an AAC system is introduced. Proposed reasons for this include:
Reduced pressure on speech production as the sole means of
Continued development of language skills
Continued development of conversational skills
Children will use the easiest method possible as their preferred
means of communication. It is much easier for a child to use
speech and/or vocalizations if possible to communicate than to
formulate a message using an augmentative communication
For additional information:
Burkhart, L. (1993). Total Augmentative Communication in the Early
Childhood Classroom. Eldersburg, MD: Linda J. Burkhart. For ordering
information contact: Linda J. Burkhart. In particular, see page 37:
Augmentative Communication Techniques Can Reduce Pressure for
What we are learning about early learners and augmentative
communication and assistive technology. (L. Burkhart)
- Who is Augmentative Communication for?
- General Philosophical Basis
Does AAC Impede Natural Speech - and other Fears - Includes a chart
- Common fears and myths
- What the facts are
- Practical Solutions
"A child should spontaneously use an augmentative
communication system as soon as they get it."
"An augmentative/alternative communication system is only for
expressive language purposes."
Reality: From the moment a baby is born, they hear and respond to the
spoken word. We bombard that infant with language for the first 12-18
months of their lives. During that time, we do not expect that they will
utter a single understandable word.
Why then do we expect a child to spontaneously begin using an
augmentative system from the first day they receive it? They too, need
and deserve a period of learning from the models of others. This
modeling can and should be done by parents, peers, siblings,
professionals and others on a regular basis for an extended period of
time. In this manner, the system becomes not only an expressive
language tool but a receptive one as well.
Note: Expressive language refers to "speaking", Receptive language refers to
"listening and processing"
"AAC means an expensive device."
Reality: There are many types of augmentative communication
systems. These range from gestures and sign to simple battery
operated systems to high-tech devices. The best approach for students
who require AAC is to have a menu of multiple systems. For example,
the student may have a vocalization that means "yes", a gesture for
"hello", a simple system that plays messages one at a time for greeting
friends in the hall. They may also have another device for carrying on
more complex conversations. No one system can and should "do it all".
Remember: AAC Competency Takes Time!
Jane Korsten points out that the average 18 month old child has been
exposed to 4,380 hours of oral language at a rate of 8 hours/day from
birth. A child who has a communication system and receives
speech/language therapy two times per week for 20-30 minutes
sessions will reach this same amount of language exposure in 84 years.
What we are Learning about Early Learners and Augmentative
Communication and Assistive Technology - (L. Burkhart)
- Who is Augmentative Communication for?
- Who is Assistive Technology for?
- General Philosophical Basis
Getting Past Learned Helplessness for Children Who Face Severe
Challenges: Four Secrets for Success- (L. Burkhart)
American Speech-Language-Hearing Association - Augmentative
Communication Information Section contains:
- Introduction to AAC
- Glossary of terms
- Assembling a team
- Questions to ask an AAC team
- After the evaluation
- Learning to use an AAC system
- One woman's story of growing up with AAC systems
Motivation Formula Vocab Selection Goal Core vs. Activity-Based
Determining Appropriate Vocabulary
Begin with the following activity to create a communication board:
Draw a 4 x 8 grid on a piece of paper
Write at least 16 vocabulary items into your grid you think your
student/child needs to communicate
Think about vocabulary that is "functional"
Look at the vocabulary you selected. Did you have any of the following?
eat _______drink_______ bathroom
Frequently, eat, drink and bathroom are among the first vocabulary
items chosen by parents and professionals. Communication boards are
then constructed to represent these messages and the child does not
use them. The child is then accused of "not being ready for a
communication system" or "not liking communication boards" and the
idea of their using an AAC system is abandoned.
Taking a closer look at this scenario, we typically find that the child's
basic needs such as eating, drinking and toileting are taken care of
regardless of whether they request it or not. Thus, the child is left with
little motivation or need to communicate these messages.
Bruce Baker developed the following formulation to identify the factors
inherent in communication motivation. Each of the formula components
are defined as follows:
Motivation: Refers to how much the student wants to communicate this
Physical effort: This takes into consideration the amount of energy
required to produce the message. This may involve pointing to a picture
or series of letters. It could also mean pressing a switch once or multiple
times as in the case of a communicator who has significant physical
Cognitive Effort: Involves remembering where a message is located
Time: refers to how long it takes to produce the message.
If the motivation to communicate a message is greater then the physical
effort, cognitive effort and time required to produce it, then
communication will occur. If not, no message will be generated.
Jenny is a 7 year old child who has cerebral palsy. She requires
assistance going to the bathroom. Everyday she is toileted at 10:15. It is
10:05 and she has to go to the bathroom. Rather than using her switch
to scan to a message that says "I need to go to the bathroom", she waits
10 minutes for a classroom assistant to take her to the rest room.
Jenny loves to interact socially with others. She has a communication
system that produces sequential single messages. Jenny sees a friend
in the hallway at school. She presses her sequential communicator to
talk to her friend about a TV show they both watch.
Ideas for creating these "social scripts" have been compiled by Linda J.
Burkhart and Caroline Ramsey Musselwhite. See communication social
scripts for more information.
Vocabulary Selection Goal
Influencing factors to consider when selecting vocabulary include:
When selecting initial vocabulary for an augmentative system, keep in
mind the following goals:
Power in Communication
Core vs. Activity-Based Vocabularies
Core vocabularies represent a core of words identified as being
important for a student to express across activities and
environments. The core vocabulary is the main communication system
that travels with the student, being available whenever other activity-
based vocabularies are not represented. The fact that the vocabulary
can be used across multiple situations builds in opportunities for
repeated practice and generalization of the child's core vocabulary.
The following pictures show two overlays for a student's AAC system.
The "Core" overlay is placed on the system whenever it is not being
used for a specific activity. The student uses "The Picnic" overlay when
reading a book by the same title. Notice the bottom four vocabulary
items remain constant across both overlays.
Consider the following when designing communication systems for
Who am I working with?
What are their specific interests/needs?
Have I involved the individual and their significant others in the
vocabulary selection process?
Do I have a long-range plan for vocabulary
Myth: Pictures are Easy Evaluating Pictures Selecting Symbols Lesson-Specific
Vocabulary Story Vocabulary Activity-Based Vocabulary Theme-Based
(Consider Picture Representation From the Student's Perspective)
Words can be divided into:
Picture Producers (car, cat, house)
Keep in mind that although these pictures are more concrete in nature,
they may not necessarily look anything like the items the student has
experienced. For example, whose car looks exactly like the one above?
Non-picture Producers (hard, fun)
The majority of the words we use on a daily basis are not picture
Only 10% of the 330 most frequently used words by
preschoolers are picture producers.
Examples of non-picture producers: Yes, thank you,
why, not, cold, I, you, do, more, no.
Representing and understanding non-picture producers
in graphics requires the use of metaphor, memory and a
Myth: Pictures are Easy Evaluating Pictures Selecting Symbols Lesson-Specific
Vocabulary Story Vocabulary Activity-Based Vocabulary Theme-Based Vocabulary
"Much of the magic of AAC lies in the vast array of symbols and signals,
other than those used in speech, that people can employ to send
messages. Especially for individuals who cannot read or write, the ability
to represent messages and concepts in alternative ways is central to
(Beukelman & Mirenda, 1998, p. 40)
A variety of symbols can be used to represent the messages a student
needs to communicate. "Symbols" refer to something that "stands for
something else". The actual "symbol" used can be anything from real
objects to photos to line drawings to other forms of picture symbols.
Considerations when selecting a symbol system include:
Iconicity. This refers to how closely the symbol represents the
item/message it depicts. For example, using a potato chip bag to
represent "potato chips" is a much closer association than the
written word "potato chip".
In general, symbols with a more concrete representation will be
easier for students to learn.
For students who are not yet reading - look closely at the picture
without the text. Many of us make the mistake of thinking that
"pictures are easy" because we can read the associated word and
neglect to really look at the picture.
Ability to replicate the symbol. Can the symbol be easily
reproduced if the original is lost or the communication board
needs to be rearranged or expanded? This factor needs to be
taken into account in particular when using photographs. What
happens if the negative is lost once the student is trained to the
picture meaning? This is also a consideration if pictures are to be
Is the symbol set available commercially? Many professionals
Post-It Note Approach
1. Identify vocabulary in the story.
a. Write each unique word from the book on a post-it
b. Make a hash mark or other notation on the post-it
for each additional occurrence of the word.
When done, you should have the following word
1) Total number of words in the book
2) Total number of unique words
3) Number of times each word appears in the book
c. Use this information to prioritize which vocabulary
should be placed on the student's communication
board. Also plan to include some messages which
allow the student to interact and control the activity.
For example: Turn the page, Act it out, Read that
again, All done, Let's do something else.
2. Arrange vocabulary
Arrange the post-it notes to match the display format
your student will be using (e.g. communication board,
IntelliKeys overlay, ChatBox, Macaw). It is much
easier to move them around and change their
arrangement when they are in this format before you
begin creating boards and overlays on the computer.
3. Create communication boards &/or IntelliKeys
Planning vocabulary arrangements out on paper prior
to beginning the creation of boards and overlays on
the computer can be a significant time saver.
4. Print duplicate board.
5. Place one board in sheet protector.
6. Laminate symbols.
7. Add velcro
Using Database Software
Another way to gather word frequency information is to use a computer
Set up one field for "Word" and another for "Frequency".
Type in each word from the book as a unique "word" entry. When
done, sort alphabetically in descending order.
Count the number of times each word appears and enter that
number in the "Frequency" column. Specific instructions for doing
this using ClarisWorks are included here. These can be adapted
for use with other database programs.
Web based Approach
Highlight and copy the text you wish to analyze.
Go to the following website:
Web Frequency Indexer (Georgetown Linguistics)
Paste your text in the box in the box that says "Enter your text
Click on "Do It!" for a word frequency list which includes the total
number of words in the book as well as the total number of unique
Note: This is especially handy for doing word frequency counts on e-text.
If the number of words in the book exceeds the number of spaces
available on the communication system, you will need to do some
Does the story contain a repeated line? If so, you could put that
all on one space.
Give greater weight to the words which occur most frequently.
Compare your word frequency count to published vocabulary lists.
These lists show the frequency of word use by individual of
different age ranges. An excellent resource for this on the web
can be found at: AAC Messaging and Vocabulary. Give greater
weight to words used most frequently by the same age peers.
At the Barkley Communication site of the University of Nebraska you will
find numerous vocabulary lists including words most frequently used by
preschoolers who are non-disabled, school aged children, and children
who use AAC systems. There are also lists of conversational phrases,
vocabulary for school settings, vocabulary for classroom activities and
initial vocabulary recommendations.
Include Interactive Vocabulary
Interactive vocabulary includes words and phrases which encourage
interaction between the augmentative system user and their
communication partners and peers. Examples include:
What's that? That's silly! More
Different one Act it out! Turn the page
Read it again All done
When making pages for this BookTalker, the
interactive vocabulary listed above was included
in the bottom row of each page. Thus the
students had a consistent array of comments
and questions available on every overlay. This
consistency allows the students to learn the
vocabulary more quickly and the teachers to
have a realistic expectation of what the students
can say for every story. For example after
reading a page, the teacher would know they
could call on this student and ask "What should
I do next?" and expect the student could say
"Turn the page".
Prioritizes the list based on factors such as student motivation
and how often the activity occurs.
Lists all the possible vocabulary associated with a specific
Prioritizes the vocabulary list.
Creates the communication overlays following a set of guidelines
Use a variety of parts of speech (e.g. verbs, nouns,
Place frequently used vocabulary in the same location
on every overlay whenever possible
"Engineer the environment" so communication overlays
are prominently placed in locations where they will be
During the teaching and implementation phase, use a
variety of sound teaching practices such as:
Modeling use of the overlay when talking with the
Systematically cue correct responses
Teach overlay use in the context of real and
For additional information on the implementation of this approach
see:Aided Language Stimulation
This approach has a more narrow in focus than aided language
stimulation as it involves selecting and representing vocabulary
pertaining to a particular classroom theme. One way to do this is to
create AAC Theme Kits with ready-made activity and communication
resources based upon typical themes used across schools.
The following is an example of a bear kit developed for use by the Eau
Claire Area School District in Eau Claire, WI.
The kit contains activities and props commonly used
by elementary educators teaching a unit on bears. It
also includes a notebook of suggestions and symbols
for use with students who have AAC needs.
Bear Activities from various Internet sites.
Communication boards made for various AAC
systems commonly used by students in the district.
Reproducible books and pictures.
Symbols for the repeated lines in books pertaining to
A classroom schedule using Boardmaker symbols
Single Picture Location cards worn by staff members.
Staff hold card next to their face as they say the location
to pair verbal and visual prompts.
Student's Personal Schedule
Student Specific Schedule binder with Part day or All day
picture symbols from Boardmaker arranged on thefirst
page of the binder.
Student specific all day wall schedule located on the
wall within the classroom.
Student specific schedule board mounted on a file
Left column - Locations the student is going to that day.
Middle (green) Column - Where the student is currently.
Right Column - When the student moves to a different
location in the school, they move the symbol to the done
The yellow velcro strip in the middle is a place for staff to
place symbols relating activities in that location.
Inside the folder are additional symbols, a school lunch
menu and a daily check sheet so staff can chart daily
progress, document behavior and communicate with the
family about food eaten at lunch.
Student specific schedule board using words to help the
student construct sentences.
Schedule cards are located inside the folder along with
the student's communication diet.
(Highlighting the events in a group lesson.)
Use picture symbols to visually represent the schedule of
activities within a small group lesson. This system of
visual organization has the activities to complete in a
column on the left. As an activity starts the corresponding
symbol is moved to the center of the board. When the
activity is finished it is moved to the column on the right.
Work Session Schedule
(How much work is expected)
Use number symbols to visually represent the schedule of
activities within a work session.
Use work baskets, so the student can visually see how
much work remains.
Use picture symbols to visually represent the schedule of
activities within a work session. In this schedule the
student moves the symbol up next to work when they
start an activity. They move the symbol into the all done
baggie when finished.
Other Schedule Ideas
Visual schedule symbol organization. Boardmaker from
Mayer-Johnson can be used to easily create visual
representation of activities and vocabulary. Organize
symbols in a binder for easy access.
Use a timer to show the student how long they need to
remain at an activity. http://www.timetimer.com in
conjunction with their work session schedule
Task Organizers/ Reminder Strips
Task Organizers and Reminder Strips visually represent the steps
involved in completing a task. A child can use these visual reminders to
gain independence in completing tasks on their own.
Step by Step
Visual Directions for steps involved in getting ready to
Visual directions to prompt steps for getting dressed.
You can make an activity visual by creating a storybook
format to highlight the sequence of a lesson and and
use a visual chart to document the results.
I Spy Activity
Visual Directions to prompt students when playing "I
Visual Directions to prompt students when playing
Bathroom Task Strip
Visual Directions posted in the bathroom.
The Technology Integration Questionnaire
Where is your team on the continuum of AAC integration? Perceptions of
the success and use of AAC strategies often vary among staff members.
To evaluate the strengths and needs of your team, it is suggested that
your team complete the following questionnaire. The purpose of this tool
is to gather information, not to judge staff performance; therefore
questionnaire respondents do not need to identify themselves on the
Staff Integration of AAC Rubric
This rubric was designed to provide speech/language pathologists and
educational staff with the opportunity to identify their skill level in the area
of augmentative communication. It can also be used to identify the current
level of integration of AAC by the school team. This handout also has a
section that teams can use to quickly identify personal training needs.
Minspeak Meets Aided Language Stimulation
Lesson Planning Example
Story Title and Description: Froggy Gets Dressed
The theme for the week: Frogs
Concepts to reinforce all week: on/off, grow, change
Targeted standards (Wisconsin): Oral Lang. C.4.2 Listen to and
Comprehend Oral Communications, Science F.4.3 Illustrate ways
organisms grow through life stages
The week before (Things to do/Materials to gather): 5 Frogs Hop
IntelliPics, Froggy Gets Dressed boards, Tadpoles
AAC Theme Kits
1 Month Check Out
Some assembly required :)
2 experienced people 1 week in
addition to their caseload
Binder: Theme Activity Ideas
Activity Ideas for Kit Materials
Clipart & Other Pictures
The process of choosing an appropriate device ideally involves a team
A team assessment which includes the individual who will be
using the device, their family and/or support staff as well as
professionals who are familiar with the student and those
experienced in the selection and implementation of AAC
A trial period in which a recommended system(s) is used and
efficacy data are collected and analyzed
Feature Match: No Tech to High Tech
There are differing opinions and definitions as to what constitutes a no
tech, low tech, mid tech or high tech communication system. For the
purposes of this resource, AAC devices will be defined as:
No tech systems: Any communication system that does not
require a power source.
Low tech systems: Any communication system that requires a
source of power and is very easy to program.
Mid tech systems: Any communication system that requires a
power source and requires some level of training to adequately
program and maintain the device.
High tech systems: Any communication system that requires a
power source and extensive training to competently program
and maintain the device.
A sampling of systems contained in each category include:
No Tech communication systems
Choice boards: Objects, pictures, and/or symbols can be used on a
choice board to offer students opportunities to communicate the
language of snack/leisure activities, learning activities, transitioning,
literacy activities, daily living activities, and more.
Choice boards can be used alone or in combination. In this example, the
student can select an answer from one choice board to complete a
sentence started on another choice board.
Boards can be cut to various sizes from foam core board. This material
is commonly used to mat pictures or make posters. It can be found in
the school supply section of discount stores, at craft stores or at framing
Communication boards: These can be computer generated and/or hand-
made. They can range from a single symbol to a single page to multiple
pages either stored together or in the actual environments where they
will be used.
Picture or symbol overlays that provide opportunities for
students to communicate about specific activities in which they
A general or core overlay to communicate general language
across activities and environments,
A communication overlay to communicate about literacy activity,
Picture exchange systems provide students
opportunities to physically give communication picture or
symbol during activity or through self-initiation.
Communication books, wallets
Low Tech systems
BIGmack, LITTLEmack, Step-by-Step Communicator, Step-by-
Step Communicator with Levels, SpeakEasy available
CheapTalk series of simple voice output systems available
fromEnabling Devices: Toys for Special Children
Chatbox by Saltillo
Talk Pad, Voice-in-a-Box, Voice-in-a-Box 6 by Frame
Tech Talk series from Mayer Johnson
Mid Tech systems
AlphaTalker and SideKick by Prentke-Romich
Macaw by Zygo Industries
Hand Held Voice available from Mayer Johnson
High Tech systems
Vanguard, DeltaTalker, SpringBoard and Liberator by Prenke-
Dynavox and Dynamite by Sentient Systems
Companies Offering Augmentative/Alternative Communication
and/or Assistive Technology Products:
Assistive Technology, Inc.
Attainment Company, Inc.