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

Last updated 2026-07-09

What are autism communication symbols?

Communication symbols are picture images, line drawings, or photographs that stand in for words or phrases. For an autistic child with limited or no spoken language, a symbol can mean the difference between being understood and total frustration. The child points to, hands over, or touches the symbol on a board, book, or device, and a communication partner responds as if the child had said the word.

Symbols come in several forms. Some are realistic photographs of actual objects and people the child knows. Others are stylized line drawings designed to be recognized instantly across cultures. Some systems use color coding, with verbs one color and nouns another, to help children pick up grammar patterns over time.

The wider category these systems belong to is augmentative and alternative communication, or AAC. The American Speech-Language-Hearing Association defines AAC as "all forms of communication (other than oral speech) that are used to express thoughts, needs, wants, and ideas" ^[1]. Symbols are one of the most accessible entry points into AAC because they need no reading and very little fine motor skill.

Symbol use is not a last resort. Speech-language pathologists usually recommend starting symbol systems early, before a child's lack of communication turns into behavioral frustration. The research here is consistent enough that the American Academy of Pediatrics' guidance on autism management names AAC as a recommended communication support ^[2].

What are the main types of autism communication symbol systems?

Three symbol sets come up constantly, and they're genuinely different in design philosophy, cost, and evidence base.

Picture Communication Symbols (PCS) are the line drawings that ship with Boardmaker software, made by Tobii Dynavox. PCS is probably the most widely used symbol library in North American schools and therapy settings. The library holds over 45,000 symbols as of the current Boardmaker catalog ^[3]. Color coding stays consistent: green for verbs, yellow for descriptors, orange for nouns, and so on. The catch is cost. Boardmaker licenses start around $349 per year for home use as of 2024, though many school districts provide access.

ARASAAC (Aragonese Portal of AAC) symbols are free. The Spanish government funds this library and releases every symbol under a Creative Commons license. There are over 12,000 color symbols and thousands more in black and white ^[4]. Quality is high. Plenty of free apps and low-tech boards use ARASAAC graphics. If cost is a barrier, start here.

PECS (Picture Exchange Communication System) is a different animal. It's more than a symbol set. It's a structured teaching protocol developed by Andy Bondy and Lori Frost in the late 1980s at the Delaware Autistic Program. PECS uses photographs or simple drawings, but the method matters as much as the images. Children learn to physically hand a symbol to a communication partner in exchange for something they want. A 2002 randomized study in the Journal of Applied Behavior Analysis found that children using PECS made gains in spontaneous communication, and some showed increased spoken words alongside symbol use ^[5].

A quick comparison:

There are also photograph-based systems, which help children who struggle to generalize from a drawing to a real object. That struggle is more common than many parents expect.

Does using symbols actually help autistic kids communicate better?

Yes, and the evidence is stronger than for many interventions families spend real time and money on.

A 2014 systematic review in the American Journal of Speech-Language Pathology examined 23 studies on AAC and autism. It found consistent evidence that symbol-based systems increased communicative acts in children with autism spectrum disorder, with no evidence that AAC suppressed speech development ^[6]. That last part matters enormously, because the fear that symbols will "replace" speech and kill the motivation to talk is one of the most common reasons families hesitate.

The honest picture has more shading. AAC does not automatically produce spoken words. What the research shows is that it doesn't hurt speech development, and in many cases it gives the child a communication platform that lowers frustration enough that spoken attempts become more frequent, not less. The National Institute on Deafness and Other Communication Disorders notes that for nonspeaking or minimally verbal individuals, AAC "may help them communicate more effectively." ^[7]

For children who are minimally verbal, meaning they use fewer than 20 functional words, symbol systems often become the main path toward any communication at all. The question stops being "symbols or speech" and becomes "symbols while we also work on speech" with a speech therapist.

One thing nobody has clean data on: the ideal age to start. Clinical consensus from ASHA and most SLPs leans toward starting as early as possible, often at 18 to 24 months once communication delays are visible. The early intervention window before age 3 is real, and it matters.

What is the difference between core vocabulary and fringe vocabulary in symbol systems?

This distinction is one of the most practical things a parent can learn, and most AAC training programs explain it badly.

Core vocabulary is the set of words that makes up the bulk of everything people say, no matter the topic. Words like "more," "go," "stop," "want," "help," "no," "yes," "I," "you," and "that" are core. Research consistently shows that roughly 200 to 400 words make up 80% of what typically developing speakers say ^[8]. Core words are flexible. "Go" works at the park, in the car, during play, and at bedtime.

Fringe vocabulary is topic-specific. "Dinosaur," "swing," "cheese," "iPad" are fringe words. They matter to one child but don't travel across situations.

Early AAC boards were often built almost entirely from fringe vocabulary, because it felt more useful to give a child symbols for favorite foods and toys. The problem: a board full of fringe words produces a child who can request specific things but can't say "stop" when something hurts or "more" when they want an activity they love to keep going.

Most SLPs now build around core vocabulary first, with a small amount of personalized fringe. A starting board of 12 to 20 symbols, mostly core words plus a few high-motivation fringe items (the child's favorite food, the pet's name), is a reasonable place to begin. The call about exactly which symbols to start with should involve a speech-language pathologist who knows your child.

How do low-tech symbol boards work and when should you use them?

A low-tech symbol board is exactly what it sounds like. Paper or laminated cards with printed symbols, arranged on cardboard, a binder page, or a small flip book. No battery, no screen, no app.

Low-tech boards have real advantages. They're nearly indestructible. A laminated card survives the bathtub, the car seat, and being thrown across a room. They're cheap, sometimes free if you print ARASAAC symbols at home. They're always on. No loading time, no dead battery at the worst possible moment.

For very young children, or children just starting with symbols, a simple first/then board (a two-panel strip showing what happens now and what happens next) is often the first low-tech tool an SLP introduces. It's not a full communication system, but it gives the child a visual anchor for daily transitions, which cuts down on anxiety-driven communication breakdowns.

Activity boards are another low-tech staple. You make a specific board for a specific moment: a snack-time board with choices for drinks and foods, a bath-time board, a playground board. The symbols fit the moment, so the child has a real reason to use them.

Low-tech doesn't mean low ambition. Plenty of children communicate complex ideas through well-designed paper systems. The PODD (Pragmatic Organisation Dynamic Display) communication book, developed by Gayle Porter in Australia, is a sophisticated low-tech system used with children who have complex communication needs, including many autistic children ^[9]. It's organized by communicative function instead of category, a genuinely different approach that some children find more intuitive.

How do high-tech AAC devices use symbols, and are they worth the cost?

High-tech AAC devices are tablets or dedicated devices running communication software. The software shows symbol grids, and the child selects symbols to build messages that the device speaks aloud with text-to-speech. PRC-Saltillo, Tobii Dynavox, and Lingraphica are the main dedicated device makers.

Dedicated devices are expensive. A purpose-built AAC device usually runs between $6,000 and $10,000 before insurance ^[10]. Medicaid covers AAC devices in most states for children who qualify, and private insurance coverage has improved since the 21st Century Communications and Video Accessibility Act and various state parity laws. The process involves a formal AAC evaluation by a speech-language pathologist, a recommendation letter, and often a long prior authorization.

Apps on consumer iPads cost far less. Proloquo2Go (AssistiveWare) runs around $250 as a one-time purchase and uses a PCS symbol library. TouchChat, LAMP Words for Life, and Snap Core First are other established options, each with a different symbol layout philosophy.

Whether high-tech is worth it depends on the child. High-tech devices generate speech output, which matters for talking with people who don't know the child's symbol system. They can hold hundreds or thousands of symbols across pages. They can grow with the child. For a child who shows clear potential for complex communication, the investment is often justified. For a child just starting to explore symbols, a low-tech board while you wait for insurance approval is not a step backward.

One honest caveat: device abandonment rates in AAC are high. Studies have estimated that 25 to 33% of AAC devices end up unused ^[11]. The device is not the solution. Consistent, supported use of the device is. That takes training for the family, more than for the child.

What is aided language stimulation and why do speech therapists use it with symbols?

Aided language stimulation, sometimes called modeling or AAC modeling, is when communication partners point to or activate symbols while they speak normally to a child. If you're telling a child "let's go eat lunch," you also touch the "go" and "eat" symbols on the board or device as you say the words.

The idea comes from how children learn spoken language. They hear thousands of hours of speech before they produce it. Symbol users need the same kind of input. Handing a child a board and expecting them to use it without ever seeing adults use it is like expecting a child to read without ever watching anyone read.

The evidence for modeling is solid. A 2014 study in Augmentative and Alternative Communication found that aided language stimulation was linked to increases in symbol use by children with autism when communication partners did it consistently ^[12].

In practice, this means everyone in the child's world needs to model, more than the SLP once a week. Parents, siblings, teachers, and grandparents all touching the symbols during natural conversation is what actually moves outcomes. It feels awkward at first. It becomes automatic with practice.

A common mistake is only pointing to symbols when you're prompting the child to communicate. That teaches the child that symbols are for being tested, not for talking. Modeling should run throughout the day, with no expectation of imitation.

Which symbol system works best for nonverbal or minimally verbal autistic children?

No single system is universally best for minimally verbal autistic children. That's not a dodge. It reflects real differences in how children process visual information, what motivates them, and what their motor skills allow.

Still, a few patterns show up in the research. Children who are very young, or who have significant cognitive delays, often do better starting with a small set of high-contrast, highly motivating symbols than with a large grid. Starting big overwhelms. Starting with three symbols that matter enormously to the child, like "more," "help," and a symbol for a favorite food, produces faster early success than a 64-symbol board.

For children with apraxia of speech alongside autism, the case for a full AAC system is especially strong. Apraxia makes spoken word production unreliable even when the child knows the words, so a symbol system gives a dependable output channel while speech therapy works on the motor planning.

For children who don't respond to two-dimensional drawings, object-based systems exist. Actual physical objects (a spoon for mealtime, a small car for a car trip) can serve as early symbols. The goal is always to move toward more portable, flexible systems over time.

The best approach starts with an SLP completing a formal AAC assessment. That assessment weighs the child's visual skills, motor skills, cognitive level, what motivates them, and the communication environment at home and school. No app or article replaces that evaluation.

How do you introduce communication symbols to an autistic child at home?

Start with something the child genuinely wants. This sounds obvious, but it decides everything about motivation. If your child would move mountains for crackers, make a cracker symbol the first one. The exchange has to matter to them.

For a first board, three to five symbols is plenty. Put them somewhere highly visible in the right context: on the refrigerator for food requests, on the bathtub ledge for bath choices. Don't move the board around constantly at first. Predictability helps.

Model constantly, without pressure. Touch the symbol as you say the word, all through normal daily talk. If your child grabs your hand to drag you to the kitchen, touch the "eat" or "want" symbol and say "eat? You want to eat?" Then follow through right away. The symbol has to reliably get results, or the child stops using it.

Expect a long stretch before the child starts using symbols on their own. Some children take weeks. Others take months. Resist the urge to prompt constantly or to test. Prompting can create prompt dependence, where the child only uses the symbol when asked, which is not functional communication.

Keep a few symbols portable. A small keyring with four or five laminated cards can go to the grocery store, the car, and the playground. Limiting symbols to one room at home accidentally teaches the child that symbols only work in that room.

A tool like Little Words can support daily practice by giving parents a structured, symbol-rich setup that adapts to what the child already knows. It's useful in the stretches between therapy appointments.

And connect with a speech therapist who has AAC experience. Home practice works best when it mirrors what's happening in therapy.

Do communication symbols work for autistic adults too?

Yes, and this area has grown as more autistic adults speak publicly about their own communication needs.

Some autistic adults who grew up without AAC find symbol-based or text-based systems later in life. Others go through periods of reduced verbal fluency, sometimes called autistic burnout or situational mutism, where they need symbol or text support even when they usually speak. This is more common than most medical literature admitted even a decade ago.

For older teens and adults, the symbol sets and display styles often look different. Vocabulary needs shift. Social communication symbols, symbols for medical settings, symbols for work, and symbols for getting around the community become more relevant. The core vocabulary approach still holds.

AAC for adults falls under the same speech therapy framework, though insurance pathways and access vary. Speech therapy for adults with autism is a legitimate and underused resource, and an adult AAC assessment from an SLP is the right starting point.

Autistic self-advocates have pushed back, usefully, against the assumption that AAC is only for children or only for people who "can't talk at all." Communication needs shift with time, context, and stress. A system that helps someone communicate more reliably on hard days is worth having.

How does symbol-based communication connect to broader autism speech therapy?

Symbols are one tool inside a much larger approach to autism spectrum speech therapy. Most SLPs working with autistic children address several things at once: social communication, speech production, language comprehension, and AAC as needed.

Symbol systems handle the output side of communication. They give the child a way to send messages. But communication also means understanding incoming messages, taking turns, holding a topic, and reading social cues. Symbol training alone doesn't cover all of that.

Some children using symbols also show echolalia, repeating phrases they've heard. Echolalia and symbol use can live together, and a good SLP will help sort out whether a child's echolalic phrases are serving communicative functions, which they often are. Understanding echolalia meaning is part of reading the child's whole communication picture.

For children with motor-based speech difficulties alongside autism, childhood apraxia of speech and symbol-based AAC often go together. The AAC doesn't replace speech therapy for apraxia. It gives the child functional communication while that therapy does its slow work.

If you're not already working with an SLP, online speech therapy is a real and often insurance-covered option that has widened access a lot, especially for families in rural areas or those without local specialty providers.

Frequently asked questions

At what age should an autistic child start using communication symbols?

There's no minimum age, and earlier is almost always better. Clinical consensus from ASHA supports introducing AAC as soon as a communication delay is identified, which can be as early as 18 months. Waiting to see if speech develops on its own before introducing symbols is not recommended by major professional bodies. Symbols don't interfere with speech development.

Will using picture symbols stop my child from learning to talk?

Research says no. A 2014 systematic review in the American Journal of Speech-Language Pathology found no evidence that AAC suppresses speech development, and several studies found increases in spoken communication alongside symbol use. The concern that symbols replace speech has been studied repeatedly and not supported. Most SLPs treat AAC as a complement to speech therapy, not a substitute for it.

What is the PECS method and how is it different from other symbol systems?

PECS stands for Picture Exchange Communication System. It's a teaching protocol where children physically hand a picture symbol to a communication partner to make requests. The exchange action is the key feature. PECS has six phases, moving from simple single-picture requests to sentence construction. It differs from other systems in its emphasis on the child initiating the exchange rather than waiting to be prompted.

Are there free autism communication symbol resources online?

Yes. ARASAAC (arasaac.org) offers over 12,000 free color symbols under a Creative Commons license. You can download, print, and laminate them at home. Widgit and Mulberry Symbol sets also have free components. Many SLPs make activity boards using these free resources. The Boardmaker software with PCS symbols costs money, but your child's school may already have a license.

How many symbols should a beginner board have?

Most SLPs recommend starting with 3 to 10 symbols for a brand-new symbol user. The exact number depends on the child, but starting small lets you model consistently and gives the child clear choices without overwhelming them. Focus on core vocabulary words like "more," "help," "stop," and "want," plus one or two high-motivation fringe words personal to your child.

What is aided language stimulation and how do I do it at home?

Aided language stimulation means you touch or point to symbols on your child's board as you speak naturally throughout the day. You're not prompting the child to use symbols; you're modeling how they're used. Touch "go" when you say "let's go." Touch "eat" at mealtimes. Research supports this approach as the main driver of symbol learning. Aim for consistent modeling all day long, across activities.

Can an autistic child use both symbols and speech at the same time?

Absolutely, and this is actually the goal for many children. Using symbols alongside spoken words, called multimodal communication, is how most successful AAC users communicate. Children who start with symbols and also receive speech therapy often develop spoken words over time. The symbol system stays available as a reliable backup and for moments when speech is harder to produce.

What's the difference between a communication board and a PECS book?

A communication board is a fixed display of symbols arranged on a surface, often a binder page, laminated card, or board. A PECS book is a portable binder where individual symbol cards are stored with Velcro, so the child can remove a card and hand it to a partner. PECS books follow a specific teaching protocol. Communication boards are a broader, less protocol-bound tool that many families and therapists use.

Does insurance cover AAC devices and speech therapy for autistic children?

Medicaid covers AAC devices in all states for eligible children, typically requiring an SLP evaluation and prior authorization. Private insurance coverage varies by state and plan but has improved. The 21st Century Communications and Video Accessibility Act created some federal frameworks. Many states have autism insurance mandates that include speech therapy and AAC. Your SLP can help with the documentation process for device approval.

What do I do if my child refuses to use their communication board?

Refusal is common and usually signals one of a few things: the symbols don't represent anything the child cares about, the prompting feels like a test rather than a conversation, or the board is too big or visually confusing. Revisit which symbols are included, reduce the board size, increase your own modeling without pressure, and make sure symbol use reliably gets the child what they want. An SLP can observe and troubleshoot.

How is symbol-based communication different from sign language for autism?

Symbol systems are visual images on surfaces or screens. Sign language uses hand and body movements. Both are forms of AAC. Signs require consistent fine motor execution and a partner who understands them. Symbols work with anyone who can see the board. Many children use both. There's no evidence one is superior; the choice depends on the child's motor skills, the communication environment, and what their support team recommends.

Can autistic adults use communication symbols, or is this just for kids?

Adults use them too, and the autistic adult community has been vocal about needing AAC options at any age. Some autistic adults use symbols situationally, during high-stress moments or when verbal communication breaks down. Others use them as a primary system. The vocabulary and display design look different for adults, but the underlying approach is the same. An adult AAC evaluation from an SLP is the right first step.

What symbol app works best on an iPad for autistic children?

Proloquo2Go is the most researched app in peer-reviewed literature and uses PCS symbols. TouchChat and LAMP Words for Life are also widely used in clinical settings. LAMP follows a motor-learning approach that some children respond to strongly. The "best" app depends on the child's needs, their SLP's experience, and your budget. Most have free trials. Involve an SLP before committing to a paid system.

Sources

1. ASHA, Augmentative and Alternative Communication Overview: ASHA defines AAC as 'all forms of communication (other than oral speech) that are used to express thoughts, needs, wants, and ideas'
2. American Academy of Pediatrics, Management of Children with Autism Spectrum Disorder: AAP guidance on autism management includes AAC as a recommended communication support for children with ASD
3. ARASAAC, Aragonese Portal of AAC: ARASAAC offers over 12,000 color symbols released free under a Creative Commons license, funded by the Spanish government
4. Charlop-Christy et al., Journal of Applied Behavior Analysis, 2002: A 2002 study in JABA found that children using PECS showed gains in spontaneous communication and some showed increased spoken words alongside symbol use
5. Ganz et al., American Journal of Speech-Language Pathology, 2014: A 2014 systematic review of 23 studies found consistent evidence that symbol-based AAC increased communicative acts in children with ASD, with no evidence that AAC suppressed speech development
6. National Institute on Deafness and Other Communication Disorders, AAC: NIDCD notes that AAC 'may help them communicate more effectively' for nonspeaking or minimally verbal individuals
7. Gayle Porter, PODD Communication Books, Cerebral Palsy Alliance Research Foundation: PODD (Pragmatic Organisation Dynamic Display) is a sophisticated low-tech communication system organized by communicative function, used with children who have complex communication needs including autism
8. ASHA, AAC Funding Resources: Purpose-built AAC devices typically cost between $6,000 and $10,000 before insurance coverage
9. Johnson et al., AAC device abandonment review, Disability and Rehabilitation: Assistive Technology: Studies have estimated that 25 to 33% of AAC devices end up unused, with device abandonment a recognized challenge in the field
10. Cafiero, Augmentative and Alternative Communication, 2014 (aided language stimulation): Aided language stimulation was associated with increases in symbol use by children with autism when implemented consistently by communication partners