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Alternative communication tools

Communication can be difficult for some autistic people. Every autistic person will have their own preferred method of communication. Non-vocal individuals may use an Alternative and Augmentative Communication (AAC) system to communicate their needs, thoughts, observations and motivations.

AAC is an individual’s voice and should always be with them.

AAC may be someone’s only method of communication, their main method of communication or their back up method of communication.

There are several different methods of AAC

Aided: These are communication methods that use additional items, for example objects, pictures, or Apps on devices like an iPad or tablet.

Unaided: These are communication methods that do not require additional aids. For example, body language and signing systems such as Makaton.

High tech: These are communication methods that require technology to power them, for example tablet or iPad Apps and VOCAs (voice output communication aid).

Low tech: These systems do not use additional technology, for example communication books or boards, Makaton, gesture, Picture Exchange Communication System (PECS) books.

There is cross over between these categories:

Unaided (examples) Aided (examples)
Low-tech (examples) Makaton
Body language
Letter board
Communication book
Communication board
High-tech (examples) Proloquo2Go


A Speech and Language Therapist can support in identifying the best system for an individual.

High-tech AAC is not better than low-tech AAC, it is about finding the best communication method for your child.

If using a high-tech AAC system, there must also be some access to a low-tech method. This is because technology can break or run out of battery and if this happens it will leave an individual without a voice.

Top tips for communication partners

A communication partner is anyone who communicates with an individual.

  • Come down to the child’s level/be in their eye line: Being at the same level encourages engagement, joint attention and conversation. Think about position. Can you both see each other, access preferred objects and the AAC system?
  • Follow their interest: Join in with what they are doing and what they are focused on. You can use their communication book or board to comment on what they are doing as well as your voice. This will model appropriate use of their AAC system to them.
  • Model: Use their AAC system when engaging with them e.g. if you are playing with trains, pick out the picture/icon or point to the button on their device that says ‘train’. This will help them to develop their language using their system. When commenting and sharing attention, say the words as you point to them. Use repetitive routines and events to encourage repeated exposure to language and use of AAC.
  • Allow processing time: Give a count of 10 in your head before prompting a response.
  • Embrace silence: You do not have to fill the silence with endless chat and comments. Give them time to process and consolidate what you have modelled to them.
  • Respond to everything: All actions and vocals are communication. Remember to respond to these to show how important all communication is. Respond to them either verbally or by using their AAC system. Comment on what you think they want or what they are looking at, as this provides a model. Don’t worry if your modelling is slow this can help increase processing time and understanding. Be patient with your child (and yourself!) as teaching a new type of communication can be a lengthy process.
  • Support generalisation of communication by accessing a range of communication partners: Do this by practising communication with siblings, family members, peers, teachers and other professionals they may interact with.
  • Use everyday opportunities to comment on things: E.g., when taking a walk in the park.
  • If they communicate a word, model this back: And add a word, for example if they comment by pointing to their car picture, you might say and point to ‘big car’.

5 points to remember:

  • Make sure the AAC system is always available. This is an individual’s voice!
  • Make it fun
  • Model
  • Use it as much as possible
  • Repeat, repeat, repeat


If you are concerned about your child’s communication, contact your GP, Health Visitor or education setting, for advice on how they can make a referral. Alternatively, you can contact your local NHS Speech and Language Therapy service. Our Roles of professionals factsheet can also help you to navigate who to go to for support with communication.

How to contact a Speech and Language Therapist?

You can contact a Speech and Language Therapist through your local NHS service website, or you can request a referral to a Speech and Language Therapy service via your GP, Health Visitor or Education Setting. Alternatively, you can access private speech and language therapy input by searching the Association of Speech and Language Therapists in Independent Practice. (ASLTIP) website. (

You can also access support, information and advice on AAC through the Communication Matters website:

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