Augmentative Communication: How Speech Therapists Empower Communication for All

Posted in Rehabilitation Articles, Speech Therapy, Technology & Seniors

Two orange speech bubbles representing communication.
By Alison Starkey PT MBA MHA CAPS CDP CFPS, owner of Gaitway of Charlotte, 833.232.4574

Communication is a fundamental human right, yet for millions of people with speech or language impairments, expressing even basic needs can be a daily struggle.

Enter augmentative and alternative communication (AAC), a set of tools, strategies, and technologies designed to support or replace spoken or written language. At the heart of AAC is the speech-language pathologist (SLP), also known as a speech therapist, whose role is to assess, customize, and implement communication solutions tailored to each individual’s needs.

What is Augmentative and Alternative Communication (AAC)?
AAC encompasses all forms of communication, other than oral speech, that are used to express thoughts, needs, wants, and ideas. It includes:

  1. Unaided systems: such as gestures, facial expressions, sign language.

  2. Low-tech systems: like picture boards, communication books, or letterboards.

  3. High-tech systems: including speech-generating devices (SGDs), communication apps on tablets, or computer-based communication systems.

AAC can be augmentative (used to support existing speech) or alternative (used when speech is not functional at all).

The Role of a Speech Therapist in AAC
Speech therapists play a central role in helping individuals who may benefit from AAC. Their responsibilities typically include:

  1. Assessment
    An SLP begins by conducting a comprehensive evaluation, considering:

  • The individual’s current communication abilities

  • Cognitive, motor, and sensory needs

  • Daily communication environments and partners

This ensures that the selected AAC method is both accessible and practical for the user.

  1. Selection of AAC Tools
    Based on the assessment, the SLP collaborates with families and caregivers to choose the most appropriate AAC system. This could range from a simple picture exchange system to a complex speech-generating app tailored with specific vocabulary and voice options.

  2. Customization and Programming
    AAC systems are not one-size-fits-all. Speech therapists personalize devices and systems to include relevant vocabulary, intuitive layouts, and culturally appropriate content.

  3. Training and Implementation
    Introducing an AAC system is just the beginning. SLPs provide training to the individual, as well as their communication partners (parents, teachers, aides), to ensure consistent use across all environments. They teach strategies such as modeling (demonstrating use of the device), prompting, and encouraging spontaneous communication.

  4. Ongoing Support and Monitoring
    As the individual’s needs change—due to age, development, or progress—so should their AAC system. SLPs continually monitor progress, update vocabulary, and provide additional support to ensure continued communication growth.

Who Can Benefit from AAC?
AAC is not limited to one condition or age group. People who may benefit include those with:

  • Autism Spectrum Disorder (ASD)

  • Cerebral Palsy

  • Down Syndrome

  • Developmental delays

  • Aphasia (post-stroke and other neurological conditions)

  • Apraxia

  • Traumatic Brain Injury (TBI)

  • Amyotrophic Lateral Sclerosis (ALS)

The Impact of AAC
With the right AAC support, nonverbal or minimally verbal individuals can:

  • Express their wants and needs

  • Participate in social interactions

  • Engage in educational and vocational activities

  • Build independence and confidence

For many, AAC is a life-changing intervention. With guidance from skilled speech therapists, individuals who were once unable to communicate verbally gain a voice that allows them to connect with the world around them.

Final Thoughts
Augmentative communication is more than just tools and technology—it’s about inclusion, dignity, and unlocking potential.

Speech therapists are not just experts in communication; they are advocates, innovators, and partners on the journey to a fuller, more connected life for those with complex communication needs.

Gaitway of Charlotte provides these critical and widely needed assessments and training services to Greater Charlotte. Even if you had a stroke 15 years ago and have been non-verbal ever since, you may benefit from an AAC system.