AAC and Functional Communication in Children: Devices, Goals, Examples, Assessment & Activities

AAC & Functional Communication

Helping Children Communicate in Every Way

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Definition AAC Support AAC Types Functional Communication Signs a Child May Benefit from AAC Device AAC Myths vs. Evidence Speech Therapy for AAC Support AAC and Functional Communication Assessment AAC and Functional Communicartion Goals AAC and Functional Communication Activities AAC and Functional Communication FAQ

Definition

What Are AAC and Functional Communication?

AAC supports functional communication by giving children reliable ways to express wants, needs, thoughts, feelings, choices, questions, and ideas. Communication is more than spoken words. Children may communicate through speech, gestures, facial expressions, signs, pictures, objects, communication boards, speech-generating devices, writing, or a combination of methods.

AAC or augmentative and alternative communication refers to the tools, strategies, and supports that help a child communicate when speech alone does not fully meet their communication needs. AAC is used to support functional communication. Functional communication means communication that works in real life. It allows a child to express needs, make choices, reject or protest, ask for help, share feelings, comment, greet others, answer questions, participate in routines, and connect socially with other people. Many children use AAC together with speech, gestures, signs, facial expressions, body language, and other communication methods. A child may use AAC to communicate when they:

request something they want

say “no,” “stop,” or “all done”

ask for help

make a choice

greeet a person

comment on something interesting

answer a question

tell someone they are hurt, tired, excited, or upset

share an idea, opinion, joke, or story

The goal of using AAC is not to use a device alone. The goal is use the device to help increase functional communication, help a child communicate with different people, across different places and for different functions.

AAC Support

How Does AAC Support Functional Communication?

AAC supports functional communication by giving a child tools to express ideas in ways different from traditional spoken language. A child may already communicate through facial expressions, body language, sounds, gestures, behavior, or speech. AAC builds on those existing communication attempts and gives the child additional ways to communicate.

For example, a child may use AAC to point to “more” during snack, select “stop” during a loud activity, use a picture to ask for help, choose a toy from a communication board, or use a speech-generating device to tell a peer, “I want to play.”

AAC Support

Functional Communication Intent

Picture choice board

Helps the child make choices during snacks, play, or routines

“Stop”, "no" or “all done” symbol

Helps the child reject, protest, or end an activity appropriately

Speech-generating device

Helps the child use common functional words such as go, stop, more, help, want, like, not, and turn

Visual schedule

Helps the child understand and communicate about routines and transitions

AAC is most effective when it is treated as part of the child’s whole communication system. Speech, gestures, signs, pictures, body language, writing, and devices can all work together to support functional communication.

AAC Types

What Types of AAC Can Children Use?

AAC can be no-tech, low-tech, mid-tech, or high-tech. Many children use more than one type depending on the situation, communication partner, environment, and message.

No-Tech AAC

No-tech AAC does not require equipment. It includes communication methods that use the child’s body, movement, expression, or natural gestures. Some examples include:

facial expressions

eye gaze

reaching

pointing

gestures

head nodding or shaking

body language

Low-Tech AAC

Low-tech AAC uses tools that do not require batteries or electronics. These supports can be portable, and easy to use across routines.

Low-Tech AAC Support

Examples

Communication board

A page with pictures, symbols, words, or choices

Picture cards

Snack choices, activity choices, feelings, people

Object symbols

Spoon for snack, shoe for outside, book for reading

Visual schedule

Pictures showing what happens first, next, and last

Communication Book

Organized pages of words, symbols, or phrases

Choice board

Two or more options the child can point to or select

High-Tech AAC

High-tech AAC uses electronic tools that may produce voice output or allow complex message creation.

speech-generating devices

tablet-based AAC apps

dedicated communication devices

eye-gaze systems

switch-access systems

keyboards or text-to-speech tools

dynamic display systems with multiple pages

Multimodal Communication

Multimodal communication means the child uses more than one way to communicate. A child may use speech for familiar words, gestures for quick messages, a picture board during snack time, a device at school, signs during play, facial expressions to show emotion, and writing or typing for academic tasks.

Functional Communication

What Needs Can AAC Help a Child Communicate?

AAC should support a wide range of functional communication. Requesting is important, but it is only one part of communication. Children also need ways to protest, comment, ask questions, share feelings, participate socially, and repair breakdowns.

Requesting and Choice-Making

Requesting helps a child ask for what they want or need. Choice-making helps a child express preferences and make decisions. Requesting is often an early AAC target. Examples include: “more”, “want bubbles”, “apple”, “go outside”,“that one”,“I want blue”, of choosing between two activities.

Rejecting, Protesting, and Saying No

Children need to learn ways to reject, protest, and stop an activity. Being able to say “no” is part of communication autonomy. Examples include: “no”, “stop”, “all done”, “not that”, “I don’t want it”, “too loud”, or “finished”. A child who cannot reject may show challenging behavior to communicate discomfort, refusal, fear, fatigue, or frustration.

Asking for Help and Repairing Breakdowns

Functional communication includes knowing how to ask for help and what to do when someone does not understand. Examples include: “help”, “open”, “I need help”, “wait”, “I don’t know”, “say it again”, “not that one”, “I mean this”, “look at my board”, or “let me show you”

Commenting and Sharing Ideas

Commenting helps children connect socially and share ideas. For example: “fun”, “big truck”, “I like it”, “that’s funny”, “look”, “I see dog”, “my turn”, “it’s loud”, “I made it”, or “she is sad”

Social Communication

AAC can also support social interaction and pragmatic functions. Children may use AAC to greet others, say goodbye, ask a peer to play, take turns, make a joke, share feelings, tell news, participate in group routines, express opinions, advocate for themselves.

Operational, Linguistic, or Social Skills

Children who use AAC build multiple skills at a time, they learn about the device, learn the language system and different communication functions:

AAC Skill

What It Means

Operational

Learning how to access and use the AAC system

Linguistic

Learning symbols, words, grammar, and syntax

Social

Using AAC with people for interaction and participation

Signs a Child May Benefit from AAC

Signs a Child May Need AAC to Support Functional Communication

A child may benefit from AAC when their current communication does not meet their needs across daily routines. This does not mean the child has no speech. AAC may help children who are nonspeaking, minimally speaking, inconsistently speaking, difficult to understand, or unable to communicate efficiently in certain environments.

AAC for Toddlers

A toddler may benefit from AAC if they:

use very few words or symbolic messages

rely mostly on crying, pulling, grabbing, or leading adults by the hand

have difficulty making choices

cannot consistently request help, more, stop, or all done

use behavior to escape, protest, or gain access to items

have speech that is not clear enough for daily needs

need visual supports to participate in routines

AAC for Preschool Children

A preschool child may benefit from AAC if they:

have limited spoken language for their age

use words but cannot communicate a range of needs and ideas

repeat words or scripts but have difficulty using language in different settings

have difficulty answering questions or making choices

have speech that unfamiliar listeners do not understand

need support communicating during transitions, meals, toileting, play, or preschool routines

AAC for School-Age Children

A school-age child may benefit from AAC if they:

cannot communicate in the classroom

have speech that is difficult to understand in groups or noisy settings

need support answering questions or participating in lessons

cannot ask for clarification, repetition, help, or a break

rely on adults to speak for them

have limited access to academic vocabulary or classroom participation

need support for written, spoken, or multimodal expression

need support self-advocating across classes or community settings

AAC Myths vs. Evidence

AAC Myths: What Families Should Know

Many families worry that AAC means giving up on speech or that a child must be older before AAC can be introduced. Current evidence-based guidance does not support these myths.

Myth

Explanation

AAC is only for children who do not talk.

AAC can support children with no speech, limited speech, unclear speech, unreliable speech, or speech that does not meet all communication needs.

AAC will stop my child from talking.

AAC does not have to replace speech. It can support communication and may support language and speech development for some children.

AAC is a last resort.

AAC can be introduced early when a child needs support communicating.

A child must prove readiness first.

There are no required prerequisite skills before considering AAC support.

High-tech AAC is always better.

The best system depends on the child’s communication, access, sensory, motor, language, and social needs.

AAC is only for requesting.

AAC should support many functions, including commenting, refusing, asking questions, social interaction, and self-advocacy.

Using AAC means adults should stop modeling speech.

AAC is part of multimodal communication. Speech, gestures, signs, pictures, and devices can all be supported together.

Speech Therapy

How Speech Therapy Uses AAC to Support Functional Communication

Speech-language pathologists support children who use AAC and children who need help with functional communication. Therapy is individualized based on the child’s communication profile, strengths, motor access, sensory needs, language skills, family priorities, school routines, communication partners, and daily environments.

Speech therapy for AAC includes helping the child communicate for functional purposes with real people across everyday routines. Speech therapy may focus on:

identifying the child’s current communication methods

labeling and identifying AAC symbols and pictures

building functional vocabulary

increasing AAC use for different communication functions

modeling AAC use during routines

teaching communication partners how to respond

training caregivers on AAC use

supporting literacy and written communication when appropriate

AAC and Functional Communication Assessment

What Happens During an AAC and Functional Communication Assessment?

An AAC and functional communication assessment is a comprehensive, multidisciplinary process that evaluates a child’s current communication abilities and identifies supports needed to improve communication effectiveness across natural environments. It systematically examines the interaction between the individual, communication partners, environments, and tasks. Consideration is given to access methods, vocabulary requirements, cultural and linguistic factors, and functional participation goals. A comprehensive AAC and functional communication assessment may include:

caregiver and family report of communication strengths, needs, and priorities

input from educators and related service providers

developmental, medical, and communication history

hearing and vision status and implications for access

current speech production and intelligibility

existing communication modalities, including gestures, signs, vocalizations, words, and behaviors

receptive and expressive language abilities

social communication and play skills

motor abilities related to access (e.g., direct selection, eye gaze, switch access)

sensory processing factors that may influence communication access and use

symbol comprehension and preferences (e.g., objects, photographs, line drawings, text)

structured and dynamic trials with no-tech, low-tech, and high-tech AAC systems

observation across natural contexts (e.g., meals, play, classroom routines, peer interactions)

identification of functional communication needs across settings and partners

vocabulary analysis for home, school, therapy, and community participation

cultural and linguistic considerations, including language exposure and use

child preferences, motivation, and self-report when feasible

AAC assessment is iterative and collaborative, often requiring ongoing data collection, system trials, and adjustments to optimize communication outcomes. Modifications may include changes to access methods, vocabulary organization, system features, and communication partner supports. For multilingual children, assessment should incorporate all languages used in the child’s daily environments. AAC systems should support culturally and linguistically relevant communication to promote meaningful participation across contexts. The selection of an AAC system should be guided by functional outcomes rather than technological complexity. The most appropriate system is one that the child can access efficiently, learn over time, and use effectively to communicate across everyday routines and interactions.

AAC Goals

AAC Goals for Functional Communication in Speech Therapy and IEPs

AAC goals should be specific, measurable, functional, and directly related to the child’s functional communication needs. Strong goals should focus on communication outcomes, not just touching icons or using a device in isolation. A SMART AAC-supported functional communication goal should describe:

time reference

specific skill being targeted

context or activity

level of support

measurable outcome

how progress is measured

AAC Area of Need

SMART Goal Example

Requesting AAC Goal

By the next review period, during meals, play, or classroom routines, the child will request a preferred item or activity using speech, sign, picture, gesture, or AAC picture board, in 4 out of 5 opportunities, given modeling as needed.

Rejecting and Protesting AAC Goal

By the next review period, during daily routines, the child will make a functional message such as “no,” “stop,” “all done,” or “not that” using speech, sign, picture, or AAC board, in 4 out of 5 opportunities.

Choice-Making AAC Goal

By the next review period, given two or more options, the child will make a choice using eye gaze, pointing, gesture, picture selection, or AAC board, in 4 out of 5 opportunities across three routines.

Requesting Help AAC Goal

By the next IEP, during classroom or therapy tasks, the student will request help using speech, a visual support, or AAC system in 4 out of 5 opportunities, given no more than one prompt.

Making Comments AAC Goal

By the next IEP, during play, book reading, or classroom activities, the student will make a comment using speech, sign, picture symbols, or AAC in 4 out of 5 opportunities, given aided language modeling.

Core Vocabulary AAC Goal

By the next IEP, during structured tasks and routines, the student will use target core vocabulary words (e.g., go, stop, more, help, want, like) on their AAC device, across three different activities with 80% accuracy.

Operational AAC Goal

By the next IEP, given access to their AAC system, the student will navigate to a familiar vocabulary page or symbol category to communicate a functional message in 4 out of 5 opportunities, given minimal support.

AAC and Functional Communication Activities

AAC Activities That Support Functional Communication

AAC intervention should be embedded within naturalistic routines and contexts. Evidence-based practice supports providing frequent, functional communication opportunities with responsive communication partners who model language and respond contingently to the child’s communicative attempts.

AAC Activities for Toddlers

Try activities such as:

providing structured choice-making opportunities during routines such as snack or play

modeling core vocabulary (e.g., “more,” “go,” “stop,” “all done”) using aided language input

pairing gestures with spoken language to support multimodal communication

using simple picture-based choice boards or object symbols

incorporating expectant pauses within familiar routines to prompt communication

engaging in predictable routines such as “ready, set, go”

using motivating, cause-and-effect activities (e.g., bubbles, songs, toys)

responding consistently and contingently to all communicative attempts

For example: During a bubble activity, the communication partner models “more,” “go,” “stop,” and “again” using a picture board or AAC system. The partner pauses before continuing the activity to create an opportunity for the child to initiate communication.

AAC Activities for Preschoolers

Try activities such as:

embedding AAC use within symbolic and pretend play routines

modeling descriptive vocabulary during shared book reading

facilitating choice-making during structured classroom activities

using visual schedules to support transitions and predictability

incorporating communication boards during daily routines such as snack time

introducing emotion vocabulary within stories and play contexts

prompting functional communication such as requesting assistance during activities

For example: During pretend kitchen play, the communication partner models phrases such as “I want,” “eat,” “hot,” “more,” “help,” “my turn,” and “all done” using the child’s AAC system. The child may respond using speech, sign, symbols, or a speech-generating device.

AAC Activities for School-Age Children

Try activities such as:

integrating AAC use into classroom routines such as attendance and morning meeting

supporting participation in shared reading and academic discussions

facilitating functional requests for assistance during academic tasks

promoting use of core vocabulary across curricular areas

developing personalized messages for social interaction with peers and staff

using visual supports or scripts to scaffold classroom participation

teaching self-advocacy language within structured contexts

supporting communication in community-based and vocational contexts

teaching repair strategies for interactions with unfamiliar communication partners

expanding vocabulary related to personal interests, employment, and future goals

supporting expression of opinions, humor, and identity

For younger students, during a science lesson, the communication partner models and supports use of phrases such as “I think,” “look,” “different,” “same,” “because,” “help,” “I know,” and “I have a question” to facilitate participation. For older students, prior to a group project, the students may prepare messages such as “What should I do?” “I agree,” “I need more time,” “Can you explain?” and “My idea is…” using their AAC system.

Data Collection

Data Collection for Communication and Language Goals

SLPs often need to document not only whether a student performed a skill, but how much support was needed, how consistently the skill occurred, and whether the skill generalized across people, materials, or settings.

Accuracy and trials

Prompt level and cueing type

Level of independence

Frequency, duration, and rubric scores

Spontaneous use and generalization

See Data Collection Tools

Documentation

Documentation Examples for SLPs

Accurate documentation helps SLPs summarize what was targeted, how the student performed, what supports were needed, and how therapy connects to functional communication.

SOAP notes and session notes

Caregiver updates

IEP goal documentation

Evaluation summaries

Progress reports and present levels

Explore Documentation Features

Workflow

From Goal Writing to Progress Reports

Receptive language therapy is not one isolated session, it requires strcutured and individualized approach. iSpeax is designed to support complete workflow from goal setting to intervention, data, collection, documentation management, finance, scheduling and more.

Choose communication skill

Write measurable goals

Plan therapy activities

Collect session data

Document progress

Generate reports

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AAC Questions and Answers

AAC and Functional Communication FAQ

What is AAC?

AAC stands for augmentative and alternative communication. It includes tools and strategies that help a person communicate when speech alone is not enough. AAC may include gestures, signs, pictures, communication boards, apps, speech-generating devices, writing, or other supports.

What is functional communication?

Functional communication is communication that helps a child participate in daily life. It includes requesting, protesting, choosing, asking for help, commenting, greeting, answering, sharing feelings, repairing misunderstandings, and connecting socially.

How does AAC support functional communication?

AAC supports functional communication by giving a child reliable ways to communicate messages in daily life. AAC may help a child request, refuse, comment, ask for help, answer questions, participate socially, and advocate for themselves.

Is AAC only for children who do not talk?

No. AAC can support children who do not speak, speak very little, speak inconsistently, are hard to understand, or need communication support in certain settings. AAC can be used along with speech.

Will AAC stop my child from talking?

AAC does not have to replace speech. It can support communication while speech and language continue to develop.

Is my child too young for AAC?

No. Children do not need to wait until a certain age to use AAC. AAC can be considered whenever a child’s current communication methods are not meeting their needs.

Does a child need prerequisite skills before AAC?

No. A child does not need to prove readiness before AAC is considered. The AAC system and support is matched to the child’s current communication, access, sensory, motor, and language needs.

What is the difference between low-tech AAC and high-tech AAC?

Low-tech AAC includes tools such as pictures, communication boards, objects, visual schedules, and communication books. High-tech AAC includes electronic tools such as speech-generating devices, AAC apps, eye-gaze systems, or switch-access systems.

What is a speech-generating device?

A speech-generating device is a type of AAC system that produces spoken output when the child selects a symbol, word, phrase, or message. It may be a dedicated device or a tablet-based AAC app.

What is core vocabulary in AAC?

Core vocabulary includes high-frequency words that can be used across many situations, such as go, stop, more, help, want, like, not, turn, look, and all done. Core words help children communicate across different settings.

Should AAC be used only during therapy?

No. AAC should be available across daily life, including home, school, therapy, play, meals, routines, peer interaction, and community settings. Communication access should not be limited to one room or one provider.

Speech-Language Pathology Areas

Communication and Language Areas

Explore all communication and language areas that speech-language pathologists help with:

Receptive Language

Understanding directions, concepts, questions, vocabulary, and spoken or written language.

Expressive Language

Using words, phrases, sentences, grammar or narratives.

Pragmatic Language

Social communication, conversation, perspective-taking, greetings, topic maintenance, and social interaction skills.

Early Language Development

Joint attention, imitation, play, gestures, first words, and early communication routines.

Articulation & Phonology

Speech sound production, intelligibility, phonological patterns, speech sound acquisition and generalization.

AAC

AAC & Functional Communication

Communication through gestures, signs, picture systems, speech-generating devices, or multimodal communication.

Support AAC and Functional Communication with iSpeax

iSpeax helps speech-language pathologists, educators, and therapy teams organize AAC support, track functional communication progress, and manage documentation in one connected workflow.

From communication boards, AAC devices, core vocabulary, requesting, protesting, commenting, and choice-making to self-advocacy, communication repair, and social connection, iSpeax helps providers connect AAC intervention planning to meaningful data and streamlined documentation.

Whether you are supporting students who use speech, gestures, signs, pictures, or speech-generating devices, iSpeax helps turn communication data into organized notes, progress updates, caregiver-friendly summaries, and compliant reports.

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