Last updated 2026-07-10
A communication board is a low-tech tool, just a flat surface with pictures, symbols, or photos your child can point to instead of speaking. You can put one together in an afternoon with printed symbols, a laminator, and some velcro. Start small: 6 to 12 symbols your child actually cares about, grouped loosely by category, and spend time teaching pointing before expecting your child to use the board on their own.
Speech-language pathologists call this kind of tool AAC, short for augmentative and alternative communication. 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," and low-tech boards are among the oldest and most studied forms of it [1].
A board won't hold your child back from talking. There's no evidence that giving a child a picture board slows verbal development, and several studies point the other way. A 2006 systematic review in the American Journal of Speech-Language Pathology found that AAC "did not impede and in many cases facilitated natural speech production" across the studies it examined [2]. The fear that a picture board will make a child stop trying to talk is one of the most persistent myths in pediatric speech therapy, and the data just doesn't support it. For a child who is nonverbal or has very few words, a board solves something immediate: it gives them a way to be understood before spoken words show up. A lot of meltdowns in young children with autism or other communication disorders start with the frustration of not being understood, and a board can cut that frustration from day one.
Any child who can't reliably use spoken words to get their needs met is a reasonable candidate, whether they're completely nonverbal, have some words that vanish under stress, or lean on echolalia (repeating phrases they've heard) instead of coming up with their own words. Our article on echolalia gets into why children do this.
There's no minimum age. Boards have worked for toddlers as young as 18 months and for older kids and adults with complex communication needs. The American Academy of Pediatrics recommends referring children who miss communication milestones, no words by 12 months, no two-word phrases by 24 months, or any loss of language they'd already gained, for early intervention right away, without waiting [3]. You don't need a diagnosis in hand to start, either. If your child is struggling to communicate, you can build a simple board this week while an evaluation is still pending, and a speech-language pathologist can refine it later once they've assessed your child. Waiting for a diagnosis first just means more weeks of avoidable frustration. Children with autism spectrum disorder, childhood apraxia of speech, cerebral palsy, Down syndrome, and global developmental delays use these boards often, but really any child who needs a bridge to communication can benefit.
Choosing what goes on the board
Start with what your child actually wants, not what seems logical to you. High-motivation vocabulary gets used right away: favorite foods, favorite toys, key people, basic feelings. A symbol for "more" is almost always worth including, since it applies to so many situations.
The symbol sets most clinicians reach for are Boardmaker's Picture Communication Symbols (PCS) and Widgit Symbols. Both are proprietary but offer free samples and lite versions. The Mulberry Symbol Set is a free, open-licensed alternative used internationally [4]. For young children, real photos of their own toys, food, and family often land better than abstract line drawings, simply because it's obvious what they represent.
Most SLPs suggest starting with 6 to 12 symbols: enough to cover the basics (eat, drink, more, stop, help, go, yes, no) plus a few favorites, but not so many that the child feels overwhelmed. You can add more once pointing clicks as a form of communication.
Feelings are a category parents often skip, but even a board with just "happy," "sad," "scared," and "angry" gives a child a way to name what's going on inside, which tends to cut down on meltdowns and build self-awareness over time. The CDC's Learn the Signs, Act Early materials list basic emotion vocabulary as a communication target starting at 24 months [5]. Whatever you do, don't cram too much onto one page early on: crowding slows scanning and hurts accuracy, especially for kids with motor or visual processing differences.
Laying the board out
Layout matters more than most parents assume. AAC specialists favor a grid because it's predictable: your child learns where each category lives, motor memory builds, and pointing speeds up over time. Put your highest-frequency words in the top-left area, since most people, including children who can't yet read, tend to scan left to right and top to bottom. That means "more," "help," and "stop" need to be easy to reach, not tucked in a corner.
Color-coding by category, a practice called Fitzgerald Key after the educator who developed it in the early 20th century, is still common in AAC today. Typical assignments: people in yellow, verbs and actions in green, nouns in orange, descriptors in blue, social words in pink, and small connecting words like prepositions in white. Not every SLP follows Fitzgerald Key exactly, and the evidence for specific colors is modest, but the underlying idea, that grouping symbols visually helps kids navigate the board, holds up well [6].
How big to make each cell depends on your child's motor control. If pointing is hard for them, go bigger, at least 5 cm by 5 cm, to give more room to land on target. If they can point accurately to small targets, you can fit more vocabulary onto a denser grid. A formal AAC assessment will measure this properly, but you can get a rough sense at home: print a simple 4-square grid and see if your child can reliably touch individual squares on command.
Laminate whatever you make. A laminated sheet survives spilled drinks, dropped lunches, and being dragged outside. A basic laminator runs $25 to $40 at any office supply store, and pouches cost next to nothing. Velcro on the back of each symbol card lets you rearrange and expand vocabulary as your child grows.
What it costs to put one together
You don't need to spend much to get started. Here's a realistic look at your options at different budget levels.
| What you need | Free or very cheap option | Mid-range option |
|---|---|---|
| Symbols/images | Google Image Search photos, Mulberry Symbol Set (free download) [4] | Boardmaker Online (subscription ~$99/year) |
| Board surface | Cardstock printed at home | Foam board from dollar store |
| Lamination | Clear packing tape over symbols | Laminator ($25-40) + pouches |
| Fastening symbols | Tape | Velcro dots (~$5/pack) |
| Carrying system | Ziplock bag or small binder | Binder with sheet protectors |
For the bare minimum, print 12 symbols on one sheet of cardstock and cover it with clear packing tape. That's it, done in under an hour with nothing special on hand. If you'd rather build something that grows with your child, get velcro dots and laminate individual symbol cards so you can swap vocabulary without reprinting the whole thing. A small three-ring binder with sheet protectors doubles as a portable communication book with multiple pages sorted by category.
Some families skip straight to apps. AAC apps for iPad, Proloquo2Go, TouchChat, LAMP Words for Life among them, work as dynamic communication boards with essentially unlimited vocabulary. They run $200 to $300 as a one-time purchase, or come with subscription pricing, and insurance sometimes covers them when an SLP prescribes one. If you want to weigh low-tech against high-tech options side by side, our overview of AAC devices covers the full range.
How do you teach a child to use a communication board?
Having the board is step one. The harder part is teaching your child that pointing to a symbol actually makes something happen, and that only comes with repetition.
The method with the most evidence behind it is aided language stimulation, sometimes called modeling. You, the adult, use the board constantly throughout the day: point to "eat" at lunchtime, point to "more" when your child reaches for another cracker, point to "stop" when you stop tickling. You're not drilling your child, you're showing them how the board works by using it yourself. Research suggests modeling by communication partners is associated with increased AAC use and more diverse vocabulary in children [7].
Don't wait around for your child to communicate on their own. Early on, set up moments where they'll need to reach out: hold up something they want and pause, stop a favorite video partway through, give a tiny bit of a favorite snack and watch what they do when they want more. The moment they reach, look at you, or make a sound, guide their hand to the right symbol and hand over the item right away. Some call this mand training, others call it creating communication opportunities. Whatever the label, the point is the same: your child needs to feel, directly, that communication gets results.
Hand-over-hand guidance to the symbol is a fine way to start, but fade it out as soon as you can. The goal is independent pointing, not a prompted routine that never changes.
Keep the board within reach always. One stuck in a drawer does nothing. AAC specialists call this "aided language input," and it needs to happen everywhere communication might happen: home, car, playground, grandma's house. Everywhere, really.
Give it weeks or months, not days. Some kids catch on fast, others take much longer, and there's no clean data on exactly how long it should take, since it depends on cognitive level, motor skills, vision, and how consistently the adults around a child model the board. The rough guidance from clinical practice is that daily modeling for 4 to 6 weeks usually produces some independent symbol use, but treat that as an average, not a promise.
Communication board, PECS, or an AAC app: what's the difference?
People mix these up constantly, so here's the plain version.
A communication board is static: every symbol sits visible at once, in a fixed place, and the child points to it there.
PECS, the Picture Exchange Communication System, is a specific protocol Bondy and Frost developed in the early 1990s. The child picks up a physical picture card and hands it to another person, and that exchange is the whole point. PECS runs on a six-phase protocol, starting with trading a single card for something desired and building up to simple sentences. It has solid evidence behind it for early-stage communicators, particularly children with autism [8]. A board and PECS aren't mutually exclusive; you can run both, or pick whichever fits your child better.
AAC apps and speech-generating devices are dynamic: multiple pages to navigate, synthesized speech when you touch a symbol, room for thousands of vocabulary items. They do more, cost more, and need charging, updates, and some tech comfort from whoever's using them with the child. Starting with a low-tech board and moving to an app later makes sense for many kids. Others, especially those with accurate pointing and strong receptive language, do fine jumping straight to an app.
Don't think of a paper board as something to outgrow. Plenty of people use low-tech boards as their main system for life, because they're durable, need no charging, survive water, and cost almost nothing to replace. An SLP trained in AAC can help you figure out which system, or mix of systems, fits your child; our guide to speech therapy and speech therapists can help you find one.
Should the board use words, pictures, or both?
Both, if your child reads or is getting close. Pairing written words with symbols is standard practice for any child who might develop literacy: it puts print in front of them in context, and it helps anyone unfamiliar with the symbol set understand the board too.
For a child who's pre-literate and not yet showing interest in letters, pictures alone work fine. A symbol doesn't need a word underneath to do its job. What matters is accurate, consistent use, not reading ability.
Kids with childhood apraxia of speech often understand language well and are working toward literacy even while speech itself is hard to produce, so written words next to symbols can be especially motivating: they know the gap between what they understand and what they can say out loud.
Pick symbols your child can actually tell apart visually. Some children do much better with real photographs than line-art icons; others find photos cluttered and prefer a clean PCS-style outline. The honest answer is to try both and watch which one your child looks at and points to more accurately. That's genuinely how these decisions get made in an AAC assessment.
How do you get the board working at school and with other caregivers?
Consistency across settings is the single biggest factor in whether AAC use actually generalizes. A child using the board at home with no access at school will progress more slowly, full stop.
If your child has an Individualized Education Program under the Individuals with Disabilities Education Act, AAC tools including communication boards have to be considered as part of the assistive technology assessment. IDEA defines assistive technology as "any item, piece of equipment, or product system, whether acquired commercially off the shelf, modified, or customized, that is used to increase, maintain, or improve functional capabilities of a child with a disability" [9], and a board clearly qualifies. You can request an assistive technology evaluation through the IEP team at no cost.
Send a duplicate board to every setting: home, school, grandparents' house, therapy. Print several copies. An extra laminated sheet costs almost nothing; inconsistent access costs real progress.
Get everyone who spends time with your child modeling on the board. A five-minute walkthrough is enough to start: here are the symbols, here's how you point while you talk. Grandma doesn't need to become a speech therapist, she just needs to point to "eat" before lunch.
Keep a simple log of what's working: which symbols your child uses on their own, which still need prompting, what new words they seem drawn to. Bring it to every therapy visit. It saves your SLP time and makes progress visible.
What free tools can help you build a board quickly?
A handful of solid free tools can speed this up a lot.
Board Builder on the Boardmaker share site has thousands of free pre-made boards in multiple languages. SymbolStix offers a limited free tier. The Mulberry Symbol Set is free for both personal and commercial use [4].
PracticalAAC.com, run by SLP researchers, has free downloadable core vocabulary boards and how-to guides. CommunicationFIRST.org and the Communication Matrix (built by Charity Rowland at OHSU) offer free resources for figuring out where your child is communicatively and what vocabulary to target next [10].
If you'd rather not build a board from scratch, apps like Little Words (littlewords.ai/start) use AI to suggest a layout and vocabulary based on your child's age, goals, and interests. The quiz takes about five minutes and gives you a vocabulary list you can print or use digitally.
Google Slides and Canva both work fine for arranging symbols in a grid to print, and neither needs design skill. Search "AAC board template Canva" and you'll find free community-made templates ready to copy and edit.
Make Print Go (makeprintgo.com) is a browser tool built specifically for low-tech AAC boards, with built-in symbol search, and it's free for basic use.
Talk to a speech-language pathologist now, honestly. A communication board built with SLP guidance will match your child's actual communication level far better than one built from a generic template. That said, you don't need to wait for an appointment to get started. Build the board this week, then bring it in and refine it together. ASHA recommends that any child with suspected communication delays be evaluated by a certified SLP. The earlier that evaluation happens, the earlier intervention can begin, and the evidence for early intervention in communication disorders is strong [11]. If your child is under 3, contact your state's early intervention program (Part C of IDEA) directly. Most states don't require a referral, and services are free or low-cost depending on income [9]. If your child is already school-age, request an evaluation through the school district in writing; the district has to respond within a set timeframe, typically 60 days, though this varies by state. A school SLP can run a formal AAC assessment that includes feature matching: testing which symbol types, grid sizes, and vocabulary sets fit your child's motor, visual, and cognitive profile. Children with autism spectrum disorder often do better with SLPs who have specific AAC and autism training; our piece on autism spectrum speech therapy covers what to look for in a provider. Telemedicine evaluation is also widely available now and often covered by insurance since telehealth expanded after 2020. Online speech therapy can include AAC support, board review by video, and parent coaching, which tends to be more practical than weekly in-person visits for busy families. **How do you know if the board is working?** Set concrete, observable targets before you start, so you actually know what "working" looks like. Something like: within four weeks, the child independently touches the "more" symbol at least three times a day without a physical prompt. That's measurable. "Communication is improving" isn't. Track which symbols the child uses independently versus with prompting, how often they initiate rather than just respond, whether they're combining symbols (even two in sequence is a real milestone), and whether frustration behaviors are dropping. If, after 6 to 8 weeks of consistent daily modeling, there's no sign of symbol use or interest, that's worth acting on. Get an SLP evaluation if you haven't already, or revisit the vocabulary and layout with your SLP if you have one. Sometimes the board itself is off: too many symbols, the wrong symbol type, vocabulary that misses the child's real motivations, or a layout that's hard to point to given their motor abilities. Success looks different depending on age and ability. For a child who was completely nonverbal, touching one symbol to request one thing is real progress. Celebrate it, then build from there. **Frequently asked questions** *What age can you start using a communication board?* There's no minimum. Boards have worked with children as young as 12 to 18 months. For very young kids, start with just 2 to 4 high-motivation symbols, use real photos rather than abstract icons, and focus on modeling rather than expecting independent use right away. The American Academy of Pediatrics supports introducing AAC as soon as a delay is suspected [3]. *Will a communication board stop my child from trying to talk?* No, and this is the concern parents raise most often. A 2006 systematic review in the American Journal of Speech-Language Pathology found that AAC use "did not impede and in many cases facilitated natural speech production" [2]. Giving a child a way to communicate reduces frustration, which usually makes speech easier to emerge, not harder. *How many symbols should be on a first board?* Start with 6 to 12: enough to cover basic needs plus a few favorites without overwhelming the child. Common starting symbols are more, stop, help, eat, drink, yes, no, and two or three preferred people or items. Add vocabulary gradually as existing symbols get used reliably rather than building a large board all at once. *What's the difference between core and fringe vocabulary?* Core words are high-frequency and cross-context: more, help, want, go, stop, like, no. They make up roughly 80% of what most people say. Fringe vocabulary is specific to a person or situation, like a favorite character's name or a particular food. A good board has both, but lean heavy on core vocabulary first since it generalizes; fringe fills in around it. *Does insurance cover communication boards or AAC devices?* Low-tech paper boards are cheap enough that insurance rarely comes into it. High-tech speech-generating devices are often covered under Medicaid for children, and many private plans cover them too when prescribed by a physician or SLP and documented as medically necessary. That usually means an AAC evaluation report, a prescription, and a letter of medical necessity. Coverage varies a lot by state and insurer. *Can a child use a communication board and sign language together?* Yes, and many do. Using several modalities at once is called total communication, a common approach for kids with complex communication needs; signs, board pointing, vocalizations, and gestures can all work side by side. The rule of thumb is to never remove a tool that's working, just add new ones alongside it. An SLP can help coordinate this without creating confusion. *Where can I find free symbols and templates?* The Mulberry Symbol Set is a free, open-licensed library [4]. PracticalAAC.com has free printable core vocabulary boards, and Make Print Go (makeprintgo.com) is a free browser tool with built-in symbol search. Google Slides or Canva both work for layout, and for personal photos, a phone camera and a printer are enough to build a functional first board at no cost. *What is aided language stimulation, and why does it matter?* Aided language stimulation is when you model the board yourself, pointing to symbols as you talk naturally throughout the day, rather than asking your child to use it. Research links consistent modeling by caregivers to more spontaneous AAC use and broader vocabulary [7]. It's the single most effective teaching strategy for communication boards, and it costs nothing. *How is a communication board included in an IEP?* Under IDEA, AAC tools including low-tech boards have to be considered as part of the assistive technology evaluation for kids receiving special education services [9]. You can request that assessment through your child's IEP team in writing. If a board or fuller AAC system is recommended, it should appear in the IEP with specific goals, and the school has to provide it at no cost to the family. *My child ignores the communication board. What now?* Start by checking the vocabulary: are those symbols things your child actually wants? A board full of vegetables won't motivate a kid who hates vegetables. Then check the format, real photos versus icons or vice versa. Then increase your own modeling substantially. Most kids go through an observer phase before they initiate anything, and 4 to 6 weeks of consistent adult modeling often comes before the first spontaneous use. If nothing changes after that, bring in an SLP. *Can a child with apraxia of speech use a communication board?* Yes, and many do. Childhood apraxia of speech is a motor speech disorder where the brain struggles to plan the movements needed for speech. These children often understand language well despite limited verbal output, which makes a board a natural bridge: it keeps communication active while reducing the motor demand. More on this in our overview of childhood apraxia of speech. *How do you move from a paper board to an AAC app or device?* The vocabulary and layout principles carry over directly. If you've used a color-coded core board, look for an app with similar color coding and grid layout so the switch feels familiar. Work with an SLP on feature matching, comparing your child's motor, visual, and language profile against available devices. Many apps offer free trials, and the switch usually takes several weeks of parallel use before a child prefers the new system.A picture board or a handful of picture cards taped to the fridge isn't a last resort for a child who isn't talking yet: it's often the thing that gets speech moving. The research backs this up. That review from Millar, D.C., Light, J.C., & Schlosser, R.W. (2006). The impact of augmentative and alternative communication intervention on the speech production of individuals with developmental disabilities. American Journal of Speech-Language Pathology, 15(3), 228-237. found that giving kids with developmental disabilities an AAC system "did not impede and in many cases facilitated natural speech production." Parents worry that handing a child pictures will make them lazy about talking, but the evidence points the other way. It helps to know what actually counts as AAC. ASHA (American Speech-Language-Hearing Association), AAC overview page describes it simply as any form of communication besides oral speech used to get across thoughts, needs, wants, and ideas, and that includes low-tech options like a laminated board of symbols, not just tablets and speech-generating devices. If you want free, ready-made images to build one, the Mulberry Symbols, open-licensed AAC symbol set is licensed for personal and commercial use. Many boards organize symbols by color and category, people, actions, objects, descriptors, following the Fitzgerald Key system described in Beukelman, D.R., & Mirenda, P. (2013). Augmentative and Alternative Communication: Supporting Children and Adults with Complex Communication Needs (4th ed.). Paul H. Brookes Publishing., the field's main textbook. If you're picking vocabulary, it's worth knowing that the CDC's CDC, Learn the Signs, Act Early developmental milestones lists basic emotion words as a target starting around 24 months, so boards for that age often include happy, sad, and mad alongside everyday wants. Simply owning a board doesn't do much on its own. What moves the needle is modeling: pointing to symbols yourself as you talk, so the child sees the system in use rather than being handed it and expected to figure it out. Sennott, S.C., Light, J.C., & McNaughton, D. (2016). AAC modeling intervention research review. Research and Practice for Persons with Severe Disabilities, 41(2), 101-115. found that this kind of aided language input from parents and caregivers leads to more spontaneous use and a wider vocabulary. If you're looking for a structured approach rather than building your own system, PECS (the Picture Exchange Communication System) is a specific six-phase protocol where the child physically hands over a picture card to request something. Bondy, A., & Frost, L. (1994). The Picture Exchange Communication System. Focus on Autistic Behavior, 9(3), 1-19. lays out the method, which has a solid evidence base, particularly for autistic children. If you're not sure where your child stands communicatively before choosing vocabulary or a system, the Rowland, C., Communication Matrix, Oregon Health & Science University is a free tool built at OHSU for exactly that, and it can help guide what to target first. As for when to get outside help: the American Academy of Pediatrics (AAP), Developmental Surveillance and Screening Policy recommends an evaluation if a child has no words by 12 months, no two-word phrases by 24 months, or loses language skills they once had. Under IDEA Part C, children under three can be referred straight to state early intervention programs, and ASHA, Early Intervention under IDEA Part C recommends a certified speech-language pathologist do the evaluation. Once a child is school-aged, Individuals with Disabilities Education Act (IDEA), 20 U.S.C. § 1401, U.S. Department of Education requires schools to consider assistive technology, defined broadly as any equipment or product system that helps a child function better, as part of IEP planning, at no cost to the family. This article is for general information and isn't a substitute for an evaluation by a qualified speech-language professional.