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AAC

AAC: communicating without speech

AAC (augmentative and alternative communication) means any way of communicating that isn't speech, or that adds to it: signing, symbols, books and apps.

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What is AAC?

It covers a wide range. Some children use Makaton-style signs or gestures. Some point to pictures or symbols, or use a communication book. Others use an app or a device that speaks when they touch a symbol. Many children use a mix, and what they use can change over time.1

AAC is for children who don't use speech yet, whose speech is hard for others to understand, or who find speaking exhausting or unreliable in some situations.2 It can support an autistic child, a child with a physical disability, a child with apraxia and plenty of others.

My view is that AAC doesn't stop speech from developing, and the research I know of backs that up. Two reviews found that AAC did not hold back speech: in the better-controlled studies none of the children's speech got worse, and most spoke a little more, although the gains were modest and the studies were small.3,4 Giving a child a way to say what they mean takes pressure off. Speech comes for some children and not for others, and either way they have a way to be heard.

Bright window and swing chair at the Wanstead clinic
somewhere to try things out

When might AAC be worth thinking about?

  • Your child has few or no words and is getting frustrated.
  • They communicate by pulling you to things, crying or having meltdowns.
  • People outside the family struggle to understand them.
  • They can say words sometimes but not when they need them most.
  • They already use signs or pictures at nursery or school and you'd like to join in.
  • You're unsure whether a device or app is the right choice.

How do you choose AAC?

  1. Watching how they already communicate

    Every gesture, look, sound and sign counts. I start with what your child does and build from there, before any device comes into it.

  2. Trying options together

    We try signing, symbols, a book or an app and see what your child enjoys and can use. There's no single right system. I'll tell you honestly what I think fits and why.

  3. Making it work at home and school

    AAC only works if the people around your child use it too. I can coach you, and I can visit or train staff at nursery or school. I do coaching and school training online or in person.

Whatever a child uses to say "I want that", "no" or "look at me", I treat it as their voice and help other people hear it.

What does it cost?

  • Free15-minute call
  • £270Assessment
  • £85Therapy, per hour

The assessment doesn't include a written report; that's £95 extra if you want one. A block of eight sessions is £680. Everything is on the fees page, and you can email me with questions first.

Questions parents ask

Will AAC stop my child talking?

No. Reviews of the research have found that AAC does not get in the way of speech developing, and in most studies speech gained a little.3,4 It also often gives children the confidence and understanding to try. Some children go on to use more speech, some don't, and both are fine.

What kinds of AAC are there?

Signing and gesture, picture symbols, communication books and boards, and apps or devices that produce speech. I'll help you work out which suits your child.

Can school learn it too?

Yes, and they should. I can visit, show staff how to model it and help them make it part of the day. See the schools page.

Do I need a referral?

No. You can book a free call or email me directly. Seeing me doesn't take your child off an NHS waiting list either.

References

Sources checked on 18 October 2026.

  1. Communication Matters. (n.d.). About AAC systems. https://www.communicationmatters.org.uk/about-aac-systems/ ↩
  2. Royal College of Speech and Language Therapists. (n.d.). Augmentative and alternative communication (AAC) overview. https://www.rcslt.org/speech-and-language-therapy/clinical-information/augmentative-and-alternative-communication/ ↩
  3. Millar DC, Light JC, Schlosser RW. (2006). The impact of augmentative and alternative communication intervention on the speech production of individuals with developmental disabilities: a research review. Journal of Speech, Language, and Hearing Research, 49(2), 248–264. https://doi.org/10.1044/1092-4388(2006/021) ↩ ↩
  4. Schlosser RW, Wendt O. (2008). Effects of augmentative and alternative communication intervention on speech production in children with autism: a systematic review. American Journal of Speech-Language Pathology, 17(3), 212–230. https://doi.org/10.1044/1058-0360(2008/021) ↩ ↩

Related services

Not sure where to start with AAC?

A free 15-minute call is enough to talk through what your child does now and what might help.

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Pick the one that fits. Booking and payment happen together, in the same place, via Calendly.

Not sure? Start with the free call — it costs nothing and commits you to nothing. School visits, training, meetings and Tribunal work are arranged by email, because the fee depends on the hours and the travel.