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

Last updated 2026-07-09

What counts as an AAC device?

AAC stands for augmentative and alternative communication. The American Speech-Language-Hearing Association defines AAC as "all forms of communication (other than oral speech) used to express thoughts, needs, wants, and ideas," and that definition covers everything from a handmade picture card to an $8,000 tablet-based system.^[1] The word "device" gets used loosely. It covers physical objects, apps, and dedicated hardware.

The field splits AAC into two big buckets. Unaided AAC uses only the body: sign language, gestures, facial expression. Aided AAC needs something external, and that external thing is what most parents mean when they say "AAC device."

Within aided AAC there are three tiers: no-tech (nothing needs batteries or internet), low-tech (simple static displays, single-message recordable buttons), and high-tech (dynamic-display devices and apps that speak out loud). Each tier has real examples worth knowing, and no tier is inherently better. Research does not back the idea that starting a child on a simpler device helps them "earn" their way up to speech. ASHA's evidence map is clear that full AAC access does not suppress spoken language development.^[1]

What are the main examples of no-tech AAC devices?

No-tech options need zero power and zero internet. They break less, go everywhere, and cost almost nothing to make.

PECS (Picture Exchange Communication System). PECS is a structured teaching protocol, not 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 PECS training workshop costs around $200-400, but the system itself is built from printed or laminated cards you make yourself.

Communication boards. A flat display of symbols, photos, or words organized by category. Core vocabulary boards put high-frequency words ("more," "stop," "want," "help") in the center and fringe vocabulary around them. The Communication Matrix project at the University of Oregon has free downloadable boards.^[3]

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

Choice boards. A small set of 2-8 pictures used for specific routines: bedtime, mealtime, getting dressed. Often the right starting point for toddlers or kids with very early communication profiles.

What are examples of low-tech AAC devices?

Low-tech usually means simple electronics, a fixed display, or a single-message output device. These make a good bridge, and often a good permanent solution for specific contexts.

Single-message voice output devices. The BIGmack (AbleNet) is a large button you record a message onto. Press it, it plays your voice. These run $80-130 retail and get used in classrooms for greetings, requesting, or turn-taking activities. The Step-by-Step Communicator lets you record a sequence of messages (one per press), which works well for scripted routines.

GoTalk series (Attainment Company). GoTalk devices are laminated overlays on a fixed grid of buttons, each pre-recorded with your voice. The GoTalk 9+ has 9 cells across 5 levels (45 messages total) and costs around $200-250 new. They are waterproof, drop-resistant, and ask nothing of parents or teachers in the way of a learning curve.

Cheap single-output buttons. Buttons like the Cheap Talk 4 (around $30) or various Amazon-brand clones let you record four messages. These are practical for kids who are just learning that communication gets results.

The limit on all low-tech devices is the vocabulary ceiling. A 9-cell fixed display cannot grow with the child, so these often get paired with other approaches rather than used alone.

What are the best-known high-tech AAC device examples?

High-tech AAC means dynamic-display devices: the screen changes based on what you select, so vocabulary can be genuinely large. This category includes dedicated hardware and software apps.

Dedicated speech-generating devices (SGDs)

These are purpose-built computers with durable cases, loud speakers, and specialized software pre-loaded. Insurance, including Medicaid, covers them as durable medical equipment under HCPCS code E2510, which is why they still matter even though apps are cheaper.^[4]

Prices vary a lot by vendor, configuration, and whether the device is new or refurbished. These figures reflect 2024-2025 market pricing and will shift.

AAC apps on consumer tablets

Apps run on an iPad or Android tablet you already own, which drops the barrier to entry. The app cost is $0-300; the tablet is $250-1,000. The tradeoff is that consumer tablets are not as tough, speakers are quieter, and insurance reimbursement is harder to get for software-only solutions.

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

For young children or beginners, apps like TouchChat with WordPower Lite or Gotalk NOW (free starter version) let families try before committing.

What AAC apps are free or low-cost?

Free options are real and worth knowing, though most have limits.

Cboard is an open-source, browser-based AAC board that is completely free. It is not as polished as commercial apps but works on any device with a browser and has been used in low-resource settings internationally.^[5]

Communicator Go! from Tobii Dynavox has a limited free tier. LetMeTalk is a free Android app built on ARASAAC symbols. Grid Player (free on iOS) plays pre-built grids but needs the paid Grid 3 software on a computer to edit them.

Little Words (littlewords.ai) takes a different approach: it is an AI-powered speech companion app built specifically for neurodivergent kids, designed to support communication practice at home between therapy sessions. It is not a replacement for a dedicated AAC system but a lower-barrier daily tool. If you want to see whether it fits your child's situation, their start quiz takes about three minutes.

For symbol sets specifically, the ARASAAC library (the Aragonese Portal of Augmentative and Alternative Communication) offers over 40,000 free pictograms licensed under Creative Commons.^[6]

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

Eye gaze technology uses an infrared camera to track where a person is looking on a screen. The user selects symbols or letters by resting their gaze on them for a set amount of time (typically 0.5-2 seconds). This is the main access method for people who cannot use their hands reliably, including children with cerebral palsy, Rett syndrome, or spinal muscular atrophy.

Tobii Dynavox makes the most widely used eye gaze hardware in AAC. Their I-Series and I-13 devices combine an integrated eye tracker and SGD in one unit. Prices for eye gaze systems typically run $10,000-15,000 before insurance.

Eye gaze needs a good evaluation from an SLP and sometimes an assistive technology specialist, because camera positioning, lighting conditions, and the child's seating all affect accuracy. Children as young as 6-12 months can begin learning to use their gaze on purpose, though a formal AAC assessment usually happens around age 2-3 when communication delays are clearer.

Switch access is the other big alternative to direct touch. A child presses a single switch (a button, a puff of air, a head movement) to scan through options on the screen and select one. Slower than eye gaze but very reliable and usable by people with almost any motor profile.

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

Cost varies enormously. A homemade PECS binder costs under $20. A dedicated eye gaze SGD can cost $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. The specific coverage rules vary by state Medicaid 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 legal teeth: 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 coverage is more variable. The Individuals with Disabilities Education Act (IDEA) requires schools to provide AAC as part of a free appropriate public education if the IEP team decides the child needs it, at no cost to the family.^[8] That does not mean the family gets to keep the device at home, but it does mean the school must fund the device for school use.

Many AAC manufacturers run lending libraries, trial programs, and keep funding specialists on staff. PRC-Saltillo and Tobii Dynavox both offer funding support services. Some states run assistive technology programs that loan devices for free. The AT3 Center (funded by the Administration for Community Living) keeps a directory of these state programs.^[9]

For families who cannot get insurance approval quickly, refurbished SGDs are available through manufacturers and third-party vendors for roughly 40-60% of the new price.

What AAC system is best for a nonspeaking autistic child?

There is no single correct answer, and anyone who gives you one without an evaluation is guessing. That said, the evidence points toward a few principles worth knowing before you sit down with an SLP.

The LAMP (Language Acquisition through Motor Planning) approach, developed by The Center for AAC and Autism, applies principles of motor learning to AAC: the same symbol is always in the same location, building motor memory over time.^[10] It is available as a dedicated app (LAMP Words for Life) and as a hardware device. Research support for LAMP is growing but still limited to small studies.

Core vocabulary approaches, used in apps like Proloquo2Go and TouchChat with WordPower, prioritize teaching 200-400 words that account for about 80% of what people say in daily life. A 2019 systematic review in the journal Augmentative and Alternative Communication found core vocabulary interventions had positive outcomes for symbol-based AAC users across ages.^[11]

For young autistic children (ages 2-5), the choice often comes down to what the child will actually pick up and use. Some children respond better to full symbol-based apps. Others engage more with physical picture exchange first. Language acquisition research consistently shows that the medium matters less than the consistency of aided input: when adults model AAC throughout the day, children use it more.^[1]

If your child is already working with a therapist on autism spectrum speech therapy, that therapist is your best starting point. If your child is awaiting evaluation, early intervention services (for children under 3) include free AAC assessment in every state under IDEA Part C.^[8]

What is the difference between AAC for a child with apraxia vs. autism?

The two populations often overlap but have meaningfully different profiles.

Childhood apraxia of speech (CAS) is a motor speech disorder. The child knows what they want to say but cannot reliably get the mouth movements to cooperate. AAC for CAS often works as a bridge rather than a permanent communication system. Many children with CAS who get appropriate speech therapy (motor-learning based, high-repetition, like DTTC or ReST) do develop functional speech, and AAC supports them in the meantime. For CAS, apps and devices that allow pre-programmed phrases and support clear modeled speech output can cut communication frustration while therapy works. See more on this at childhood apraxia of speech.

For autistic children who are minimally verbal or nonspeaking, AAC is often a longer-term or permanent communication system. The goal is not necessarily to replace speech but to give the child a reliable way to communicate now, whatever happens with speech later. Research on AAC and autism consistently shows that providing AAC does not reduce a child's motivation to develop speech.^[1]

In both cases, an SLP evaluation is the right first step. The evaluation should look at the child's motor skills (for access), cognitive and language level, vision, and what communication partners are willing and able to learn. An AT (assistive technology) specialist can add a second layer of evaluation for hardware selection.

If you want background on apraxia of speech more broadly, that context helps you ask sharper questions at the evaluation.

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

Earlier than most parents expect. There is 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 been trialed successfully with children as young as 2. Eye gaze systems can be introduced even earlier for children with severe motor impairments.

The question is not "is my child old enough for AAC?" The question is "what communication system fits where my child is right now?" If you are waiting for 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 does not replace speech therapy. It is a tool that speech therapists teach children to use, and it gives therapists something concrete to work with in sessions.

A good SLP who works with AAC users does something called aided language input, or aided language stimulation: they model the AAC system during natural interactions, pointing to or pressing symbols while speaking, so the child sees what the device is for. This is different from handing a child a device and hoping they figure it out.

For home carryover, parents who learn to model AAC see faster gains in their child's use. Studies on parent-implemented AAC intervention (reviewed in Augmentative and Alternative Communication journal) consistently show that parent training is one of the strongest predictors of outcome.^[11]

If in-person therapy access is limited, online speech therapy options have grown a lot since 2020, and several platforms now specialize in AAC. Telepractice AAC therapy has a reasonable evidence base for school-age children, though the literature on toddlers via telehealth is still thin.

For families doing a lot of work at home, a speech therapy speech therapist can coach parents in AAC modeling during a monthly consult rather than weekly direct therapy, which stretches the budget without losing clinical oversight.

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

What should I look for when comparing AAC device examples for my child?

Five things matter more than anything else in a device comparison.

1. Access method. Can the child reliably touch a screen with a finger? If yes, direct touch works. If motor control is limited, consider switch access or eye gaze. Choosing a device the child cannot physically operate is the single most common reason AAC fails.

2. Vocabulary depth. Can the device grow with the child? A 9-cell fixed display is fine for a 2-year-old starting out but may box in a 6-year-old who wants to say original sentences. Dynamic display systems (apps and high-tech SGDs) have effectively unlimited vocabulary; low-tech systems do not.

3. Symbol system. Different devices use different symbol sets: PCS (Boardmaker), SymbolStix, ARASAAC, or just photographs. Match the symbol style to what the child recognizes and responds to. Some children do better with real photos than abstract pictograms. Most apps let you import custom photos.

4. Durability and portability. A device a child cannot bring to the playground is a device they will not use. SGDs come in rugged cases. Apps on consumer tablets need a good protective case and ideally a carrying strap.

5. Communication partner buy-in. The best device in the world fails if no one around the child knows how to model it. Weigh how much training the parents, teachers, and aides need, and whether they will actually do it. A slightly simpler system that everyone models consistently beats a sophisticated one that sits unused.

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

Frequently asked questions

What is the most commonly used AAC device for autism?

Proloquo2Go is the most widely used AAC app in North America for autistic children, according to survey data from AssistiveWare. Among dedicated hardware, Tobii Dynavox systems hold the largest market share. That said, 'most common' does not mean 'best fit for your child.' An SLP evaluation is the only reliable way to match a device to a specific child's motor, cognitive, and communication profile.

Can a 2-year-old use an AAC device?

Yes. Research by Romski and Sevcik showed that introducing AAC to toddlers under age 3 produced better language outcomes than speech-only intervention. Simple picture boards, single-message buttons, and touchscreen apps have all been used successfully with 2-year-olds. The American Academy of Pediatrics supports early AAC introduction as soon as a communication need is identified, with no minimum age requirement.

Does using an AAC device prevent a child from learning to talk?

No. ASHA's evidence map and multiple peer-reviewed studies consistently show that AAC does not suppress spoken language development. Research by Romski and Sevcik and others suggests AAC actually supports speech development by reducing communication frustration and giving children a reliable way to practice communicating. Delaying AAC access to 'encourage speech' is not supported by evidence.

How much does an AAC device cost?

Costs span a huge range. 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 and IDEA funding can offset or eliminate costs for eligible children; an SLP or AT specialist can help sort out funding.

Will Medicaid pay for an AAC device?

Medicaid covers speech-generating devices as durable medical equipment (HCPCS code E2510) when a licensed SLP documents medical necessity. For children under 21, the EPSDT benefit provides additional legal backing: states must cover medically necessary assistive technology regardless of their standard coverage rules. Specific approval processes vary by state, and most SGD manufacturers have funding specialists who help families through the paperwork.

What is the difference between PECS and a high-tech AAC device?

PECS (Picture Exchange Communication System) is a no-tech, behavior-based protocol where the child physically hands picture cards to a communication partner. High-tech AAC devices use dynamic touchscreens or eye gaze to generate synthesized or recorded speech. PECS builds early requesting skills and requires no technology. High-tech devices allow much larger vocabulary and more spontaneous communication but cost more and require more training for communication partners.

What AAC apps work on Android tablets?

LetMeTalk, Cboard (browser-based, works on any device), TouchChat HD, and Snap Core First all have Android versions. Proloquo2Go is iOS only. GoTalk NOW is iOS only. If you are buying a tablet specifically for AAC, iOS has a broader selection of well-supported AAC apps, which is why many SLPs recommend iPad. That said, Android-compatible apps are real and some work very well.

How do I get my child's school to provide an AAC device?

Under IDEA, if the IEP team decides that AAC is necessary for your child to receive a free appropriate public education, the school must fund it. Request an assistive technology evaluation in writing as part of the IEP process. The school must evaluate within a reasonable timeline. The device the school funds typically stays at school, but you can request in the IEP that it go home too; schools sometimes agree to this.

What is eye gaze AAC and what conditions is it used for?

Eye gaze AAC uses an infrared camera to track where the user looks on a screen, letting them select symbols or letters without using their hands. It is primarily used for people with cerebral palsy, Rett syndrome, spinal muscular atrophy, or ALS who cannot reliably use direct touch or switch access. Systems from Tobii Dynavox are the most common. Costs typically run $10,000-15,000 before insurance, and evaluation by an AT specialist is required.

What is the difference between a dedicated SGD and an AAC app?

A dedicated SGD is purpose-built hardware: rugged case, loud speaker, specialized software, and support for multiple access methods. An AAC app runs on a consumer tablet and costs far less but is less durable, has quieter speakers, and is harder to get insurance reimbursement for. SGDs are easier to fund through Medicaid. Apps are a faster and cheaper way to start, and many families use both: an app at home and an SGD at school.

Is LAMP (Language Acquisition through Motor Planning) better than other AAC approaches?

LAMP has a growing research base and strong clinical support, particularly for autistic children who respond well to motor-learning approaches (consistent symbol placement building motor memory). But the research is mostly small studies without randomized controls. Core vocabulary approaches also have strong evidence. The best approach depends on the individual child. An SLP familiar with both can help compare them based on your child's profile.

Can a child use AAC alongside sign language?

Yes, and this is common. Using multiple modalities at once, called total communication, is supported by ASHA. Signs, picture boards, and speech can all be used together without confusing children. Some children sign for familiar words and use a device for less familiar vocabulary. The goal is giving the child every reliable tool available, not picking one and discarding the others.

What symbols does Proloquo2Go use and can I add photos?

Proloquo2Go uses SymbolStix symbols by default, with the option to switch to PCS (Boardmaker) or custom photos. You can import any photo from your camera roll to replace any symbol. This matters for children who recognize real objects better than stylized pictograms. Custom photos of the child's own toys, family members, and food items often improve initial engagement significantly.

What AAC resources are free for parents?

Several: the Communication Matrix (University of Oregon) has free assessment and planning tools. ARASAAC offers 40,000+ free pictograms. Cboard is a free browser-based AAC app. PrAACtical AAC (praacticalaac.org) is a well-regarded free blog for parent education. ASHA's public portal has overview materials. Many SGD manufacturers also offer free trial periods and online training videos, even if you have not purchased 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