Comité Permanent de Liaison des Orthophonistes-Logopèdes de l’UE

Standing Liaison Committee of E.U. Speech and Language Therapists and Logopedists

An overview of AAC for SLTs

Augmentative and Alternative Communication

Susan Balandin, Inaugural Chair of Disability and Inclusion, Deakin University, Australia

Children and adults who have severe speech and/or language disability experience a communication disability that can lead to social exclusion, marginalization, and loss of identity. Severe communication disability may impact on the use and/or understanding of language and restricts participation with others and inclusion in the community. Those with little or no functional speech or complex communication needs (CCN) (Balandin, 2002) are likely to benefit from augmentative and alternative communication (AAC) to support their communication and ensure that they can participate in the communities of their choice (The Speech Pathology Association of Australia, 2012).

We all use AAC when we gesture, write, or use facial expressions but individuals with CCN need AAC, for example, picture boards, letter boards, objects, speech generating devices as their primary mode of communication. Complex communication needs may be part of a lifelong disability (e.g., cerebral palsy, Intellectual disability, autism spectrum disorder); an acquired disability (e.g., stroke, traumatic brain injury); a degenerative disorder (e.g., motor neuron disease, Parkinson’s disease); or may be temporary, (e.g., Guillain-Barre syndrome). Anyone who has CCN is a candidate for AAC regardless of his/her skills or capability. Furthermore, there is no evidence that AAC interventions delay spoken language acquisition and some evidence that they may facilitate language development for some individuals (e.g., people with autism spectrum disorder) (Millar, Light, & Schlosser, 2006).

AAC interventions are usually seen as the domain of the speech and language therapist. However, any intervention should be multi-disciplinary and involve collaboration with others, including occupational therapists, teachers, psychologists, engineers, the person needing AAC, family members and support workers (Beukelman & Mirenda, 2013; Chung & Stoner, 2016). Since its inception in the 1970s, the field of AAC continues to advance and change rapidly. Consequently, it is important that speech and language therapists adopt an evidence-based practice approach and evaluate their interventions, including their goals, rigorously. It may be difficult for a speech and language therapist to remain abreast of the research and practice in such a swiftly advancing filed; therefore, it is unlikely that all speech and language therapists will be AAC experts, up to date with the latest research, and practice.

Nevertheless, it is incumbent on our field that all speech and language therapists understand the importance of AAC, and have a basic understanding of AAC assessments and interventions (The Speech Pathology Association of Australia, 2012). Additionally, it is important that speech and language therapists know when and how to refer to an appropriate specialist or resource centre, if they are unable to confidently deliver the service required to ensure that people benefit from AAC. Communication is more than expressing wants and needs, it is an integral part of life, a human right (United Nations Convention on the Rights of Persons with Disabilities 2006). It is important for all interactions, including play, information transfer, social closeness, learning and the world of telecommunication and social media (Light & McNaughton, 2012). Speech and language therapists are integral to ensuring that those who require AAC are provided with a range of appropriate AAC modes that meet their communication needs, whatever their ability.


  • Balandin , S. (2002). Message from the President. ISAAC Bulletin, 67, 2.
  • Beukelman, D. R., & Mirenda, P. (2013). Augmentative and alternative communication : Supporting children and adults with complex communication needs. Baltimore: Paul H Brookes.
  • Chung, Y.-C., & Stoner, J. B. (2016). A meta-synthesis of team members’ voices: what we need and what we do to support students who use AAC. Augmentative and Alternative Communication, 32(3), 175-186. doi:10.1080/07434618.2016.1213766
  • Light, J., & McNaughton, D. (2012). The Changing Face of Augmentative and Alternative Communication: Past, Present, and Future Challenges
  • . AAC, 28, 197-204.
  • Millar, D. C., Light, J. C., & Schlosser, R. W. (2006). The impact of augmentative and alternative communication intervention on the speech production of individuals with developmental disabilities: a research review. Journal of Speech, Language, and Hearing Research 49, 248-264.
  • The Speech Pathology Association of Australia. (2012). Augmentative and Alternative Communication Clincal Guidelines. Melbourne: SPAA.
  • United Nations Convention on the Rights of Persons with Disabilities (2006). Retrieved from


Other References

Baxter, S., Enderby, P., Judge, S., Evans, P. (2012) Barriers and facilitators to use of high technology augmentative and alternative communication devices: a systematic review and qualitative synthesis, International Journal of Language and Communication Disorders, 47 (2), pp. 115-129 

Beukelman D., Mirenda P. and contributors Garrett K., Light J. (2005). Augmentative and Alternative Communication: Supporting Children and Adults with Complex Communication Needs, Fourth Edition.

Callaghan 1999. : Early understanding and production of graphic symbols. Child Development, 70, 1314-1324

Judge, S & Townend, G.(2013) Perceptions of the design of voice output communication aids. Int J Comm Dis. 48 (4) 366-381

Murphy, J. & Cameron, L. (2008) The effectiveness of Talking Mats® with people with intellectual disability. British Journal of Learning Disabilities. 36 (4) 232-241

Smith, M. & Connolly, I. (2008) Roles of aided communication: perspectives of adults who use AAC Disability & Rehabilitation: Assistive Technology. 3:5, 260-273

Smith, M. & Murray, J. (2011) Parachute without a ripcord; The skydive of communication interaction. Augmentative and alternative communication 27 (4) 292-303


 Other resources

1. ISAAC – Home

The International Society for Augmentative and Alternative Communication (ISAAC) works to improve the lives of children and adults who use AAC

American Speech-Language-Hearing Association (ASHA).
Making effective communication, a human right, accessible and achievable for all.

3.Communication Matters-Home

Communication Matters is a UK charity which promotes the use of AAC to increase the participation of people with comunication disabilities


4. Communication Matters - AAC Evidence Base

Symmary of evidence relating to the use of AAC.

youtube links on AAC

Upcoming conferences on AAC

European Day materials

Poster 2018 - word