AAC device examples: what they are and how to choose one

What counts as an AAC device?

AAC stands for augmentative and alternative communication, and it covers a lot more ground than most parents expect. The American Speech-Language-Hearing Association defines it as "all forms of communication (other than oral speech) used to express thoughts, needs, wants, and ideas," which stretches from a handmade picture card all the way to an $8,000 tablet-based system.^[1] So when someone says "device," they might mean a physical object, an app, or a piece of dedicated hardware. All of it counts.

The field generally splits AAC into two buckets. Unaided AAC uses only the body: sign language, gestures, facial expression. Aided AAC needs something outside the body, and that's usually what people picture when they hear "AAC device."

Aided AAC breaks into three tiers. No-tech options need no batteries or internet at all. Low-tech covers simple static displays and buttons that record a single message. High-tech means dynamic-display devices and apps that produce speech out loud. No tier is inherently better than another, and there's no evidence a child needs to start simple and earn their way to a fancier device, or to speech itself. ASHA's evidence map states plainly that giving a child full access to AAC does not hold back spoken language development.^[1]

No-tech options

No-tech options don't need power or internet, which means they break less, go everywhere, and cost almost nothing to make. Here are the ones speech-language pathologists reach for most often.

PECS (Picture Exchange Communication System) is a structured teaching protocol rather than a single object. A child starts by handing a single picture card to a communication partner to request something, then builds toward multi-card sentences. Bondy and Frost published the original research in 1994 showing gains in spontaneous communication for autistic children.^[2] The official training workshop runs around $200-400, but the system itself is just printed or laminated cards you can make at home.

Communication boards are a flat display of symbols, photos, or words organized by category. Core vocabulary boards put high-frequency words like "more," "stop," "want," and "help" in the center, with less common words arranged around them. The Communication Matrix project at the University of Oregon offers free boards to download.^[3]

For someone who can spell but has limited speech motor control, a laminated alphabet grid costs pennies to print and lets them communicate letter by letter. Spelling-based AAC is increasingly recognized as an option for autistic individuals with strong literacy skills, though the evidence for specific protocols like Rapid Prompting Method or Spelling to Communicate remains debated and is worth discussing with a licensed SLP.^[1]

Choice boards are smaller, usually 2 to 8 pictures, built around one specific routine such as bedtime, mealtime, or getting dressed. For toddlers or kids at a very early stage of communication, this is often the right place to start.

Low-tech AAC generally means simple electronics, a fixed display, or a device that plays back one recorded message at a time. These make a good bridge to something more complex, and for some kids, in some situations, they're the right permanent solution rather than a stepping stone.

The simplest option is a single-message voice output device. The BIGmack (AbleNet) is a large button you record a message onto: press it, and it plays back your voice. These run $80-130 retail and show up a lot in classrooms, used for greetings, requesting, or turn-taking games. A step up is the Step-by-Step Communicator, which records a sequence of messages, one per press, so it works well for routines that follow a script, like the steps of a recipe or a morning routine.

The GoTalk series from Attainment Company works differently: these are laminated overlays sitting on a fixed grid of buttons, each pre-recorded with your voice. The GoTalk 9+ has 9 cells across 5 levels, 45 messages in total, and costs around $200-250 new. They're waterproof, drop-resistant, and don't ask parents or teachers to learn anything new to use them.

At the cheap end, buttons like the Cheap Talk 4 (around $30) or various Amazon-brand equivalents let you record four messages, which is practical for a kid who's just starting to understand that communicating gets a result.

The catch with all low-tech devices is the vocabulary ceiling: a 9-cell fixed display can't grow along with the child, so these tend to get paired with other approaches rather than serve as the only tool.

High-tech AAC devices

High-tech AAC means dynamic-display devices, where the screen changes based on what a child selects, so the vocabulary available can genuinely be large. This covers both dedicated hardware and software apps.

Dedicated speech-generating devices (SGDs) are purpose-built computers with durable cases, loud speakers, and specialized software already installed. Insurance, including Medicaid, covers them as durable medical equipment under HCPCS code E2510, which is one reason they still matter even though apps cost far less.^[4]

Device	Manufacturer	Approx. retail price	Access methods
Accent 1400	PRC-Saltillo	$7,000-9,000	Touch, eye gaze, switch
Snap + Core First	Tobii Dynavox	$6,000-8,500	Touch, eye gaze, switch
LAMP Words for Life (on Tobii hardware)	Tobii Dynavox	$6,000-8,000	Touch, switch
TD Snap	Tobii Dynavox	$6,000-8,500	Touch, eye gaze
NovaChat	Saltillo	$2,500-4,500	Touch

Prices swing quite a bit depending on the vendor, the configuration, and whether you're buying new or refurbished. These figures reflect 2024-2025 market pricing, so expect them to shift over time.

The other route is an AAC app on a tablet you already own, which lowers the barrier to entry considerably. App costs run $0-300, and the tablet itself is another $250-1,000. The tradeoff is that consumer tablets aren't built as tough, their speakers are quieter, and getting insurance to reimburse a software-only solution is harder.

Proloquo2Go (AssistiveWare) is probably the most widely used AAC app in North America. It uses a grid-based vocabulary system built around core words and costs $250 on iOS. TouchChat HD is another long-standing grid-based option, around $200, and works with several symbol sets including SymbolStix and PCS. Snap Core First is available as an app subscription, and LAMP Words for Life comes as a standalone iOS app for around $300.

Families who want to try before committing have a couple of lighter entry points: TouchChat with WordPower Lite, or the free starter version of Gotalk NOW, both reasonable starting points for young children or beginners.

Free and low-cost AAC apps

There are genuinely free options out there, though nearly all come with some kind of catch or limit.

Cboard is a completely free, open-source AAC board that runs right in a browser. It's not as polished as the commercial apps, but it works on any device with internet access and has seen real use in low-resource settings around the world.^[5]

Tobii Dynavox's Communicator Go! has a free tier, though it's limited. LetMeTalk is a free Android app built on ARASAAC symbols. Grid Player is free on iOS and will play grids that have already been built, but you need the paid Grid 3 software on a computer if you want to edit them yourself.

Little Words (littlewords.ai) takes a different approach: it's an AI-powered speech companion built specifically for neurodivergent kids, meant to give them a way to practice communication at home between therapy sessions. It won't replace a dedicated AAC system, but it's a lower-barrier tool for daily use. If you're wondering whether it would suit your child, the three-minute start quiz gives you a quick read on fit.

If you're looking specifically for symbol sets, the ARASAAC library (the Aragonese Portal of Augmentative and Alternative Communication) has more than 40,000 free pictograms under a Creative Commons license.^[6]

How does eye gaze AAC work and who is it for?

An infrared camera tracks where a person is looking on a screen, and they select letters or symbols by resting their gaze on a spot for about 0.5 to 2 seconds. This is the main route into AAC for kids who can't reliably use their hands: children with cerebral palsy, Rett syndrome, or spinal muscular atrophy, for example.

Tobii Dynavox makes the most widely used eye gaze hardware in the field. Their I-Series and I-13 devices pair an integrated eye tracker with a speech-generating device in one unit, and these systems typically run $10,000-15,000 before insurance.

Getting eye gaze right takes a proper evaluation from an SLP, and often an assistive technology specialist too, since camera positioning, lighting, and seating all affect how accurately the system reads a child's gaze. Babies as young as 6-12 months can start learning to look with intention, but a formal AAC assessment usually waits until age 2-3, once communication delays become clearer.

Switch access is the other major alternative to touching a screen directly. A child presses a single switch (a button, a puff of air, a head movement) to scan through the available options and select one when it's highlighted. It's slower than eye gaze, but dependable, and it works for people with almost any motor profile.

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

Cost varies enormously. A homemade PECS binder costs under $20. A dedicated eye gaze SGD can run $15,000. Most families land somewhere in between.^[4]

Medicaid covers SGDs as durable medical equipment in all 50 states when a licensed SLP documents medical necessity. Coverage rules vary by state plan, but federal Medicaid law requires coverage of medically necessary assistive technology for children under 21 through the EPSDT benefit (Early and Periodic Screening, Diagnostic and Treatment).^[7] That protection has real legal weight: if a doctor and SLP document that an SGD is medically necessary for a child under 21, state Medicaid cannot simply deny it.

Private insurance is more of a mixed bag. The Individuals with Disabilities Education Act (IDEA) requires schools to provide AAC as part of a free appropriate public education whenever the IEP team decides a child needs it, at no cost to the family.^[8] That doesn't mean the family keeps the device at home, but the school does have to fund it for school use.

Many AAC manufacturers run lending libraries and trial programs and keep funding specialists on staff; both PRC-Saltillo and Tobii Dynavox offer funding support services. Some states also run assistive technology programs that loan devices for free, and the AT3 Center (funded by the Administration for Community Living) keeps a directory of these programs.^[9] Families who can't get insurance approval quickly can also look at refurbished SGDs through manufacturers and third-party vendors, usually priced at roughly 40-60% of new.

What AAC system is best for a nonspeaking autistic child?

There's no single right answer, and anyone who hands you one without evaluating your child first is guessing. Still, a few things are worth knowing before you sit down with an SLP.

One option is LAMP (Language Acquisition through Motor Planning), developed by The Center for AAC and Autism. It applies motor learning principles to AAC: the same symbol always sits in the same spot, so the child builds motor memory over time.^[10] You'll find it as a dedicated app (LAMP Words for Life) or loaded on hardware. The research behind it is growing but still limited to small studies.

Then there are core vocabulary approaches, used in apps like Proloquo2Go and TouchChat with WordPower, which teach 200-400 words covering roughly 80% of what people actually say day to day. A 2019 systematic review in the journal Augmentative and Alternative Communication found that core vocabulary interventions led to positive outcomes for symbol-based AAC users across a range of ages.^[11]

For younger autistic children, say ages 2 to 5, the real question is often what the child will pick up and actually want to use. Some take to full symbol-based apps right away. Others do better starting with physical picture exchange. What the research keeps showing is that the tool matters less than how consistently adults model it: when grown-ups use AAC throughout the day themselves, children pick it up faster.^[1]

If your child already sees someone for speech therapy related to autism, that person is your best starting point for choosing a system. And if you're still waiting on an evaluation, early intervention services for children under 3 include a free AAC assessment in every state, under IDEA Part C.^[8]

Apraxia and autism can both come with AAC recommendations, but the reasoning behind them isn't the same, and it's worth understanding why before your evaluation.

Childhood apraxia of speech (CAS) is a motor speech disorder. The child already knows what they want to say; the problem is getting the mouth to execute the movement reliably. Because of that, AAC for CAS usually works as a bridge rather than something the child keeps using forever. Many kids with CAS make real gains in speech therapy, especially motor-learning, high-repetition approaches like DTTC or ReST, and go on to develop functional speech. AAC just gives them a way to communicate with less frustration while that therapy does its work: apps and devices with pre-programmed phrases and clear modeled speech output can take a lot of pressure off in the meantime. There's more on this in the piece on childhood apraxia of speech.

For autistic children who are minimally verbal or nonspeaking, AAC tends to be a longer-term system, sometimes a permanent one. The point isn't necessarily to replace spoken language; it's to give the child a dependable way to communicate now, regardless of what happens with speech later. Studies on AAC and autism have found again and again that giving a child AAC doesn't reduce their drive to develop speech.^[1]

Either way, the right first move is an evaluation with a speech-language pathologist. A good evaluation looks at the child's motor skills (since that affects how they'll physically access a device), their cognitive and language level, their vision, and how ready the people around them are to actually learn and use the system. Bringing in an assistive technology specialist as well can help with picking the right hardware. If you want more background before that appointment, reading up on apraxia of speech in general will help you walk in with better questions.

At what age can a child start using an AAC device?

Earlier than most parents expect. There's no evidence-based minimum age for AAC introduction. The American Academy of Pediatrics supports early AAC access and has stated that AAC should be introduced as soon as a communication need is identified, not held back until a child has "tried everything else" first.^[12]

In practice, picture boards and simple choice displays get used with infants in NICU settings and with toddlers as young as 12-18 months when communication delays are apparent. Research by Romski and Sevcik showed that introducing AAC to toddlers under 3 produced better language outcomes than speech-only intervention.^[13] High-tech SGDs with dynamic displays have also been trialed successfully with children as young as 2, and eye gaze systems can be introduced even earlier for children with severe motor impairments.

The real question isn't whether your child is old enough for AAC. It's what communication system fits where they are right now. If you're waiting on an evaluation and your child is under 3, contact your state's early intervention program: under IDEA Part C, evaluation and services are free and must begin within 45 days of referral.^[8] You can find your state program at the ECTA Center (Early Childhood Technical Assistance Center).^[3]

How do AAC devices and speech therapy work together?

AAC doesn't replace speech therapy. It's a tool that speech therapists teach children to use, and it gives them something concrete to work with in sessions.

A good SLP who works with AAC users practices what's called aided language input (or aided language stimulation): modeling the system during natural interactions, pointing to or pressing symbols while talking, so the child sees what the device is actually for. That's a very different approach from handing a child a device and hoping they figure it out on their own.

Carryover at home matters just as much. Parents who learn to model AAC themselves tend to see faster gains in how their child uses it. Studies on parent-implemented AAC intervention, reviewed in the journal Augmentative and Alternative Communication, consistently show that parent training is one of the strongest predictors of outcome.^[11]

Families with limited access to in-person therapy have more options now than they used to. Online speech therapy has expanded a great deal since 2020, and several platforms specialize in AAC specifically. Telepractice AAC therapy has a reasonable evidence base for school-age children, though research on toddlers via telehealth is still thin.

For families already putting in a lot of hours at home, it can help to find a speech therapist who coaches parents in AAC modeling during a monthly consult rather than weekly direct sessions. That stretches the budget without losing clinical oversight.

Little Words (littlewords.ai) is one option for supporting communication practice at home between sessions, built to fit into daily routines rather than replace structured therapy.

What actually matters when you're comparing AAC devices

Five things separate a device that works from one that ends up in a drawer.

Start with how the child will actually operate it. Can they reliably touch a screen with a finger? Then direct touch is fine. If motor control is limited, look at switch access or eye gaze instead. Picking a device the child physically can't operate is the single most common reason AAC doesn't work out.

Then think about whether the vocabulary can grow with the child. A 9-cell fixed display suits a 2-year-old just starting out, but it boxes in a 6-year-old who wants to build original sentences. Dynamic display systems (apps and high-tech speech-generating devices) offer effectively unlimited vocabulary; low-tech systems don't.

Symbol style matters too. Devices use different sets, such as PCS (Boardmaker), SymbolStix, ARASAAC, or plain photographs, and it's worth matching the style to what the child actually recognizes and responds to. Some kids do better with real photos than abstract pictograms, and most apps let you import custom photos if that's the case.

Durability and portability come next: a device a child can't bring to the playground is a device they won't use. SGDs come in rugged cases, while apps on consumer tablets need a solid protective case and ideally a carrying strap.

And last, maybe the biggest factor of all: will the people around the child actually use it? The best device in the world fails if no one knows how to model it. Consider how much training parents, teachers, and aides will need, and be honest about whether they'll actually put in the work. A simple system everyone models consistently beats a sophisticated one that sits unused in a bag.

Before buying anything, most SLPs recommend a trial period. Many manufacturers offer 30-60 day trials, and your child's school district may be required to fund one under IDEA if it's part of the IEP process.^[8]

Proloquo2Go is the most widely used AAC app in North America for autistic children, according to survey data from AssistiveWare, and among dedicated hardware, Tobii Dynavox systems hold the largest market share. Popular doesn't mean right for your kid, though. An SLP evaluation is really the only way to match a device to a child's motor, cognitive, and communication profile.

Is a 2-year-old too young for AAC?

No. Romski and Sevcik found that introducing AAC to toddlers under age 3 led to better language outcomes than speech-only intervention. Picture boards, single-message buttons, and touchscreen apps have all worked well with 2-year-olds. The American Academy of Pediatrics backs early AAC introduction as soon as a communication need shows up, with no minimum age requirement.

Does AAC stop a child from learning to talk?

No, and this is one of the most persistent myths out there. ASHA's evidence map and a number of peer-reviewed studies consistently show AAC doesn't suppress spoken language. Romski and Sevcik's work and other research suggests AAC actually supports speech development, since it cuts down on communication frustration and gives children a reliable way to practice. Holding off on AAC to "encourage speech first" just isn't backed by the evidence.

What does an AAC device cost, and will Medicaid help?

The range is huge. Homemade picture boards cost almost nothing. Single-message buttons like the BIGmack run $80-130. AAC apps cost $0-300 plus the price of a tablet ($250-1,000). Dedicated speech-generating devices run $2,500-9,000 for touch-access systems and $10,000-15,000 for eye gaze systems. Medicaid covers speech-generating devices as durable medical equipment (HCPCS code E2510) once a licensed SLP documents medical necessity, and for children under 21 the EPSDT benefit adds legal weight: states must cover medically necessary assistive technology regardless of their usual coverage rules. Approval steps vary by state, but most SGD manufacturers have funding specialists on staff who walk families through the paperwork, and an SLP or AT specialist can help sort out the rest.

PECS or a high-tech device?

PECS (Picture Exchange Communication System) is a no-tech, behavior-based protocol where the child physically hands a picture card to a communication partner. It builds early requesting skills and needs no technology at all. High-tech AAC devices use dynamic touchscreens or eye gaze to produce synthesized or recorded speech, and they open up a much larger vocabulary and more spontaneous communication, but they cost more and take more training for whoever the child is talking to.

What runs on Android, and what about the school route?

LetMeTalk, Cboard (browser-based, works on any device), TouchChat HD, and Snap Core First all have Android versions. Proloquo2Go and GoTalk NOW are iOS only. If you're buying a tablet specifically for AAC, iOS has the broader lineup of well-supported apps, which is why many SLPs point families toward the iPad, though the Android options are real and some work very well.

As for getting a device through school: under IDEA, if the IEP team decides AAC is necessary for your child to get a free appropriate public education, the school has to fund it. Ask for an assistive technology evaluation in writing as part of the IEP process; the school must evaluate within a reasonable timeline. The device the school pays for usually stays at school, though you can ask in the IEP for it to go home too, and schools sometimes say yes.

What is eye gaze AAC, and how does it differ from an app?

Eye gaze AAC uses an infrared camera to track where someone looks on a screen, so they can select symbols or letters without using their hands. It's used mainly by people with cerebral palsy, Rett syndrome, spinal muscular atrophy, or ALS who can't reliably use direct touch or a switch. Tobii Dynavox systems are the most common, costs typically run $10,000-15,000 before insurance, and an AT specialist needs to do the evaluation.

That's worth contrasting with a dedicated speech-generating device more broadly versus an app. An SGD is purpose-built hardware: a rugged case, a loud speaker, specialized software, and support for several access methods. An AAC app runs on a regular consumer tablet, costs far less, but is less durable, has a quieter speaker, and is harder to get insurance to reimburse. SGDs tend to be easier to fund through Medicaid, while apps are a faster, cheaper way to get started. Plenty of families end up using both: an app at home, an SGD at school.

Is LAMP better than other approaches, and can AAC mix with sign language?

LAMP (Language Acquisition through Motor Planning) has a growing research base and solid clinical support, especially for autistic children who respond well to motor-learning approaches where consistent symbol placement builds motor memory. Most of that research is small studies without randomized controls, though. Core vocabulary approaches have strong evidence too, and which one fits best really depends on the child; an SLP familiar with both can help you compare them against your child's profile.

And yes, a child can use AAC alongside sign language: it's common. Using several modalities at once, sometimes called total communication, is supported by ASHA. Signs, picture boards, and speech can all work together without confusing a child. Some kids sign for familiar words and reach for a device for less familiar vocabulary. The point is giving a child every reliable tool available rather than picking just one and dropping the rest.

Symbols, photos, and free resources

Proloquo2Go uses SymbolStix symbols by default, with the option to switch to PCS (Boardmaker) or custom photos, and you can import any photo from your camera roll to replace a symbol. This matters for children who recognize real objects more easily than stylized pictograms; photos of a child's own toys, family members, and favorite foods often boost initial engagement quite a bit.

If you're looking for free tools, the Communication Matrix (University of Oregon) offers free assessment and planning tools, ARASAAC has more than 40,000 free pictograms, Cboard is a free browser-based AAC app, and PrAACtical AAC (praacticalaac.org) is a well-regarded free blog for parent education. ASHA's public portal has overview materials too, and many SGD manufacturers offer free trial periods and online training videos even before you've bought their device.

Sources

1. ASHA: Augmentative and Alternative Communication (overview and evidence map): ASHA defines AAC as all forms of communication other than oral speech used to express thoughts, needs, wants, and ideas; evidence map shows AAC does not suppress speech development
2. Bondy, A. & Frost, L. (1994). The Picture Exchange Communication System. Focus on Autistic Behavior, 9(3), 1-19.: Bondy and Frost's 1994 research on PECS showed gains in spontaneous communication for autistic children
3. ECTA Center (Early Childhood Technical Assistance Center, UNC) and Communication Matrix: State early intervention program directory; free communication planning tools available through University of Oregon Communication Matrix project
4. CMS: HCPCS code E2510, speech generating devices as durable medical equipment: HCPCS code E2510 covers speech-generating devices as durable medical equipment under Medicare and Medicaid
5. Cboard open-source AAC project documentation: Cboard is a free, open-source, browser-based AAC communication board system
6. ARASAAC: Aragonese Portal of Augmentative and Alternative Communication: ARASAAC offers over 40,000 free pictograms under Creative Commons license for AAC use
7. Medicaid.gov: Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit: Federal Medicaid EPSDT benefit requires coverage of medically necessary assistive technology for children under 21 regardless of standard state coverage limits
8. U.S. Department of Education: IDEA (Individuals with Disabilities Education Act): IDEA Part B requires schools to provide AAC as part of a free appropriate public education if the IEP team determines necessity; IDEA Part C requires free evaluation and services within 45 days of referral for children under 3
9. AT3 Center: State Assistive Technology Programs (Administration for Community Living): AT3 Center maintains a directory of state assistive technology programs that offer device lending libraries and funding support
10. Augmentative and Alternative Communication journal: systematic review of core vocabulary and parent-implemented AAC intervention outcomes: 2019 systematic review found core vocabulary interventions had positive outcomes for symbol-based AAC users; parent training is among the strongest predictors of AAC outcome
11. American Academy of Pediatrics: AAC and early communication support policy: AAP supports early AAC introduction as soon as a communication need is identified, with no evidence-based minimum age
12. Romski, M., Sevcik, R.A., et al. (2010). Randomized comparison of augmented and nonaugmented language interventions for toddlers with developmental delays and their parents. Journal of Speech, Language, and Hearing Research, 53(2), 350-364.: Romski and Sevcik found that introducing AAC to toddlers under age 3 produced better language outcomes than speech-only intervention