The AAC Process for a Nonverbal Child

Sep 1

When supporting a nonverbal child, the goal of Augmentative and Alternative Communication (AAC) is to provide them with a reliable way to express themselves, interact with others, and build independence. Below is the general process an SLP follows, along with examples of popular AAC programs and systems.

1. Referral and Case History

The process often begins with a referral—either from a pediatrician, neurologist, developmental pediatrician, or school team. Families share their child’s medical, developmental, and educational history, including communication strengths, motor abilities, and prior interventions.

2. Comprehensive AAC Evaluation

An SLP trained in AAC conducts a thorough assessment, which includes:

Observation in natural environments (school, home, therapy).
Language and Cognitive Assessments to determine receptive skills, symbolic understanding, and potential for language growth.
Motor and Sensory Considerations in collaboration with OT/PT (direct touch, eye gaze, switch access).
Trial Periods with Multiple Systems to see what the child responds to.

Common AAC programs and devices used in trials include:

Proloquo2Go (iOS app, symbol-based with robust vocabulary)
TouchChat HD with WordPower
LAMP Words for Life (based on motor planning and Unity)
Snap + Core First (Tobii Dynavox)
CoughDrop (cloud-based AAC with multiple platforms)
GoTalk NOW
Avaz
TD Snap Motor Plan
PRC Accent devices with Unity/LAMP software
Tobii Dynavox eye-gaze systems for children with limited motor abilities

3. Funding and Insurance

Once an appropriate system is identified, the SLP writes a detailed evaluation report and justification letter. This includes standardized test results, communication needs, and why a specific AAC program/device is necessary.

Funding may come from:

Private insurance
Medicaid
School district (IEP-based provision)
Out-of-pocket or grant funding

Vendors like Tobii Dynavox, PRC-Saltillo, and AbleNet often provide loaner programs and assist with insurance paperwork.

4. Device Acquisition and Setup

When approved, the device is ordered, programmed, and personalized. This includes:

Adding the child’s name, family members, favorite activities, and school vocabulary.
Organizing core and fringe vocabulary for functional communication.
Locking or simplifying settings if needed for beginner communicators.

5. Training and Implementation

AAC success depends on consistent modeling and support. The SLP trains:

Child: How to use the device to request, comment, protest, and engage socially.
Family: How to model AAC at home (using aided language input).
Teachers/Staff: How to integrate the device into classroom routines.

Popular strategies include:

Aided Language Stimulation (modeling on the device while speaking).
Core Vocabulary Approach (teaching high-frequency words like “go,” “want,” “more”).
Routine-Based Programming (embedding device use into daily routines like meals, play, school).

6. Ongoing Therapy and Adjustment

AAC is not “set it and forget it.” Children grow, develop, and change, so devices must evolve with them. The SLP provides:

Regular updates to vocabulary and grid size.
Support for literacy integration (pairing AAC with phonics and reading programs).
Troubleshooting and caregiver training refreshers.
Collaboration with the IEP team to ensure AAC use across settings.

7. Long-Term Outcomes

With consistent support, children who use AAC often develop stronger communication, increased independence, and, in some cases, improved verbal speech. The ultimate goal is always functional communication—helping the child say what they want, when they want, to whoever they want.

✅ Key Takeaway: The AAC process is highly individualized. By trialing multiple systems—like Proloquo2Go, TouchChat, LAMP Words for Life, Snap + Core First, Avaz, and PRC/Tobii Dynavox devices—and providing consistent training for families and schools, SLPs can give nonverbal children a voice that grows with them.

Nicolette Contella