Busting Myths About Augmentative and Alternative Communication



Speech-language pathologists work with people who have difficulty with speech, language and/or communication. Speech-language pathologists work in a variety of settings including educational settings, medical settings and private practice.

According to the American Speech-Language-Hearing Association, speech-language pathologists assess and treat clients in the “Big 9” areas of articulation, fluency, voice and resonance, receptive and expressive language, hearing, swallowing, cognitive aspects of communication, social aspects of communication and communication modalities.

When a client has either permanent or temporary limited speech, speech-language pathologists may need to complete an assessment for an augmentative and alternative communication (AAC) program or device.

Speech-language pathologists work with clients who could benefit from AAC across the lifespan from infant to older adult and across a range of disabilities including those that could be present at birth (e.g., cerebral palsy, Down’s syndrome, autism), acquired from an injury (e.g., aphasia, dysarthria), or a condition that worsens over time (e.g., ALS, dementia).

Regardless of what setting a speech-language pathologist may choose to work in, they may have a client who requires AAC for some of their daily communication needs. However, there are certain truths and myths about AAC that are important to understand.

What is Augmentative and Alternative Communication?

Augmentative and alternative communication (AAC) are different forms of communication used when someone is not able to meet their daily needs through speech alone. For example, an autistic child may use AAC to help them answer a question at school or play with their classmates. An adult who has recently had a stroke may use AAC to tell their partner they love them or joke with friends at card club. One of the most famous people who used AAC was Stephen Hawking, a brilliant theoretical physicist.

Types of AAC

There are several types of AAC solutions which are generally split into unaided and aided categories. Unaided AAC is any form of communication other than speech that does not require any additional equipment. For example, a speech-language pathologist may teach parents of a young child with Down’s Syndrome how to use sign language with their speech. Sign language is a type of unaided AAC because it only requires the parent’s body to do and nothing else.

Aided AAC is any form of communication that does require additional equipment. Aided AAC can be further divided into low tech and high tech systems. Low tech systems do not have computer parts, like a book with pictures or a printed alphabet board. High tech systems do have computer parts, like an app that speaks text on a mobile device or a computer that speaks the name of a picture while tracking a person’s eyes.

Common Myths about Augmentative and Alternative Communication

The speech-language pathologists at Elmhurst University work with families and professionals who expressed some common misconceptions about AAC. When Elmhurst would bring up the possibility, many families were concerned about the AAC impeding the person’s ability to learn how to use their voice to communicate. We reassured them that anecdotally and from well-designed research studies, this was not actually the case.

Let’s take a look at a few of these myths of AAC, and other common misconceptions:

Myth #1: My child will not learn how to speak if they use AAC

Speaking is much faster than using AAC. Communication rates for people who use AAC are approximately 15-20 times slower than communication rates for people who use typical speech (Beukelman & Mirenda, 2013).

If a child is able to use speech, they will. AAC does not prevent speech development, but may actually support gains in speech. Millar et al., (2006) noted that in well-designed studies, no participants had reduced speech, but actually demonstrated small gains in speech use after using AAC technologies.

Myth #2: My child is not ready for AAC

There are no age, language or cognitive requirements for using AAC. AAC is adaptable to the individual who needs it even for very young children or adults with very limited communication. According to the Communication Bill of Rights (Brady et al., 2016), everyone, including children, has the right to fully participate in in their daily lives through communication, regardless of their differences in ability.

Myth #3: My partner can speak a few words, they don’t need AAC

AAC can be used as a support for speech and not just a replacement. For example, a person may be able to communicate using speech at home with their significant other but may need to use AAC when ordering a drink at a coffee shop. If speech is not sufficient to meet all daily communication needs, a person is then eligible for AAC. Understanding when to use AAC and when to use speech is part of AAC intervention, specifically, strategic competence (Light et al., 2003).

Myth #4: I don’t need to know how to use my partner’s AAC app

It is important that the family, friends or other important people in someone’s life know how to use their AAC. This supports the use of the AAC in daily activities, increases AAC acceptance and improves learning of the AAC device.

For example, one common intervention strategy for AAC is augmented input. During augmented input, the communication partner, such as a caregiver or significant other, uses speech and AAC to communicate to the person who uses AAC. Augmented input interventions can be effective for a range of individuals across different ages, diagnoses, and language abilities (O’Neill et al., 2018); however, in order to do this intervention, the communication partner needs to know how to use the AAC.

Learn More

If you are interested in learning more about speech-language pathology or AAC, please visit the Elmhurst University website for information on the Master of Science in Communication Sciences and Disorders, and fill out the form below so that we can follow up with you.

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About the Author

jenna kremkow

Jennifer Kremkow is an associate professor in the Department of Communication Sciences and Disorders at Elmhurst University. She completed her master’s and doctoral degrees at The Pennsylvania State University with an emphasis in autism, augmentative and alternative communication, child language disorders, and stakeholder training and perspectives. Clinically, Dr. Kremkow has worked as a speech-language pathologist in elementary schools, outpatient clinics, and early intervention settings.


Posted March 26, 2024

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