I’ve been working on this post for several months, and I finally finished it! It’s been a bit hard to write things since the most recent brain injury, as there’s been a few health issues since – seizures, worsening complex migraines that mimic strokes, and most recently a diagnosis of Ehlers-Danlos Syndrome (although that’s been suspected for a very long time). Please be patient with me as I try to make a post that makes sense. I’ll probably periodically update this as I find resources.

 

I wanted to put together a sort of guide to different types and options for augmentative and alternative communication (AAC). I hope it helps!

It’s important to note that people can use AAC for a variety of reasons: autism, aphasia, cerebral palsy, traumatic brain injury, etc. Some people use it full time, while others use it to supplement speech when mouth words alone aren’t as effective for communication. Everyone can benefit from AAC, and AAC is for everyone!

Augmentative and alternative communication is essentially any communication that doesn’t involve mouth words. Most people think of apps and high tech, but there are many other forms of AAC too! Using a dry erase board, texting, picture communication symbols, etc – all are forms of AAC. Even this post can be considered AAC! Not only that, but there are a lot of ways to help make AAC accessible. There are options such as eye gaze (using eyes to select things on the screen), laser pointers with communication boards, having an aide help, switches to help choose things (switches can also help people operate toys too!),  and tactile options too.

Note that every person is different, and there isn’t one AAC that works for everyone. Some people even use more than one system to help communicate or to supplement speech! 

The most important thing to remember is that communication is a human right. Mouth words are not “superior” to any other form of communication, and all forms of communication should be valued.

The focus should be on providing quality and accessible communication that suits each person’s needs, not conforming to speech alone.

For me personally, I use various types of AAC – Proloquo2Go, Proloquo4Text, TD Snap, and light tech options as back-ups and also to help supplement. I’ve used SpeechAssistant, CoughDrop, and others  before in the past as low-cost AAC options, and those were also decent – in case anyone is looking for high tech AAC ideas that are more budget friendly. Also: don’t forget about discounts during April/October!
I just found the AssistiveWare and TD Snap systems a little more intuitive for my brain. Others may find the other options a better fit – remember, everyone is different!

I used to be mostly a part-time AAC user until more recent traumatic brain injuries (current tally is now five; I’ll update you all on that when it’s legal to) and other neuro issues – and as of updating this in November 2020, I’m no longer able to rely on speech to communicate effectively for long periods of time at all. So… AAC it is for me!

And now: here are some options for AAC if you’re interested! I’ve listed some light-tech and high-tech options.

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Light Tech Options:

Unaided AAC (without tools)

• Sign Language
  • Many people can benefit from sign language!
  • Sign language varies by region. There’s an American Sign Language, British sign language, etc.
  • It’s important to note that there’s some valid and very sound arguments that sign languages are not AAC – because for many Deaf/HoH people, it’s simply just another language with cultural significance/value. I’ve included it here in case someone finds signs beneficial to use as AAC, but keep in mind that it’s not quite universally seen as a form of AAC.

• Body Language
  • This can be hard to read sometimes, but it is a form of communication that most people do – whether you use speech or not.
  • Bonus: stimming can fit into this! For example, the way I flap my hands can tell someone a lot about how I’m feeling/trying to communicate something.

• Facial Expressions
  • Again, this is hard for me personally to read – but it’s often used to convey things without using mouth words. Therefore – AAC!

Aided AAC (with tools)

• Dry Erase Boards
• Paper and Pen or Pencil
• Magna Doodles and Boogie Boards
  • Remember those toys that you can write on and just slide to erase? Those can be a form of AAC too!

• Letter boards and communication boards
  • These often are boards (sometimes laminated) with letters, words, and pictures that an individual can point to or use other methods of indicating their choices.

• Picture Communication Symbols 
  • These can be used with visual schedules or to help someone convey emotions or a want/need. Make sure you use these to help with communication, not as a tool for exchanging/making someone “earn” things. I’m not a fan of the PECS program as it was designed, as it’s very ABA-based and limited in vocabulary.

• Color Communication Cards
  • I mentioned these in my Managing/Preventing Meltdowns post, but they definitely deserve a second look. The colors help indicate the person’s current mood or ability for communication – and helps give them control over social situations. You can learn more about them here: https://autisticadvocacy.org/2014/02/color-communication-badges/

• Clothing, Objects, Accessories
  • Some people have made bracelets with AAC options on them, while some people have creatively used things like t-shirts with emojis on them or even just carrying a favorite comic and pointing to scenes that help communicate how they feel.

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High-Tech Free and Low-Cost Options:

• Emergency Chat (Free; iOS and Android)

  • 

    A texting-style app where the device is passed between users. No voice output.

  • http://leonardelezi.com/emergencychat/

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• LetMeTalk (Free; iOS and Android)

  • 

    Symbol-based app. Has voice output.

  • Not very robust.
  • https://www.letmetalk.info/

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• Cboard (Free; iOS, Android, and computers – it is web-based and mainly used through a browser, but does have an app through GooglePlay)

• • Symbol-based, supports 33 different languages. Cboard is an open source project and web-based, so it’s mainly accessed through an internet browser. However, there’s offline support for Google chrome on desktop computers and Android (which has an app available).
  • Not very robust.
  • https://www.cboard.io/

• I Can Communicate! (Free; Android only)

  • Symbol-based app, with option for typing. Has voice output.

  • Not very robust
  • https://www.icancommunicateapp.com/

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• Verbally (Free; iOS only)

  • 

    Text-based app, with option for typing. Has voice output.

  • http://verballyapp.com/index.html
  • Note: a premium version does exist, but it’s $99.

• Speak My Mind  ($9.99 a month after a 1 month free trial; iOS only)
  

   

  • Picture-based AAC that uses a word-association design. Also has the traditional grid-style if the regular version is not helpful.
  • https://speakmymind.wixsite.com/speakmymind

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• SpeechAssistant AAC (Free on Android; $11.99 for iOS)

  • 

    Text-based app, with option for typing – and adding your own pictures.

  • https://www.a-soft.nl/
  • Note: the iOS version costs, but also has more features.
    

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• ChoiceWorks App ($6.99; iOS only)

  • 

    Not an AAC app in the traditional sense, but allows to create interactive visual schedules that can be beneficial.

  • http://www.beevisual.com/
  • Note: there is also a version that has a visual calendar that is nice, but it is only for iPad – and costs $4.99.

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• Tiimo (monthly $4.49, annual $28.99; iOS and Android smartphones/smartwatches)

• • Similar to ChoiceWorks, this is also not exactly an AAC app. However, this would be considered assistive technology – and might be something that neurodivergent people would find useful. It also uses visual schedules for daily routines – but also allows for flexibility, has a larger variety of features (including being able to pair with a watch), and has a color ring that works like a visual timer to help show how much time is left.
  • https://www.tiimoapp.com/

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High-Tech Moderate to High Cost

• FlipWriter (iPhone version $24.99; full iPad version is $49.99)

  • 

    Text-based app with typing. Not symbols. Text is displayed upside down in addition to regular text box, so that someone across from the user can read it.

  • https://www.flipwriteraac.org/

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• TD Snap (formally Snap Core First) ($49.99 for iPad, $199.99 for Windows; iPad and Windows  – has a free version without speech ability)

  • 

    Symbol-based app with core words and fringe, has option for typing with predictive text-style picture options. The grid size can be adjusted, and there’s an option for other page sets such as an Aphasia page set (comes with a digital white board to help describe things), the ability to purchase PODD, and others.

  • https://us.tobiidynavox.com/pages/td-snap
  • Note: this app sometimes goes on sale during April and October, usually 15% off.
  • Tobii Dynavox has other apps and dedicated devices/software as well, but they can get really pricey and you might want to consult an SLP for those in order to help get funding. Tobii Dynavox also does a lot of eye-gaze related technology.
    

• GoTalk NOW ($100; iOS only)

  • 

    Symbol-based app, has visual scene pages. I’ve been told there is an option for a free trial where you can only save five pages, but I haven’t found it on the website yet.

  • Not as robust as I’d like it to be.
  • https://www.attainmentcompany.com/gotalk-now
  • Note: there is an app made by the same company for the Apple Watch called GoTalk Wow – which is $49.99.

• Proloquo4Text ($119.99; iOS and Mac only)

  • 

    Text-based app with typing. Allows to save phrases, can customize topics and backgrounds. Large option for voices and can be personalized. Works on both iPhone and iPad – and option for Apple Watch.

  • https://www.assistiveware.com/products/proloquo4text
  • Note: this app sometimes goes on sale during April and October, usually 50% off.
  • Also: this is one of the apps I use!

• Proloquo2Go ($249.99; iOS and Mac only, can sometimes get it on dedicated devices)

  • 

    Symbol-based app and robust, with option for typing. Boards keep the core words static so that it’s easier to remember where they are – but grid sizes can be adjusted too. Large option for voices and can be personalized. Works on both iPhone and iPad – and option for Apple Watch.

  • https://www.assistiveware.com/products/proloquo2go
  • Note: this app sometimes goes on sale during April and October, usually 50% off.
  • This is the other AAC app I use that’s symbol-based! My grid size for my AAC tablet is much larger than the picture you see on the example there, so I can access a lot of words much faster. 

• LAMP Words for Life ($299.99; dedicated devices and iPad)

  • 

    Symbol-based app, very high focus on motor planning and robust. Various voice options.

  • https://www.prentrom.com/prc_advantage/lamp-words-for-life-language-system and also https://aacapps.com/
  • Note: this app sometimes goes on sale during April and October, usually 50% off.

• TouchChat with WordPower ($299.99; iOS only, can sometimes get it on dedicated devices)

  • 

    Symbol-based app with voice output, very robust. Like Proloquo2Go, you can make phone calls in the app!

  • https://touchchatapp.com/apps/touchchat-hd-aac-with-wordpower
  • Note: this app sometimes goes on sale during April and October, usually 50% off. There are a few other versions also available on the website that are lower cost
    

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• Speak For Yourself AAC ($299.99; iOS only)

  • 

    Symbol-based app and robust, various voice options.

  • https://www.speakforyourself.org/
  • Note: this app sometimes goes on sale during April and October, usually 50% off.

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As I find more things to add to this, I will! There’s probably lots more out there that I haven’t heard of yet, but I’ll update as I’m able.

All images, prices, and descriptions are accurate as of when I first published this. Images come from the official websites of the apps themselves.

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Resources

Favorite AAC Users’ Blogs, Social Medias, and Websites:

• https://anotherqueerautistic.wordpress.com/category/aac/
• https://www.instagram.com/nigh.functioning.autism/
• https://autisticaacunderground.blogspot.com/
• https://www.instagram.com/spellingwithwill/
• https://turtleisaverb.blogspot.com/
• https://www.instagram.com/afriendforlillybug/
• http://yesthattoo.blogspot.com/
• https://www.rhemashope.com/

First-hand Knowledge from AAC Users and Nonspeakers:

• LISTEN: a short film made by and with nonspeakers
  • https://communicationfirst.org/LISTEN/ 

• This Is Not About Me
  • https://thisisnotaboutme.film/

• People Like Me
  • https://vimeo.com/339903359/description

Free Printables:

• Communication Board – Tobii Dynavox-PCS and QWERTY

Funding:

• Lilly’s Voice
  • https://www.lillysvoice.org/

• The Arc 
  • https://thearc.org/find-a-chapter/
  • Sometimes your local Arc chapter may have funding to help access a communication device, depending on what’s available.

• Your state’s Assistive Technology centers
  • https://www.at3center.net/stateprogram
  • These are a thing! Many states have centers where they can help you access assistive tech.

• Medicaid, Home and Community-Based Services, and (sometimes) insurance plans
  • This can be difficult, but sometimes they will cover communication devices. I know at least in Tennessee, ECF Choices can cover assistive technology.

• Vocational Rehabilitation
  • This might be an option for older individuals rather than children – and for people who are planning on working. But Vocational Rehabilitation is supposed to provide you with things related to your disability that you need to succeed in the workplace, in your education, etc – and if that includes AAC, there you go!

Additional Resources:

This section is a work in process. I’ll update it as I’m able to, and hopefully reorganize it when I have the spoons/energy.

• AssistiveWare: What is AAC?
  • assistiveware.com/learn-aac/what-is-aac

• YouTube Playlist of AAC Review Videos I Made:
  • https://youtube.com/playlist?list=PLjZ3u9CTstK-2i-iP-9s7XhxbGTOx2pPE

• Augmentative and Alternative Communication for Speaking Autistic Adults: Overview and Recommendations by Alyssa Hillary Zisk and Elizabeth Dalton
  • https://www.liebertpub.com/doi/10.1089/aut.2018.0007?fbclid=IwAR0e4FbCUDqZFrJn5OSJK_9AsOKQCjsVeGMORaXXbg1-fERW_9Z6AtTgQrk

• Am I the curriculum? by Alyssa Hillary
  • https://www.tandfonline.com/doi/abs/10.1080/03626784.2019.1664255?fbclid=IwAR3f2T-JpfiZILWKPZ2P88rbEDW3PLRfXZGJAtYeHyzFaU7IUVi5IR131XE&scroll=top&needAccess=true&journalCode=rcui20#.Xge3DlDlAA8.link

• Leaders Around Me: Autobiographies of Autistics who Type, Point, and Spell to Communicate
  • https://www.amazon.com/Leaders-Around-Autobiographies-Autistics-Communicate/dp/1791505953

• Communication Alternatives in Autism: Perspectives on Typing and Spelling Approaches for the Nonspeaking
  • https://www.amazon.com/Communication-Alternatives-Autism-Perspectives-Nonspeaking/dp/147667891X

• Communication First
  • https://communicationfirst.org/

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