Augmentative and Alternative Communication (AAC)

At Expressable, we’ve helped people of all ages express themselves and connect with others through the use of AAC. Our unique program teaches you evidence-based strategies for using AAC devices and methods to communicate. We also make it easy to practice at home and out in the community, which leads to faster progress.

AAC stands for augmentative and alternative communication. It’s an umbrella term that covers any way of communicating other than talking. Any method that can help a person communicate counts as AAC. AAC includes many systems and devices, such as communication boards, speech-generating devices, computer apps, and picture books. It also includes “no-technology” methods such as drawing or writing, gestures, facial expressions, and other nonverbal communication.

This article explains Expressable’s clinical approach to supporting people who are learning to use an AAC device. You can also view our complete guide to AAC to learn more about the different types of AAC, the steps for getting an AAC device, and how to support an AAC user at home.

1Why is speech therapy important for people who use AAC? 2How Expressable speech therapy supports people using AAC 3Practice AAC strategies at home with the Expressable portal 4The benefits of online speech therapy for AAC 5See what people are saying about our speech therapy for AAC 6Get matched with a speech therapist today

Why is speech therapy important for people who use AAC?

AAC can be used by anyone, from children who can’t yet read to older adults. AAC is helpful for many reasons. People who use AAC may be limited in their speech, have difficulty producing or understanding language, or be completely nonspeaking. Some people use AAC for a period of time after surgery or a medical event, such as a stroke or brain injury, until their communication skills return. Some people use AAC long-term because of a diagnosis such as cerebral palsy, multiple sclerosis, or autism. While not a full list, people who can benefit from AAC may include those with:

• General problems with language, cognition, or speech

• Voice disorders, apraxia of speech, aphasia, dysarthria, autism, or Down syndrome

• Difficulty communicating their needs and wants; often experiencing “communication breakdowns”

• Hearing problems

Speech therapy helps people explore and find the right AAC method for them, then learn how to use it in everyday situations. The AAC device is essentially the person’s voice, and they need to know how to use it to express their wants and needs anywhere–at home, at school, at work, or out in the community. Speech therapy can help people and their loved ones get more familiar and comfortable with using an AAC device.

While each client’s treatment plan in speech therapy is tailored to their goals, the Expressable AAC program focuses on:

• Evidence-based techniques for helping children and adults make functional progress with their device

• Education for parents and caregivers, so they can support their loved one’s communication growth

• Empowering the person to communicate their thoughts and needs in any situation, leading to increased independence, better mental health, and more positive social interactions

How Expressable speech therapy supports people using AAC

Expressable matches clients with a licensed speech therapist trained to work with AAC methods and devices. All therapy is delivered online via face-to-face video conferencing on Zoom. Research has shown that online speech therapy works just as well as in-person therapy. Online speech therapy is convenient, offers wider access to speech therapists, and makes it easier for parents and caregivers to be involved with their loved one’s care. At Expressable, speech therapy isn’t just for the AAC user. No matter how old the client is, a parent, caregiver, or loved one also needs to be familiar with the AAC device so they can provide support as needed. That’s why parent and caregiver coaching is a key part of our AAC program.

Research shows that speech therapy for children works best when a parent or caregiver attends sessions.

Research shows that speech therapy for children works best when a parent or caregiver attends sessions. That way, you can learn how to use your child’s AAC system directly from the therapist, and confidently practice with your child throughout the week. You can tell the speech therapist about the most important concepts, items, and people in your child’s life. Then, your therapist will show you how to feature those items in your child’s AAC system. For example, say your child loves eating bananas. Your speech therapist would program "bananas" on one of the main screens of the AAC device so your child can easily ask for one.

For older people in speech therapy, it’s also important for a caregiver or loved one to attend sessions. The caregiver can help the person practice and use their AAC system both during sessions and at home.

Expressable’s clinical approach to AAC evaluations

Speech therapy for AAC begins with an evaluation. Your speech therapist will use a variety of assessment methods to determine if AAC would be helpful and if so, which type. Click here for some expert tips on preparing for an online evaluation for AAC.

There are many companies that make AAC devices. Check out this article for an overview of a few of them, as well as some pros and considerations to keep in mind. Your speech therapist can collaborate with other professionals, including physical therapists and occupational therapists, to help decide on the best AAC device for you or your loved one.

Testing is functional. This means the speech therapist will assess how the person is communicating, whether verbally or nonverbally, and how they do when presented with an AAC device or system. At Expressable, this may include using a “loaner device” from an AAC company such as Lingraphica until a permanent device is obtained. This article explains more details about the process of getting a speech-generating AAC device.

If an AAC device is recommended, or if speech therapy is recommended for a person who already uses a device, the evaluation results will be used to develop a personalized care plan. 

Evidence-based strategies for using an AAC device

Your speech therapist will help you or your loved one learn to communicate with AAC one step at a time, working through a variety of short-term goals. Therapy will likely include: 

• Teaching the person how to use their AAC device

• Teaching family and friends how to communicate with the AAC user

• Programming the device so the AAC user can communicate effectively

• Teaching the AAC user and/or caregiver how to change the words on the device

Again, AAC covers a wide variety of communication methods, from drawing and gesturing, to communication boards, to speech-generating devices. Your speech therapist will help you decide which system and initial therapy goals are best. Each person’s needs are different, but the goal is always the same: To help them communicate as easily and efficiently as possible.

Speech therapy for children who use AAC If the AAC user is a child, speech therapy will be child-led and play-based. Building a positive, playful relationship with your child is the foundation for their learning. We meet your child where they are, using their interests and motivations to help them grow their communication skills and confidence. 

Children learn best through play, so your speech therapist will incorporate play into every session while your child learns to use their AAC system. The therapist might use songs, or toys or books your child has at home. They may find fun activities or videos to present on screen. 

Your speech therapist will incorporate play into every session while your child learns to use their AAC system.

However, no matter how fun sessions are, we’d never expect a young child to sit still and look at a screen for 30 minutes! That’s why caregiver involvement during sessions is so important. In addition to learning how to use AAC, you can help your child interact with the speech therapist, or interact with your child yourself while the therapist offers tips and guidance. That way, you’ll learn how to keep practicing with your child at home in everyday situations. 

Speech therapy for adult AAC users Adult sessions are typically more straightforward, but that doesn’t mean the speech therapist won’t make therapy motivating and engaging. Let’s say a client wants to be able to say “I love you” to their partner after having a stroke. Or maybe they’d like to be able to order food at a restaurant again. Your speech therapist can help you with any personal goals, targeting them in sessions and showing you how to practice at home, too. 

Practice AAC strategies at home with the Expressable portal

At Expressable, speech therapy doesn’t stop when your session ends. You’ll have ongoing text messaging support so you can ask questions or get tips from your speech therapist between sessions. You’ll also have access to our client portal, which makes it easier to practice with your AAC system throughout the week. The more often you practice, the faster you will make progress!

In the portal, you’ll find Learning Paths that explain and reinforce therapy strategies for using AAC, such as core and fringe vocabulary and visual supports:

You can watch videos that show real AAC techniques in action, such as communication partner training and language expansion:

Your speech therapist will assign personalized home practice activities you can do during your everyday routines, such as managing communication breakdowns:

The benefits of online speech therapy for AAC

Multiple studies over several years have shown the effectiveness of online speech therapy. Not only does it work as well as in-person speech therapy, there are lots of reasons people tend to prefer it:

1 Wider access to qualified speech therapists

With online speech therapy, it’s not hard to find a speech therapist who’s experienced in using AAC. You have access to an entire network of speech therapists who are licensed to treat in your state. This is especially beneficial for people who live in more rural areas, or in areas with long waitlists for speech therapy.

2 Convenience and flexibility

Between school, work, appointments, errands, and everyday life, it can be hard to regularly attend in-person therapy sessions. Not only is there the commute time, but most speech therapy clinics are only open during normal business hours. With work schedules and after-school activities, for many people, that just doesn’t work.

Online speech therapy removes this problem. At Expressable, you can schedule sessions on the days that work best, at the times that are most convenient, including evenings and weekends. 

3 The comfort of home

If you or your loved one feels shy or uncomfortable when it comes to speech therapy, you’re not alone. Many people feel unsure in new situations, especially when they’re face-to-face with someone new, like a speech therapist. With online speech therapy, doing sessions from the comfort of your own home can put you or your loved one at ease. You can be right beside them the whole time. And when the client feels comfortable, their therapy sessions will be more effective.

One benefit of online therapy for AAC is that the speech therapist gets to see the client in their home environment, observing how they interact with family members and caregivers. The therapist can try activities that will motivate the person to use AAC to communicate at home, such as asking for a snack or discussing which TV show to watch.

4 Affordability

In-person speech therapy clinics have many expenses that aren’t directly related to your care, such as rent, utilities, and other operational costs. As with any business, these costs are often passed down to the consumer. The cost of speech therapy will vary by provider, but generally, the cost of online speech therapy will be less than an in-person practice—even though you receive the same quality of treatment. At Expressable, we offer transparent private-pay pricing and also partner with a large number of health plans across the company.

See what people are saying about our speech therapy for AAC

We’ve treated children and adults around the country who use alternative forms of communication. Our speech therapists consistently earn ratings of 4.9 out of 5 stars from their clients. Here’s just a sampling:

“Making steady and exciting progress everyday” “I am always so excited and grateful for these sessions. We are making steady and exciting progress everyday with the AAC device, and I suspect we would not be doing as well without the speech therapy supports!”

“Tailors his sessions” “Karyn is great with my husband. Seems interested in him and tries to tailor his sessions to things he can use on a daily basis. He enjoys using his Lingraphica device.”

“Great ideas and strategies” “Sarah is amazing! She's very professional, friendly, and patient. In addition, she provides great ideas and strategies for my son's AAC device.”

“Her encouragement was what we both needed” “​​We were not sure how well having speech therapy via Zoom would work, but Karyn was able to put our fears to rest and help my husband and I work through the difficulties he faces as he progresses with aphasia…We appreciated the helpful tips she passed along regarding the device and the vocal exercises that are helping his voice become stronger.  Her encouragement was just what we both needed, and we are grateful to have had Karyn as his speech therapist.”

Get matched with a speech therapist today

We’re here to support you or your loved one so they can communicate and connect with the people around them. Find the right speech therapist for your needs here.