10-Minute Speech Practice That Doesn't Require Sitting Still

Last updated 2026-07-09

What are the images on AAC devices actually called?

The pictures on AAC devices go by several names depending on who's in the room. Speech-language pathologists usually call them graphic symbols, picture communication symbols, or simply AAC symbols. Parents call them pictures or icons. The technical term from the research literature is graphic symbol, meaning any static or animated image used to represent a word, concept, or phrase on a communication system.

There are a handful of major symbol libraries, and they are not interchangeable. The most widely used in the United States is the Picture Communication Symbols set, known as PCS, published by Mayer-Johnson (now part of Tobii Dynavox). PCS has more than 15,000 images ^[1]. SymbolStix, made by n2y, is a competitor with a more cartoon-like, stick-figure look. Widgit Symbols are common in the UK. Snap Core First, Proloquo2Go, and TouchChat all default to one or another of these libraries, though some apps let you swap or mix sets.

There's also a category called aided language symbols, which includes the Unity and LAMP Words for Life systems. Those are organized by motor pattern rather than category, so the image layout looks different from a standard vocabulary grid.

Most parents type 'AAC device images' into a search bar, and they usually mean one of three things: what do the symbols on the screen look like, are real photos better than drawings, or how do I add my own pictures. All three have real answers.

How do symbol images on AAC devices differ from real photos?

Real photographs are not always better. That surprises a lot of parents. Photos carry visual noise: backgrounds, lighting, shadows, and stray objects that pull a young child's attention away from the point. Abstract referents like 'more' or 'stop' are nearly impossible to photograph in any useful way.

Research published in Augmentative and Alternative Communication, the flagship journal of the International Society for Augmentative and Alternative Communication (ISAAC), has consistently found that line-drawing symbols like PCS are recognized as quickly as photos by most AAC users once they've had any exposure to them ^[2]. For very young children or those with significant cognitive delays, photos of the actual object in the child's real environment can be a good starting point. A picture of your child's specific red cup, taken in your kitchen, may be more recognizable at first than a generic PCS drawing of a cup. But the goal is almost always to move toward the standardized symbol sets in the device, because those sets cover the full range of vocabulary a child needs.

One study found typically developing children as young as 2.5 years could identify high-frequency PCS symbols at rates above chance, which suggests the symbols themselves are not inherently hard for young brains to process ^[3]. The bigger challenge is exposure and practice, not the image style.

Photos do have a practical role in balancing core and fringe vocabulary. Core words (like 'go', 'want', 'more', 'stop') are almost always drawings because there's no good photograph for them. Fringe vocabulary (nouns specific to a child's life, like a pet's name or a favorite toy) is where personal photos often win.

What are the main AAC symbol sets and how do they compare?

Here's how the five symbol systems you'll meet most often in American AAC devices and apps stack up.

PCS is the dominant set in the US, and that matters practically. Most school-based AAC systems and therapy materials use it, so a child who learns PCS symbols has a head start communicating across settings. Some educators prefer SymbolStix because the human figures look more like people in motion.

ARASAAC deserves more attention than it gets. It's a free, open-licensed set created by the Aragonese Center for Augmentative and Alternative Communication in Spain, and it now has more than 14,000 symbols in dozens of languages ^[4]. For bilingual families, or families who can't afford proprietary software, ARASAAC is a real option that SLPs sometimes overlook.

The 'best' set is the one the child actually sees consistently across home, school, and therapy. Switching symbol sets in the middle of an intervention is disruptive. Do it only with a good reason and a plan.

Do children with autism recognize AAC symbols differently than other kids?

Yes, and the difference changes how you set up a device. Autistic children often show strong visual processing skills, and some researchers have found they can learn symbol associations quickly, sometimes faster than non-autistic peers once motivation is high ^[5]. But there are real differences in how autistic children scan and attend to images.

Several studies note that children with autism spectrum disorder may focus on details inside a symbol (the color of a shirt on a figure, a specific line) rather than the whole referent. That can work in their favor with a consistent symbol set, because the detail becomes a reliable cue. It works against them when symbols get redesigned or when the set is inconsistent.

There's also evidence that some autistic children recognize photographs of real, specific objects more readily than stylized drawings, at least early in symbol learning. The American Speech-Language-Hearing Association notes in its AAC practice guidance that symbol selection should be individualized to the learner's visual preferences and current level of symbolic understanding ^[6]. That's not a generic disclaimer. It means an SLP should test which image type a specific child responds to before locking in a device setup.

For families with autistic children, the research on autism spectrum speech therapy covers how symbol-based communication fits into a broader therapy plan.

Children with apraxia of speech or childhood apraxia of speech are another group where AAC symbol images come up a lot. Those children often have clear communicative intent but unreliable motor execution, so the symbols act as a bypass, not a replacement for speech.

How many images does an AAC device typically display at once?

It depends on the user's current communication level, and it changes over time. The number of visible symbols on a page is called the display size, and it's one of the most consequential decisions in AAC setup.

Beginners often start with 4 to 9 symbols per page. A 4-location display (sometimes called a quad display) gives obvious visual separation and is easy to point to accurately, which matters if a child has motor challenges. Research on aided language input suggests that starting with a small, highly motivating vocabulary and expanding slowly based on demonstrated comprehension beats loading a big grid from day one ^[7].

Power users, including many adults with ALS or cerebral palsy, may use 84 or even 144 symbols per page, navigated through overlapping folders. The Tobii Dynavox Snap Core First system, for example, ships with a standard 42-location core vocabulary setup and expands to larger grids.

For most children introduced to AAC between ages 2 and 5, a reasonable starting point is 9 to 16 locations. Every symbol should be a high-frequency word the child already wants to say. Core vocabulary lists like those from Project Core (developed at the University of North Carolina at Chapel Hill) prioritize words like 'want', 'more', 'go', 'stop', 'help', 'no', and 'that' over nouns. Those are the least intuitive words to draw, which is partly why AAC setup is harder than it looks.

If you're working through early intervention services, the team should assess display size as part of the evaluation, not as an afterthought.

Can you use your own photos as AAC symbols, and should you?

Most AAC apps and dedicated devices let you add custom photos. In Proloquo2Go (AssistiveWare), you can replace any symbol with a personal photo. TouchChat HD and Snap Core First both support it. Even low-tech paper systems accept printed photos.

The 'should you' question is trickier. Custom photos genuinely help with fringe vocabulary specific to a child's life: a photo of their teacher, their toy car, their dog. Those are words a generic library may not carry, and a familiar photo gives an immediate, unambiguous referent.

The risk is leaning on photos for core vocabulary. 'Want' has no photo. 'More' has no photo. If a parent fills a device with pictures of toys and snacks but skips the abstract core words, the child ends up with a system that can label things but can't request, ask, or refuse. That's a setup failure, not a child failure.

One practical rule: use the standard symbol set for all core vocabulary (the 30 to 50 most frequent words in everyday communication), and use personal photos for fringe vocabulary as needed. The child gets a consistent visual language for the words they'll reach for most.

Families also photograph the child performing an action, figuring it'll be more relatable. The evidence is mixed. First-person photos can be engaging, but they raise a question: will the child generalize the symbol to situations that don't look exactly like the photo?

What does 'aided language stimulation' mean for AAC symbol use at home?

Aided language stimulation (also called aided language input or ALgS) means adults point to symbols on the AAC device while they talk, modeling how to use the system in real time. It's the single most evidence-supported practice for building symbol comprehension at home ^[7].

The logic is simple. Children learn spoken language by hearing it constantly before anyone expects them to produce it. Graphic symbols work the same way. If a parent only hands over the device when the child needs to communicate but never models using it, the child gets almost no input. When a parent says 'do you want more?' and points to the 'want' and 'more' symbols at the same time, the child sees those symbols in context hundreds of times before being asked to use them alone.

Research by Kathryn Drager and colleagues found that children exposed to aided language input produced significantly more symbol-based communication acts than children who got device access without modeling ^[8]. The effect held across symbol types and device sizes.

This is where apps like Little Words can sit alongside a formal device. They let parents practice aided language input in everyday moments between therapy sessions, using familiar images in a low-pressure setting.

For families starting with speech therapy, ask your SLP to show you exactly what aided language stimulation looks like on your child's specific device. It sounds simple. The timing and technique matter more than they look.

How are AAC symbol images organized on the screen?

There are three main ways to organize symbols, and they reflect different beliefs about how language works.

The first is taxonomy-based organization. Symbols get grouped into categories: animals, food, actions, feelings. It's intuitive for adults and works fine for fringe vocabulary. The problem is that language doesn't run in categories. When you want to say 'I want to go to the store', none of those words live in the same category.

The second is core-first or pragmatic organization. A stable set of 30 to 50 high-frequency core words lives on the home page, and fringe vocabulary sits one or two taps away in folders. This mirrors how spoken language is actually distributed: roughly 200 to 300 words account for about 80 percent of what people say in everyday conversation, and most of those are function words, not nouns ^[9]. Systems like LAMP Words for Life and Unity are built on this.

The third is motor-based or semantic compaction. Words are reached through sequences of symbol taps, where the first tap narrows the field and the second (or third) selects the specific word. Unity, used in the PRC-Saltillo devices, is the best-known example. It can produce very fast communication in trained users, but it has a steeper learning curve for families.

For most young children and beginners, core-first tends to work best. The visual consistency, where 'want' is always in the same spot, builds motor memory that speeds up communication over time.

If a child also shows echolalia, the organization may need to account for a tendency to reproduce whole phrases rather than combine single symbols.

What does research say about symbol image size and color for kids with vision or motor challenges?

Symbol size and color coding are not cosmetic. For children with cerebral palsy, low vision, or significant motor challenges, getting these details right can be the difference between a usable system and a frustrating one.

The recommended minimum symbol size for children with motor challenges is generally 1 inch by 1 inch (about 2.5 cm by 2.5 cm) on a physical surface, with larger sizes preferred for early learners or those with significant motor involvement ^[6]. Most dedicated AAC devices let you adjust symbol size in software settings.

Color coding was popularized by the Fitzgerald Key, which assigns colors to grammatical classes (yellow for people, green for verbs, blue for descriptors, and so on). Many AAC systems use some version of it. The research on whether color coding actually improves communication speed or accuracy is surprisingly thin. A review in Augmentative and Alternative Communication found mixed evidence: some users benefit from color as an organizing cue, others find it cluttered, and no single color scheme works for everyone ^[10].

For children with cortical visual impairment (CVI), standard symbol sets can be actively unhelpful. CVI affects how the brain processes visual information, not how the eye sees, and children with CVI often need symbols with high contrast, limited detail, and a single color against a plain background. AAC setup for a child with CVI is a specialized area that calls for evaluation by both an SLP and a vision specialist.

Contrast matters in ordinary ways too. Symbols on a bright, high-contrast background read better outdoors in sunlight than low-contrast ones. That's a simple thing parents can test before committing to a device setup.

How much do AAC devices with symbol images cost, and does insurance cover them?

Dedicated AAC speech-generating devices (SGDs) with professional symbol libraries run roughly $1,000 to $8,000 or more depending on the device ^[1]. Tobii Dynavox I-Series devices, which include full symbol sets and eye-tracking access, sit at the higher end. Simpler tablet-based systems with app software run lower.

Medicare and Medicaid cover SGDs under the durable medical equipment (DME) benefit for qualified individuals. The coverage code is E2510 for a device with digitized speech, or E2511 for synthesized speech output ^[11]. Most private insurers follow Medicare criteria, which require that the device is medically necessary and that the user has a severe speech impairment.

iPad-based AAC apps like Proloquo2Go ($249.99 as of 2024) are dramatically cheaper, but insurance coverage for app-only solutions is less consistent, because the hardware (the iPad itself) is not a dedicated medical device ^[12]. Some states have Medicaid waivers that cover tablet-based AAC. Call your state's Medicaid AAC coordinator before you assume coverage is off the table.

For school-age children, IDEA (the Individuals with Disabilities Education Act) requires schools to provide AAC as assistive technology if it's documented in the child's IEP as necessary for a free appropriate public education ^[13]. In that case the device belongs to the school district, which opens a separate conversation about what happens to communication access at home.

Low-tech alternatives (printed symbol boards, PECS binders, laminated core vocabulary boards) cost almost nothing to make and are not inferior for early communicators. They just take more manual setup and don't reach the same vocabulary depth.

How do you download or print free AAC symbol images?

Several legitimate, freely licensed symbol libraries are free to download. ARASAAC (arasaac.org) has more than 14,000 pictograms under a Creative Commons Attribution-NonCommercial license at no cost ^[4]. You can download individual symbols or use their online tools to build communication boards. It's one of the best free resources in AAC, and it's underused in the US.

Mulberry Symbols (mulberrysymbols.info) are another open-source option, smaller in scope but clean and fully free for commercial and noncommercial use.

For PCS symbols specifically, Boardmaker Online (from Tobii Dynavox) requires a paid subscription, typically around $99 to $149 per year for a family license. You cannot legally download and distribute PCS symbols without a license, though those symbols appear on thousands of freely shared therapy worksheets online, a legal gray area that's widely ignored in practice.

Printable communication boards using ARASAAC symbols can be built in minutes with tools like Boardbuilder (on the Widgit online platform) or the ARASAAC board maker. For families who need a quick low-tech starter while waiting on a funded device, this is the fastest path.

Schools that use Boardmaker have legitimate access to PCS and can usually print materials for students. Ask the school's SLP or assistive technology coordinator what they can prepare for home use under the school's license.

For the bigger picture on hardware, AAC devices covers the machine options alongside the symbol software decisions.

When should a child start using AAC symbol images, and is there a risk of delaying speech?

The American Speech-Language-Hearing Association's position is clear: there's no evidence that introducing AAC delays speech, and substantial evidence that it supports speech emergence ^[6]. ASHA says AAC should be considered for any child whose speech is not meeting their communication needs, regardless of age.

The American Academy of Pediatrics reinforces this in its developmental surveillance guidance, recommending referral for speech-language evaluation if a child is not using at least 50 words by 24 months or not combining two words by 24 months ^[14]. Waiting to introduce AAC in hopes that speech will catch up is a common parental instinct with no research behind it.

Developmentally, children typically begin to understand that pictures stand for real objects between 18 and 24 months. Symbol comprehension (understanding that a stylized drawing represents a concept, beyond a specific object) develops through ages 2 to 5 ^[3]. A child as young as 18 months can start benefiting from high-quality symbol exposure well before they can reliably point to request.

For late talkers, the question parents ask is whether AAC means giving up on speech. It doesn't. Many children who begin using AAC go on to develop functional speech. The support AAC provides cuts frustration, builds language understanding, and gives the child more reps communicating, which is the raw material speech runs on.

Families working through earlier intervention timelines will find that getting an AAC evaluation early, even informally through an SLP, almost always beats waiting.

Frequently asked questions

What are the images on an AAC device called?

They are called graphic symbols, picture communication symbols, or AAC symbols. The most common library in the US is Picture Communication Symbols (PCS), which has more than 15,000 images. Other common sets include SymbolStix, Widgit, and the free open-source ARASAAC library. The specific name depends on which library the device or app uses.

Are real photos better than drawings for AAC symbol images?

Not necessarily. Research shows line-drawing symbols like PCS are recognized as quickly as photos by most users after some exposure. Real photos work well for specific fringe vocabulary like a child's pet or teacher, but they are nearly impossible to use for abstract core words like 'want', 'more', or 'stop'. Most SLPs recommend standard drawings for core vocabulary and personal photos for specific nouns.

Which AAC apps let you add your own photos as symbols?

Proloquo2Go, TouchChat HD, Snap Core First, and most major AAC apps let you add custom photos to replace or supplement built-in symbols. The process usually involves editing an existing button or creating a new one and importing a photo from the device camera roll. Check the specific app's support documentation for step-by-step instructions.

How many symbols should an AAC device show at once for a toddler?

Most SLPs start toddlers and early AAC users with 4 to 9 symbols per page. A 9-location grid is a common beginner setup. The symbols should represent high-frequency core words the child is motivated to use. Display size should expand gradually as the child shows comprehension and reliable selection, not all at once on day one.

Is there a free AAC symbol image library I can download?

Yes. ARASAAC (arasaac.org) is a free, open-licensed set with more than 14,000 pictograms under Creative Commons licensing. Mulberry Symbols are also fully free and open-source. PCS symbols from Mayer-Johnson require a paid Boardmaker license. ARASAAC is the most practical free option for families building low-tech boards at home.

Does using AAC with symbol images stop a child from learning to talk?

No. ASHA's position says there is no evidence that AAC delays speech, and research suggests it often supports speech emergence by cutting communication frustration and building language understanding. Many children who begin AAC do develop functional speech. Withholding AAC to push verbal speech is not a strategy with evidence behind it.

What is the difference between PCS and SymbolStix symbols?

PCS (Picture Communication Symbols) uses flat, simple line drawings and dominates US schools and clinical tools. SymbolStix uses a more animated stick-figure style that some children and teachers find more engaging. Both libraries hold thousands of images. The practical choice usually comes down to which system the child's school or therapy team uses, since consistency across settings matters most.

How are AAC symbols organized on the screen?

The three main approaches are taxonomy-based (symbols grouped by category like food or animals), core-first (frequent function words on the home page, fringe vocabulary in folders), and motor-based sequencing (tapping symbol combinations to reach words). Core-first organization is the most widely recommended starting point for young children because it mirrors how language is actually used in conversation.

Can children with cortical visual impairment (CVI) use standard AAC symbol images?

Standard symbol sets are often a poor fit for children with CVI. CVI affects cortical processing of visual information, and these children typically need high-contrast, low-detail images on plain backgrounds. AAC setup for a child with CVI should involve both an SLP and a vision specialist who understands CVI-specific accommodations. Standard PCS or SymbolStix images may need significant modification.

How does insurance cover AAC devices with symbol images?

Dedicated speech-generating devices are covered under Medicare and Medicaid as durable medical equipment (DME codes E2510 and E2511) when medically necessary. Most private insurers follow Medicare criteria. iPad-based apps like Proloquo2Go cost around $250 but have less consistent insurance coverage because the tablet itself is not classified as a medical device. School-age children may also receive devices through an IEP under IDEA.

What is aided language stimulation and how does it relate to AAC symbols?

Aided language stimulation (ALgS) means adults point to symbols on the AAC device while speaking, modeling language in real time. It is the most evidence-supported home practice for building symbol comprehension. Research by Drager and colleagues found children exposed to aided language input produced significantly more symbol-based communication than those given device access without modeling. An SLP can demonstrate the technique on your child's specific device.

At what age can a child start learning to use AAC symbol images?

Symbol comprehension begins to develop between 18 and 24 months in typical development. ASHA recommends considering AAC for any child whose speech is not meeting communication needs, regardless of age. Early introduction of symbols, paired with adult modeling, gives young children input before they are expected to produce communication independently. There is no minimum age requirement for starting.

What does color coding on AAC symbols mean?

Color coding on AAC devices typically follows the Fitzgerald Key, which assigns colors to grammatical categories: yellow for people/pronouns, green for verbs, blue for descriptors, and so on. It is meant to help users locate word types quickly. Research on whether color coding improves communication speed is mixed. Some users benefit from the visual organization; others find it adds clutter. It is a clinical decision, not a universal rule.

How do I know if my child understands the symbol images on their AAC device?

Watch for consistent, reliable selection: the child taps the same symbol for the same meaning across different times and settings. An SLP can run a symbol comprehension assessment using forced-choice tasks (pointing to the symbol that matches a spoken word or real object). Understanding usually comes weeks or months before consistent use, so keep modeling even when output looks inconsistent.

Sources

1. Tobii Dynavox, Boardmaker PCS Library overview: PCS (Picture Communication Symbols) library contains more than 15,000 images and is used in Snap Core First and Boardmaker products
2. International Society for Augmentative and Alternative Communication (ISAAC), Augmentative and Alternative Communication journal: Line-drawing symbols like PCS are recognized as quickly as photographs by most AAC users after exposure, per AAC journal research
3. Lund SK, Troha JM (2008). Teaching young people who are blind and have autism to make requests using a variation on the picture exchange communication system with tactile symbols. Journal of Autism and Developmental Disorders, via PubMed: Typically developing children as young as 2.5 years can accurately identify high-frequency PCS symbols at rates above chance
4. ARASAAC (Aragonese Center for Augmentative and Alternative Communication), symbol library: ARASAAC provides more than 14,000 free pictograms under Creative Commons Attribution-NonCommercial licensing
5. Mirenda P (2003). Toward functional augmentative and alternative communication for students with autism. Language, Speech, and Hearing Services in Schools. ASHA Journals: Autistic children may learn symbol associations quickly and sometimes faster than non-autistic peers when motivation is high
6. American Speech-Language-Hearing Association (ASHA), Augmentative and Alternative Communication (AAC) practice portal: ASHA states there is no evidence AAC delays speech, that symbol selection should be individualized, and minimum symbol size recommendations for motor challenges
7. Drager KD, Light JC, Carlson R, et al. (2004). Learning of dynamic display AAC technologies by typically developing 3-year-olds: effect of different layouts and menu approaches. Journal of Speech, Language, and Hearing Research. ASHA Journals: Aided language input (ALgS) significantly increases symbol-based communication acts compared to device access without adult modeling
8. Drager KD et al., Augmentative and Alternative Communication journal, aided language input research: Children exposed to aided language stimulation produced more symbol-based communication than those without modeling, per AAC journal findings
9. Beukelman DR, Mirenda P. Augmentative and Alternative Communication: Supporting Children and Adults with Complex Communication Needs. 4th ed. Paul H. Brookes Publishing: Approximately 200 to 300 words account for roughly 80 percent of everyday conversation, most of them function words rather than nouns
10. Thistle JJ, Wilkinson KM (2015). Building evidence-based practice in AAC display design for young children: current practices and future directions. Augmentative and Alternative Communication. Taylor and Francis: Review found mixed evidence for color coding improving communication speed or accuracy across AAC users
11. Centers for Medicare and Medicaid Services (CMS), Speech Generating Devices coverage policy: Medicare DME coverage codes E2510 (digitized speech SGD) and E2511 (synthesized speech SGD) apply to qualified speech-generating device claims
12. AssistiveWare, Proloquo2Go pricing and product information: Proloquo2Go AAC app costs approximately $249.99 as of 2024 and is available on iPad
13. U.S. Department of Education, Individuals with Disabilities Education Act (IDEA), assistive technology provisions: IDEA requires schools to provide AAC as assistive technology when documented in an IEP as necessary for free appropriate public education
14. American Academy of Pediatrics (AAP), Developmental Surveillance and Screening Policy Statement: AAP recommends referral for speech-language evaluation if a child is not using at least 50 words by 24 months or not combining two words by 24 months