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

Last updated 2026-07-11

What is a choice board and why does it help nonverbal toddlers?

A choice board is a physical or digital display showing a small set of pictures, photos, or symbols. Your child points to, touches, or hands you a picture to make a request. That's it. The idea looks almost too simple, but the research behind it is solid.

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 cannot rely on speech alone ^[1]. A choice board is one of the most entry-level AAC tools available, and unlike a full speech-generating device, it costs almost nothing to build.

For a toddler without reliable speech, every unanswered want is a frustration event. Frustration events stack up into meltdowns, and meltdowns make it harder to learn anything. A choice board cuts off that chain early. The child points, you respond, everyone moves on. Over dozens of repetitions, pointing to a picture also builds the same intentional communication habit that supports more advanced AAC and spoken language later.

Giving a nonverbal child a visual tool does not slow speech development. The AAP's 2022 policy statement on AAC and autism notes that AAC does not impede speech and may support it ^[2]. You are not giving up on words. You are giving your child a bridge.

How many pictures should a choice board have for a toddler?

Start with two. Two is not a placeholder. Two is the right number for a child who is just learning that pictures mean something.

The logic comes from how toddlers process choices. Research on aided language input published in the journal Augmentative and Alternative Communication found that young AAC learners make more reliable selections and show less distress when the field size is small at the start ^[3]. Two pictures means a 50% success rate on a random guess, which gives the child immediate positive feedback and keeps the interaction short and pleasant.

Once your child is consistently choosing between two options over several days, add a third. Then a fourth. Most toddlers in early AAC work stay in the two-to-four picture range for months. Some children with more complex profiles do well with up to six to eight options, but that is not a starting point.

The table below shows a rough progression based on typical early AAC practice guidelines from ASHA and AAC researchers:

Don't rush the table. A toddler who masters two pictures in a month has done something real.

What pictures or symbols should you put on the choice board?

Put things your child actually wants. This sounds obvious, but many parents' first instinct is to include things the child needs, like vegetables, medicine, or bath time. Those will fail. A nonverbal toddler will not point to a broccoli picture. They will throw the board.

Start with high-motivation items: favorite snacks, a beloved toy, a preferred video, outside, a specific person, a sensory item your child seeks out. Think about what your child already communicates about, even if that communication is dragging you to the fridge or screaming at the TV. Those are your first symbols.

On image style, there's an honest debate among AAC practitioners. Real photographs of the actual object in your house tend to work well for very young children and kids still learning symbolic representation. Line-art symbols from systems like PCS (Picture Communication Symbols, available in Boardmaker) or the free SymbolStix library are more abstract but generalize better across settings. A reasonable middle path: start with real photos, then gradually swap in symbols as your child shows understanding.

PCS symbols are the most widely used symbol set in U.S. schools and therapy ^[4]. If your child is entering or already in early intervention or a preschool program, ask what symbol set they use and match it. Consistency across environments matters a lot.

Avoid clip art, cartoon characters, and low-contrast images. The picture should be instantly recognizable. Print at least 2 inches by 2 inches, ideally 3 inches by 3 inches, so small hands can point accurately.

What materials do you need to make a choice board at home?

You don't need to buy anything special. Here are three real options, cheapest first:

Option 1, the refrigerator version: Print or cut photos from packaging and tape them to index cards. Laminate with packing tape if you have it. Hold them up two at a time. Total cost: near zero.

Option 2, the binder ring board: Laminate cards (a home laminator costs $20 to $30 at most big-box stores, or use a library laminator), punch a hole in the corner, and clip them onto a binder ring. Your child flips through options. Portable and durable.

Option 3, the Velcro board: Buy a small piece of felt, foam board, or a cheap cookie sheet. Attach adhesive Velcro to the back of each card and to the board surface. This lets you swap symbols in and out fast, which helps once your child is using more pictures. A full setup runs roughly $10 to $15 in materials.

Want a digital option? Apps like Cboard (free, open source), LetMeTalk (free on Android), or TouchChat exist, and some families find them easier to update and carry. The research on whether paper or digital works better for very young children is genuinely mixed. ASHA's Practice Portal notes there is no single best modality and that individual response varies ^[1]. Try what fits your life. Plenty of families use both.

Lamination is not optional if your child mouths or throws things. A soggy card is a useless card.

How do you teach a toddler to use a choice board?

Teaching the board is slower than making it. Plan for weeks, not days, before you see independent use.

Step one: Set up a natural wanting moment. Snack time is perfect. Hold up two pictures, one of a cracker and one of a piece of fruit. Wait. Don't prompt verbally for the first few seconds. Just hold the pictures at your child's eye level and look expectantly.

Step two: If your child touches or looks at one, immediately say the word and hand over the item. "Cracker! Here's your cracker." The gap between point and delivery should be under two seconds. Speed matters because it teaches cause and effect.

Step three: If your child doesn't point within about five seconds, use a physical prompt. Gently guide their hand to one of the pictures. Deliver the item anyway and say the word. You're teaching the system, not testing the child.

Step four: After the item is delivered, put it away briefly and offer the board again. Two to three exchanges per snack session is enough for a beginner. End on a success.

The steps above draw on aided language input (ALI) and least-to-most prompting, both of which have evidence behind them in AAC instruction research ^[3]. The key insight from ALI: you should also point to the board yourself whenever you offer a choice, so your child watches a competent communicator use the board over and over before they're expected to use it alone.

One thing many parents miss: don't ask "what do you want?" while pointing to the board in the early stages. That verbal question pulls the child's attention to your face, not the board. Just hold up the board and wait.

For more on building these foundations with professional support, see our guide to early intervention and what to expect from speech therapy.

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

Everywhere, and constantly, for the first month. That sounds exhausting, but it doesn't mean running formal sessions all day. It means you grab the board any time a natural wanting moment comes up: snack, choosing a toy, picking a show, going outside, bath or no bath.

Wanting moments happen around 15 to 25 times per day for a typical toddler, according to early AAC curriculum frameworks used in programs like PECS (Picture Exchange Communication System) ^[5]. Each one is a teaching trial if you have the board nearby. That's why keeping a copy of the board in multiple spots, on the fridge, by the toy box, in the diaper bag, matters so much.

Consistency across caregivers matters as much as frequency. Grandparents, daycare workers, and babysitters all need to know the board exists and how to use it. A one-page instruction sheet taped next to the board in each location helps. Your child's brain is building a connection between "point to picture" and "get thing." Inconsistent use breaks that circuit.

If your child gets services through early intervention (for children under 3) or an IDEA Part B preschool program (ages 3 to 5), share the board with the team and ask how to align home and school use ^[6]. Coordination across settings is one of the strongest predictors of AAC uptake, and the law requires IEP teams to consider AAC as assistive technology for eligible children.

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

This is normal. It doesn't mean the approach is wrong or that your child can't learn.

The most common reason a child refuses is that the board has nothing genuinely motivating on it. Go back to basics: spend a day just watching what your child seeks out, reaches for, or gets upset about not having. Those are your real first symbols.

The second most common reason is field size. If you started with four or six pictures, drop to two.

Throwing the board often means the child understands the board is connected to getting things and is trying to communicate urgency or frustration, not that they're rejecting the concept. If this happens, shorten the wait, offer the board right at the moment of wanting before frustration builds, and use a heavier board or one with a non-slip back so throwing is less satisfying.

Ignoring can mean the child doesn't yet grasp that the board means anything. Try being more dramatic with your own pointing. Try pairing each picture with a quick look at the real object before you present it. Some children need many more exposures before the connection forms.

If you've tried these adjustments for four to six weeks with no traction, talk to a speech-language pathologist. This isn't a failure. It's a sign your child might need a different symbol format, a different AAC approach, or a full evaluation to understand what's happening with their communication. AAC devices and dynamic display systems may be worth exploring at that point.

Is a choice board the same as PECS, and which should you use?

Not exactly. PECS, the Picture Exchange Communication System, is a structured, manualized protocol developed by Andy Bondy and Lori Frost in 1994 that begins with a physical exchange: the child picks up a picture card and physically hands it to a communication partner to get an item ^[5]. It has its own six-phase training sequence and needs specific training to run correctly.

A choice board is simpler and less prescriptive. The child points to or touches a picture rather than exchanging it. There's no required phase structure. Parents can run a basic choice board at home without professional training, which is why it's usually the first recommendation for families just starting out.

The honest answer on which to use: if your child is already in speech therapy or early intervention, ask your SLP which approach fits your child's current skills and their service model. If you're on your own and want to do something useful this week, start with a choice board. If your child needs more structured instruction and you have access to a trained professional, PECS Phases 1 and 2 have a reasonably strong evidence base for children with autism, with multiple randomized and quasi-experimental studies supporting communication gains ^[5].

They are not mutually exclusive. Many children move from a choice board into PECS or into more capable AAC devices as their skills grow. Think of a choice board as a ramp, not a destination.

Can a choice board work for a toddler with autism?

Yes, and it's one of the most common starting points for young autistic children who don't have reliable speech. The research base for visual supports and AAC in autism is substantial. A 2009 meta-analysis in the American Journal of Speech-Language Pathology reviewed aided AAC interventions for children with autism and found improvements in requesting and social communication across studies ^[7].

Children with autism often process visual information more reliably than auditory-verbal information, which is part of why picture-based systems tend to click faster than verbal prompting alone. The repetitive, predictable structure of a choice board interaction also fits how many autistic toddlers learn: same board, same routine, same result.

One thing to watch for: some autistic toddlers have echolalia or scripted speech that can make it look like they're communicating more than they functionally are. A choice board gives you a cleaner read on actual intentional requesting. If you want to understand how echolalia fits in, see our piece on echolalia.

For broader context on autism and communication development, our autism spectrum speech therapy guide covers what the research says about different intervention approaches across ages.

If your child has also been evaluated for motor speech difficulties, it's worth knowing that some toddlers who appear nonverbal have apraxia of speech as a contributing factor. That doesn't change the choice board approach, but it does affect how you think about the speech side of the picture.

When should you move from a choice board to a more advanced AAC system?

A choice board is meant to get communication started. The goal was never for your child to use it forever.

You're probably ready to think about expanding when your child uses the board reliably with multiple caregivers, initiates pointing to it unprompted, and seems frustrated by the limited vocabulary. Frustration at this stage is a good sign. It means they want to say more than the board lets them.

Next steps could include a communication book with more vocabulary organized 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 averages $3,000 to $8,000 before funding, though many children get one covered through Medicaid, private insurance, or school-based assistive technology programs under IDEA ^[6].

The move to a higher-level system really should involve an SLP, ideally one with AAC specialization. An AAC evaluation looks at the child's motor abilities, cognitive profile, vision, and communication needs together. ASHA maintains a directory of certified SLPs at asha.org ^[1].

If in-person services are hard to access where you live, online speech therapy has grown a lot since 2020, and some AAC evaluations can be done by 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 exposure, the Little Words app is an AI speech companion that works alongside what you're already doing. It's not a replacement for a choice board or an SLP. Think of it as extra practice in between.

The app is built around the same aided language input principles that make choice boards work: seeing and hearing words in context, over and over, in the moments when your child is motivated to communicate. You can take the quiz at littlewords.ai/start to see whether it fits your child's current stage.

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

What does the research say about whether choice boards actually work?

The short answer: the evidence for picture-based communication systems is solid for increasing functional requesting and reducing problem behavior, and weak-to-absent for directly producing speech. Those are two different claims, and it pays to keep them separate.

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 gains in communication for children with complex communication needs, with effect sizes in the moderate-to-large range for most participants ^[8].

For speech production, the data is thinner. Some children show increases in spoken words or approximations after starting AAC, a pattern sometimes called the "AAC speech facilitation effect." The AAP's 2022 clinical report states directly that "there is no evidence that the use of AAC inhibits speech development" ^[2]. That's not the same as proving AAC causes speech gains, but it removes the worry that a board will replace talking.

On choice boards specifically, as distinct from PECS or SGDs, the standalone research is thin because most studies bundle visual supports into broader AAC packages. The consensus from ASHA, AAP, and AAC researchers is that early, consistent, high-motivation AAC use is appropriate and helpful regardless of the specific low-tech format ^[1][2][3].

Nobody has run a clean controlled trial comparing a two-picture choice board to three pictures to a binder ring to a cookie sheet. The practical decisions you're making at home are ahead of what the literature has studied in detail, which is worth knowing.

Frequently asked questions

At what age can a toddler start using a choice board?

There's no minimum age. Children as young as 12 to 18 months can begin learning to point to or touch a picture to make a choice, provided the field size starts at two options and the items are genuinely motivating. If your child makes intentional reaches or looks toward desired items, they have the foundational skills to begin. An SLP can help you calibrate the starting point.

Does using a choice board mean my child will never talk?

No. The AAP's 2022 clinical report on AAC states clearly there is no evidence that AAC use inhibits speech development. Many children who start with choice boards develop functional speech over time. The board gives them a way to communicate while speech is still developing, which reduces frustration and keeps learning moving. It's a bridge, not a ceiling.

What's the best free app to make a digital choice board?

Cboard (cboard.io) is free, open source, and web-based, so it works on any device without a download. LetMeTalk is free on Android and uses ARASAAC symbols. Both let you add custom photos. For Apple users, the free version of Snap Core First offers limited functionality. None of these replace a full AAC evaluation, but all work as a starting board.

How do I get my child's daycare or preschool to use the choice board too?

Print a duplicate board and a one-page instruction sheet explaining what each picture means and how to respond when the child points. Ask for five minutes with the lead teacher to walk through it. If your child has an IEP or IFSP through early intervention, request that choice board use be written in as a support strategy. Consistency requirements under IDEA mean the team must implement agreed-upon communication supports.

Should I put 'no' or 'stop' on the choice board?

Yes, eventually. A 'no', 'stop', or 'all done' symbol is one of the highest-value additions you can make after your child understands the basic system. Being able to communicate refusal is a core communicative function, and children who lack a way to say no often escalate to problem behavior instead. Add it once your child is choosing reliably between two motivating items.

How do I know if my child is actually choosing or just touching randomly?

Watch what happens after the delivery. If your child accepts the item happily, the choice was probably intentional. If they push it away or cry, they may have been reaching randomly. Over days, track whether the same item gets chosen more often under similar conditions. True choosing shows a pattern. If you're seeing mostly random touches after two to three weeks, simplify to one highly preferred and one clearly disliked option to build discrimination.

Can I make a choice board for a child who doesn't understand pictures yet?

Start with real objects instead of pictures. Hold up the actual cracker and the actual toy and let the child touch one. Once they're choosing reliably between objects, introduce a photo of each object paired with the real item, then fade the real item. This object-to-photo bridge is described in early AAC intervention frameworks and works well for children with significant delays in symbolic understanding.

How long does it take a toddler to learn to use a choice board?

Most toddlers show some intentional use within two to four weeks when the board is used consistently across 10 to 20 motivated trials per day. Full reliable independent use, meaning the child approaches the board unprompted, takes longer, often two to four months. Children with more complex profiles may take longer. Consistent use across all caregivers and settings is the strongest predictor of how quickly it clicks.

What if my child can say some words but still seems to need a choice board?

Totally normal. Many children have a few words but cannot produce them reliably under pressure, fatigue, or excitement. A choice board gives them a consistent channel that works even when speech fails. Using the board does not compete with the words. Point to the picture and say the word at the same time, every time. You're pairing the visual with the verbal and supporting both.

Do I need a speech therapist to make a choice board work?

You don't need one to get started. The basics are within reach for any caregiver willing to be consistent. That said, an SLP can diagnose what's driving the speech delay, identify the right AAC level and symbol type for your child, and troubleshoot when the board isn't working. If your child is under 3, contact your state's early intervention program for a free evaluation. IDEA Part C requires states to provide this at no cost to families.

Are there choice board templates I can download and print for free?

Yes. Teachers Pay Teachers has many 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 require a subscription, but your child's school or therapy program may already have access.

Will insurance or Medicaid cover the cost of a choice board or AAC device?

Insurance rarely covers low-tech tools like printed choice boards since the out-of-pocket cost is minimal. For higher-tech SGDs, Medicaid covers them in all 50 states as durable medical equipment when medically necessary and prescribed by an SLP after an evaluation. Private insurance coverage varies by state and plan. Children in public school programs may receive AAC as assistive technology through their IEP 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.