Beyond words: Why AAC (Augmentative Alternative Communication) is a bridge, not a barrier, to speech

Written by: Nicole Lam, Senior Speech-Language Therapist 

Introduction 

When a child is diagnosed with autism or a significant speech delay, parents often feel like they are racing against a clock. You want to hear those first words, but communication is more than just sounds; it’s about connecting and being understood. For children who have multiple disabilities, whose speech muscles are not easily accessible, speaking would be an arduous task, and they might feel frustrated to get their thoughts and choices known to others. 

Depending on the child’s language development and unique needs, we can utilise a broad range of evidence-based tools, to support communication as well as facilitate speech and language development. These tools are called Augmentative and Alternative Communication (AAC). In this article, we look at the research to answer your biggest questions and show how AAC can be the bridge in your child’s speech development. 

What is AAC?  

AAC isn't just a high-tech tablet. It encompasses all the different ways that someone could communicate, apart from talking.  

• Unaided AAC: Using the body such as hand gestures, sign language, or facial expressions.  

• Aided AAC: Using picture boards, notebooks, tablet/iPad apps (e.g. Proloquo2Go or LAMP words for life), or Speech-Generating Devices (SGDs) e.g. GoTalk, BigMack.  

#1 Myth: "Will AAC stop my child from learning to speak?" 

This is the most common concern we hear. Parents worry that a device will become a crutch, making the child unmotivated to use natural speech.  

However, a landmark systematic review by Millar, Light, and Schlosser (2006) found that AAC intervention does not inhibit speech. In fact, 89% of participants in their study showed an increase in speech production after starting AAC. Other research has also found promising results for AAC interventions in young children (Romski et al., 2010; Solomon-Rice & Soto, 2014), with language gains shown via sign language (Lederer & Battaglia, 2015; Wright et al., 2013) and graphic symbols (Lerna et al., 2014; Yoder & Stone, 2006). Benefits have also been observed from the use of voice output switches (Schweigert & Rowland, 1992) and Speech-Generating Devices (Lorah, 2016; Romski et al., 2010).  

Why Does It Help? 

1. Pressure Relief: AAC lowers the communicative frustration that often leads to meltdowns. When children are given alternative means to make choices, share their thoughts and ideas, they learn that they can be understood and are more likely to attempt communication in all modes. 

2. The Acoustic Model: High-tech devices provide a consistent, clear digital voice. When a child presses "Apple", they hear the word perfectly every single time, which provides a blueprint for them to imitate. 

3. Visual Language Model: While verbal speech is transient, AAC provides some more time for a child to visually process what others are saying and learn more complex structures of language used by adults. For example, a child taps on 'car’ symbol on a picture board to request for a blue car nearby. In response, an adult acknowledges by saying “blue car” and points to the 'blue' and ‘car’ symbols on the same picture board. The child learns the adjective-noun phrase structure through this interaction.  

#2 Myth: Is My Child Too Young to Start AAC?  

Many parents are told to wait and see or to try "speech only" first. However, the American Speech-Language-Hearing Association (ASHA) and available research on young children (e.g., Romski et al., 2010) suggest that early introduction is key. 

There are no prerequisite skills for AAC. A child does not need to understand cause-and-effect or be of a certain age. If a child cannot meet their daily communication needs with speech alone, they are a candidate for AAC.  

#3: AAC is only for children who are completely non-speaking  

AAC is appropriate for many kinds of communicators, including: 

• minimally speaking people,  

• unreliable speakers,  

• situational communicators,  

• and people who lose speech during stress or overload. 

AAC can supplement speech and is not limited to non-speaking individuals (ASHA, 2026). Research on adults with autism has also suggested that AAC can support self-advocacy and expression during emotional shutdowns or fluctuating communication states (Frisch, Betts and Vertanen, 2025). 

Conclusion: The Multi-Modal Approach 

We don't view AAC as a replacement for speech and neither do we use AAC as the sole approach for developing speech. Rather, we see AAC as part of a multi-modal system and a multi-pronged approach. Your child may use the device, their hands, their eyes, and their emerging voice to tell you what they need. Our goal at Speech Bubbles is simply to give them every tool possible to ensure they are understood.  

References: 

Romski M, Sevcik RA, Adamson LB, Cheslock M, Smith A, Barker RM, & Bakeman R (2010). Randomized comparison of augmented and nonaugmented language interventions for toddlers with developmental delays and their parents. Journal of Speech, Language, and Hearing Research, 53, 350–364.  

Solomon-Rice PL, & Soto G (2014). Facilitating vocabulary in toddlers using AAC: A preliminary study comparing focused stimulation and augmented input. Communication Disorders Quarterly, 35, 204–215.  

Lederer SH, & Battaglia D (2015). Using signs to facilitate vocabulary in children with language delays. Infants and Young Children, 28, 18–31.  

Lerna A, Esposito D, Conson M, & Massagli A (2014). Long-term effects of PECS on social-communicative skills of children with autism spectrum disorders: a follow-up study. International Journal of Language & Communication Disorders, 49, 478–485. 

Romski M, Sevcik RA, Adamson LB, Cheslock M, Smith A, Barker RM, & Bakeman R (2010). Randomized comparison of augmented and nonaugmented language interventions for toddlers with developmental delays and their parents. Journal of Speech, Language, and Hearing Research, 53, 350–364.  

Wright CA, Kaiser AP, Reikowsky DI, & Roberts MY (2013). Effects of a naturalistic sign intervention on expressive language of toddlers with down syndrome. Journal of Speech, Language, and Hearing Research, 56, 994–1008.  

Yoder P, & Stone WL (2006). A randomized comparison of the effect of two prelinguistic communication interventions on the acquisition of spoken communication in preschoolers with ASD. Journal of Speech, Language, and Hearing Research, 49, 698–711. 

Frisch, B., Peters, B., & Vertanen, K. (2025). The role of AAC in social communication and community engagement: Experiences and opinions of autistic adults. arXiv. https://arxiv.org/abs/2507.00202