How to make a choice board for a nonverbal toddler

Last updated 2026-07-11

A choice board is just a small display of pictures, photos, or symbols that your child can point to, touch, or hand you when they want something. That's the whole idea, and it works. The American Speech-Language-Hearing Association describes augmentative and alternative communication (AAC) as "any approach that supports, enhances, or supplements the communication of individuals" who can't rely on speech alone ^[1], and a choice board is about as basic as AAC gets. It also costs almost nothing to build, unlike a full speech-generating device.

For a toddler without reliable words, every unmet want is a small frustration, and those frustrations pile up into meltdowns that make everything harder to learn. A choice board interrupts that pattern early: the child points, you respond, and you both move on. Do that enough times and pointing to a picture becomes a real communication habit, one that can support more advanced AAC and spoken language down the road. And giving your child this tool doesn't hold speech back. The AAP's 2022 policy statement on AAC and autism notes that AAC does not impede speech and may support it ^[2]. This isn't giving up on words. It's building a bridge to them.

How many pictures to start with

Start with two. That's not a placeholder number, it's the right size for a child who's just learning that pictures stand for things. Research on aided language input published in the journal Augmentative and Alternative Communication found that young AAC learners choose more reliably and show less distress when the field of options starts small ^[3]. With two pictures, even a random guess has a 50% chance of being right, which gives your child quick positive feedback and keeps things pleasant.

Once your child chooses correctly between two options for several days running, add a third, then a fourth. Most toddlers stay in the two-to-four range for months, and that's normal. Some kids with more complex needs eventually work well with six to eight options, but nobody starts there.

Here's roughly how that progression tends to go, based on early AAC practice guidelines from ASHA and AAC researchers:

Don't rush past those first rows. A toddler who's mastered two pictures in a month has genuinely accomplished something.

Choosing pictures your child will actually use

Put things on the board that your child actually wants, not things they need. That sounds obvious, but the first instinct for a lot of parents is to include vegetables, medicine, bath time, that sort of thing. Those choices will flop. A nonverbal toddler isn't going to point to a broccoli picture. They're going to throw the board across the room.

Instead, start with whatever already gets your child's attention: a favorite snack, a beloved toy, a preferred video, going outside, a specific person, a sensory item they seek out. Think about what your child already "asks" for, even if that asking currently looks like dragging you to the fridge or screaming at the TV. Those are your first pictures.

On image style, AAC practitioners genuinely disagree. Real photos of the actual object in your house tend to work best for very young kids who are still learning what a picture represents. Line-art symbols, like PCS (Picture Communication Symbols, available in Boardmaker) or the free SymbolStix library, are more abstract but transfer better across different settings. A sensible middle ground is to start with real photos and swap in symbols gradually as your child catches on.

PCS is the most widely used symbol set in U.S. schools and therapy ^[4], so if your child is in or entering early intervention or preschool, ask which set they use and match it. Staying consistent across home and school matters more than people expect.

Skip clip art, cartoon characters, and anything low-contrast. Pictures need to be instantly recognizable, and printed at least 2 by 2 inches, ideally 3 by 3, so small hands can point accurately.

Making one at home, cheaply

You don't need to buy anything special. Three real options, cheapest first.

The refrigerator version: print or cut photos from packaging, tape them to index cards, and laminate with packing tape if you have it. Hold up two at a time. Cost: basically nothing.

The binder ring board: laminate cards (a home laminator runs $20 to $30 at most big-box stores, or use a library one), punch a hole in the corner, and clip them onto a binder ring so your child can flip through. It's portable and holds up to wear.

The Velcro board: get a small piece of felt, foam board, or even a cheap cookie sheet, then attach adhesive Velcro to the back of each card and to the board itself. This makes it easy to swap symbols in and out once your child is working with more pictures. A full setup runs roughly $10 to $15 in materials.

If you'd rather go digital, apps like Cboard (free, open source), LetMeTalk (free on Android), or TouchChat are options, and some families find them easier to update and carry around. Whether paper or digital works better for very young children is genuinely unsettled: ASHA's Practice Portal notes there's no single best modality, and it varies by child ^[1]. Try whatever fits your life, and plenty of families end up using both.

Lamination isn't optional if your child mouths or throws things. A soggy card stops being useful fast.

Teaching your toddler to use it

Teaching the board takes longer than making it. Expect weeks, not days, before you see your child use it on their own.

Start by setting up a natural moment of wanting something, snack time works well. Hold up two pictures, say a cracker and a piece of fruit, then wait a few seconds without prompting verbally, just holding the pictures at your child's eye level with an expectant look.

If your child touches or looks at one, say the word right away and hand it over: "Cracker! Here's your cracker." Keep the gap between the point and the reward under two seconds, since speed is what teaches cause and effect. If nothing happens after about five seconds, guide their hand gently to one of the pictures yourself, then deliver the item anyway and say the word. At this stage you're teaching the system, not testing whether they already know it. Once the item's delivered, put it away for a moment and offer the board again. Two or three exchanges per snack session is plenty for a beginner, and it's worth ending on a success.

These steps come from aided language input (ALI) and least-to-most prompting, both with evidence behind them in AAC instruction research ^[3]. The key idea from ALI is that you should point to the board yourself every time you offer a choice, so your child watches you use it again and again before they're expected to use it alone.

One thing a lot of parents get wrong early on: don't ask "what do you want?" while pointing at the board. The question pulls your child's attention to your face instead of the pictures. Just hold up the board and wait.

If you want to build on this with professional support, our guides to early intervention and to what speech therapy involves are good next reads.

Where should you use the choice board, and how often?

Everywhere, all the time, for the first month at least. That sounds like a lot, but it doesn't mean formal sessions all day. It just means grabbing the board whenever a natural wanting moment shows up: snack time, choosing a toy, picking a show, heading outside, bath or no bath.

A typical toddler has something like 15 to 25 of these wanting moments a day, based on early AAC curriculum frameworks used in programs like PECS (Picture Exchange Communication System) ^[5]. Each one is a chance to teach, as long as the board is within reach, which is exactly why it helps to keep copies in several spots: on the fridge, by the toy box, in the diaper bag.

Getting everyone on the same page matters as much as how often you use it. Grandparents, daycare staff, babysitters, all of them need to know the board exists and roughly how it works. A one-page instruction sheet taped up next to each copy helps a lot. Your child is building a mental link between pointing at a picture and getting the thing they want, and that link weakens fast if the response is inconsistent.

If your child gets early intervention services (under age 3) or is in an IDEA Part B preschool program (ages 3 to 5), bring the board to the team and ask how to keep home and school use lined up ^[6]. Coordination across settings is one of the strongest predictors of whether AAC actually takes hold, and the law requires IEP teams to consider AAC as assistive technology for kids who qualify.

What if your toddler ignores, throws, or refuses the board?

Totally normal, and it doesn't mean the approach is wrong or that your child can't learn this way.

The most common reason kids refuse the board is that nothing on it is actually motivating. Spend a day just watching what your child reaches for, seeks out, or melts down over not having. Those are your real starting symbols. The second most common culprit is too many choices at once: if you started with four or six pictures, cut it down to two.

Throwing the board usually means the child understands the connection between the board and getting things, and they're communicating frustration or urgency, not rejecting the idea. If that happens, shorten the wait time, offer the board the moment wanting starts (before frustration builds), and consider a heavier board or one with a non-slip back so throwing it isn't as satisfying.

Ignoring it can mean the child hasn't yet connected the picture to anything real. Try exaggerating your own pointing, or show the real object right before you present the picture. Some kids just need a lot more exposures before it clicks.

If you've tried adjustments like these for four to six weeks with nothing changing, it's worth talking to a speech-language pathologist. That's not a failure on your part, it just might mean your child needs a different symbol format, a different AAC approach, or a fuller evaluation. AAC devices and dynamic display systems become worth exploring at that point.

Is a choice board the same as PECS?

Not quite. PECS, the Picture Exchange Communication System, is a structured, manualized protocol that Andy Bondy and Lori Frost developed in 1994. It starts with a physical exchange: the child picks up a picture card and hands it to someone to get an item ^[5]. It runs on a six-phase training sequence and needs proper training to do correctly.

A choice board is simpler and looser. The child points to or touches a picture instead of handing it over, and there's no required sequence of phases. Parents can run a basic choice board at home without any special training, which is why it's usually the first thing suggested to families just getting started.

If your child is already getting speech therapy or early intervention, ask the SLP which approach fits where they're at right now. If you're figuring this out on your own and want something useful to try this week, start with a choice board. If your child needs more structured teaching and you have access to a trained professional, PECS Phases 1 and 2 have a fairly solid evidence base for children with autism, backed by several randomized and quasi-experimental studies showing communication gains ^[5].

These aren't either-or. Plenty of children move from a choice board into PECS, or into more capable AAC devices, as their skills grow. Think of the choice board as a ramp, not the final stop.

Can a choice board work for a toddler with autism?

Yes, and it's one of the most common starting points for young autistic kids without reliable speech. The research on visual supports and AAC in autism is substantial: a 2009 meta-analysis in the American Journal of Speech-Language Pathology looked at aided AAC interventions for children with autism and found improvements in requesting and social communication across the studies reviewed ^[7].

Autistic children often process visual information more reliably than spoken language, which is part of why picture systems tend to click faster than verbal prompting alone. The repetitive, predictable nature of a choice board also matches how a lot of autistic toddlers learn best: same board, same routine, same result.

One thing to keep an eye on: some autistic toddlers use echolalia or scripted speech that can make it seem like they're communicating more than they actually are, functionally speaking. A choice board gives you a clearer picture of real, intentional requesting. Our piece on echolalia gets into how that fits in, and the autism spectrum speech therapy guide covers what the research says about different approaches across ages.

If your child has also been evaluated for motor speech issues, it's worth knowing that some toddlers who seem nonverbal actually have apraxia of speech playing a role. That doesn't change how you'd use a choice board, but it does affect how you think about the speech piece.

When should you move to a more advanced AAC system?

A choice board is meant to get things started, not to be the endpoint forever. You're probably ready to expand once your child uses the board reliably across different caregivers, points to it on their own without being prompted, and starts seeming frustrated by how limited the vocabulary is. That frustration is actually a good sign. It means they want to say more than the board allows.

From there, options include a communication book with more vocabulary sorted by category, a low-tech PECS system with a full sentence strip, or a speech-generating device (SGD). SGDs range from simple single-button devices to dynamic display tablets running software like Proloquo2Go, TouchChat, or LAMP Words for Life. A full-featured SGD runs about $3,000 to $8,000 before funding, though many families get one covered through Medicaid, private insurance, or school-based assistive technology programs under IDEA ^[6].

This step really should involve an SLP, ideally one with AAC training, since a proper AAC evaluation weighs motor skills, cognitive profile, vision, and communication needs all together. ASHA keeps a directory of certified SLPs at asha.org ^[1]. If in-person services are hard to find where you live, online speech therapy has expanded a lot since 2020, and some AAC evaluations can now happen over telehealth.

How does the Little Words app fit into a choice board routine?

If you're building a choice board at home and want more structure around speech modeling and vocabulary, the Little Words app is an AI speech companion that works alongside what you're already doing. It doesn't replace a choice board or an SLP, it's more like extra practice in between.

The app runs on the same aided language input principles that make choice boards work: seeing and hearing words in context, repeated often, right when your child is motivated to communicate. You can take the quiz at littlewords.ai/start to see whether it fits where your child is right now.

The most useful thing any app or tool can do at this age is add more repetitions of intentional communication into your child's day. Choice boards do that. Good apps do that. Trained SLPs do that too. The more of these working together, the faster the pattern builds.

Do choice boards actually work? The evidence holds up well for one thing and less well for another, and it's worth keeping the two apart. For requesting and functional communication, a 2014 systematic review in the Journal of Autism and Developmental Disorders found that picture-based AAC interventions produced reliable communication gains for children with complex communication needs, with effect sizes in the moderate-to-large range for most participants ^[8]. For actual speech production, the evidence is thinner. Some children do start saying more words or approximations once they begin using AAC, sometimes called the "AAC speech facilitation effect," but that's an observed pattern, not proof that one causes the other. What the AAP's 2022 clinical report states plainly is that "there is no evidence that the use of AAC inhibits speech development" ^[2]. So a board won't replace talking, even though it can't be credited with causing it either.

Choice boards specifically, as opposed to PECS or speech-generating devices, haven't been studied much on their own. Most research lumps visual supports into broader AAC packages. ASHA, the AAP, and AAC researchers all agree that early, consistent use of a low-tech format that genuinely motivates the child is appropriate and helpful, whatever it looks like in practice ^[1][2][3]. Nobody has run a controlled trial pitting a two-picture board against three pictures, a binder ring, or a cookie sheet. The choices you're making at home are ahead of what's been studied in detail, and that's just how it is right now.

Common questions parents ask

There's no minimum age for starting a choice board. Kids as young as 12 to 18 months can learn to point to or touch a picture to make a choice, as long as you begin with just two options and pick things they actually want. If your child already reaches for or looks toward items they want, they've got the foundation they need to start. An SLP can help you pick the right starting point if you want guidance.

Using a choice board won't stop your child from talking. The AAP's 2022 clinical report on AAC is clear that there's no evidence AAC use holds back speech development. Plenty of kids who start with choice boards go on to develop functional speech just fine. The board simply gives them a way to communicate while speech is still catching up, which cuts down on frustration and keeps things moving. It's a bridge, not a ceiling.

For a free digital option, Cboard (cboard.io) is open source and web-based, so it runs on any device with no download needed. LetMeTalk is free on Android and uses ARASAAC symbols. Both let you add your own photos. On Apple devices, the free version of Snap Core First offers limited features. None of these replace a full AAC evaluation, but any of them works as a starting board.

To get daycare or preschool involved, print a duplicate board along with a one-page sheet explaining what each picture means and how staff should respond when your child points. Ask the lead teacher for five minutes to walk through it. If your child has an IEP or IFSP through early intervention, ask that choice board use be written in as a support strategy: under IDEA, the team has to implement communication supports that everyone's agreed to.

Yes, "no," "stop," or "all done" belongs on the board eventually, and it's one of the most valuable additions once your child understands the basic system. Being able to refuse something is a core communication skill, and kids with no way to say no often end up expressing that through behavior instead. Add it once choosing between two motivating items is going reliably.

To tell whether your child is choosing on purpose or just touching randomly, watch what happens after you hand over the item. Genuine delight suggests it was intentional; pushing it away or crying suggests it wasn't. Over several days, notice whether the same item keeps getting picked under similar circumstances, since real choosing tends to show a pattern. If touches still seem random after two or three weeks, scale back to one item your child loves and one they clearly don't, so they can practice telling the difference.

If your child doesn't understand pictures yet, start with real objects instead. Hold up an actual cracker next to an actual toy and let your child touch the one they want. Once they're choosing reliably between objects, add a photo of each item paired with the object itself, then gradually fade the object out. This object-to-photo bridge shows up in early AAC intervention frameworks and tends to work well for kids with more significant delays in understanding symbols.

Most toddlers show some intentional use within two to four weeks, given consistent use across 10 to 20 motivated trials a day. Getting to full independent use, where the child walks up to the board unprompted, usually takes longer, often two to four months, and kids with more complex needs may take even longer. The biggest factor in how fast it clicks is whether every caregiver uses it consistently, in every setting.

It's completely normal for a child who already says some words to still need a board. Lots of kids have a handful of words but can't reliably get them out under pressure, when tired, or when excited. A choice board gives them a channel that still works even when speech doesn't cooperate, and it doesn't compete with talking. Point to the picture and say the word at the same time, every time: you're pairing the visual with the verbal and reinforcing both.

You don't need a speech therapist to get started. Any caregiver willing to be consistent can handle the basics. That said, an SLP can figure out what's actually driving the delay, recommend the right AAC level and symbol type for your child, and help troubleshoot when things stall. If your child is under 3, reach out to your state's early intervention program for a free evaluation: IDEA Part C requires states to offer this at no cost.

Free choice board templates are easy to find. Teachers Pay Teachers has plenty of free options. Do2Learn (do2learn.com) offers free printable picture cards. ARASAAC (arasaac.org), the Spanish government's AAC symbol project, has tens of thousands of free downloadable symbols in multiple languages. Boardmaker symbols are proprietary and need a subscription, but your child's school or therapy program may already have access.

Insurance almost never covers low-tech tools like printed boards, since the cost is minimal to begin with. Higher-tech speech-generating devices are different: Medicaid covers them as durable medical equipment in all 50 states when they're medically necessary and prescribed by an SLP after an evaluation. Private insurance varies by state and plan. Kids in public school may get AAC through their IEP as assistive technology at no cost, under IDEA.

Sources

1. ASHA, Augmentative and Alternative Communication Practice Portal: ASHA defines AAC as any approach that supports, enhances, or supplements communication for individuals who cannot rely on speech alone, and notes there is no single best AAC modality.
2. American Academy of Pediatrics, 'Augmentative and Alternative Communication for Children With Complex Communication Needs' (2022 clinical report, Pediatrics): The AAP's 2022 clinical report states that AAC does not impede speech development and may support it in children with autism and complex communication needs.
3. Augmentative and Alternative Communication (journal), aided language input and field size research: Research on aided language input published in AAC journal found that young AAC learners make more reliable selections and show less distress when field size is small at the start of intervention.
4. Tobii Dynavox, PCS (Picture Communication Symbols) overview: PCS symbols are the most widely used symbol set in U.S. schools and AAC therapy programs.
5. Pyramid Educational Consultants, PECS overview and research base: PECS is a manualized, six-phase protocol beginning with physical picture exchange; it has evidence from multiple studies supporting communication gains in children with autism.
6. U.S. Department of Education, IDEA Part C and Part B overview: IDEA Part C requires free early intervention evaluations for children under 3; Part B requires IEP teams to consider AAC as assistive technology for eligible children ages 3 to 21.
7. Millar, Light, & Schlosser (2009), 'The Impact of AAC on the Speech Production of Individuals With Developmental Disabilities,' American Journal of Speech-Language Pathology: 2009 meta-analysis in AJSLP found that aided AAC interventions for children with autism showed improvements in requesting and social communication across studies, with no evidence of speech suppression.
8. Ganz et al. (2014), 'AAC Interventions for Individuals With Autism Spectrum Disorders,' Journal of Autism and Developmental Disorders: 2014 systematic review found picture-based AAC interventions produced reliable gains in communication for children with complex communication needs, with moderate-to-large effect sizes.
9. ARASAAC, Aragonese Portal of AAC (Spanish government free symbol library): ARASAAC provides tens of thousands of free downloadable pictographic symbols for AAC use in multiple languages.
10. Centers for Medicare and Medicaid Services, Medicaid coverage of speech-generating devices: Medicaid covers SGDs as durable medical equipment in all 50 states when medically necessary and prescribed following an AAC evaluation by an SLP.