How to use choice boards to encourage communication

Last updated 2026-07-11

A choice board is just a small display of two to eight pictures, symbols, or words that a child can point to instead of struggling to say what they want. Research backs visual supports like this as a first-line strategy for late talkers and autistic children, and you don't need training to start: two laminated photos on a kitchen table today is enough, and you build from there.

What a choice board actually does

A board, piece of paper, or screen shows a child two or more options they can point to, tap, or hand to you. Instead of asking "What do you want for a snack?" and waiting for a word that may never come, you hold up a picture of an apple and a picture of crackers and the child touches one. That touch is communication.

It works because it clears two hurdles at once. It drops the motor and language demand, so a child doesn't have to retrieve a word, sequence the sounds, and coordinate mouth movements before anything useful happens. And it delivers an immediate, clear result: the child points, and the thing appears. That cause-and-effect loop is what builds confidence over time.

Speech-language pathologists file choice boards under low-tech 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" and lists symbol boards as one of those forms ^[1]. A choice board isn't a workaround. It's communication, full stop, and it gets used with late talkers, kids diagnosed with autism, children with apraxia of speech, and kids who already use AAC devices but need something simpler for specific routines.

Is there actual evidence behind this?

Yes, and it's reasonably strong for a behavioral intervention. A 2021 systematic review in the Journal of Autism and Developmental Disorders looked at visual supports, including choice boards and symbol schedules, across 25 studies and found consistent positive effects on communication initiations and a drop in problem behaviors tied to unmet needs ^[2]. Effects were larger when boards traveled across settings instead of staying in the therapy room.

The American Academy of Pediatrics has recommended visual supports inside evidence-based behavioral intervention packages for autistic children for over a decade ^[3]. ASHA's AAC practice portal states there's no evidence that AAC, low-tech symbol systems included, holds back speech, and that early use is appropriate ^[1].

Nobody has clean data on the single best age to start. The nearest guidance comes from early intervention research, which favors introducing visual communication supports as soon as a delay shows up rather than waiting to see if speech catches up on its own. Aided language supports have been introduced with toddlers as young as 18 months with no reported adverse effects ^[4].

Studies in this space often run small, with uneven implementation quality. But the direction of the evidence favors choice boards strongly, the size of the benefit depends mostly on how consistently adults use them, and there's essentially no documented downside to trying one.

What to put on the board, and how it grows over time

Start with two items your child actually wants and runs into every day. Not six, not twelve, two. If your kid loves the tablet and crackers, your first board is a picture of a tablet next to a picture of a cracker box. That's a complete, working board.

Once your child points reliably to one of two options (usually within one to four weeks depending on how often you present it), expand to three or four items. General guidance from SLPs is to stay below eight symbols on a single board until a child shows reliable choice-making across many sessions ^[5], since more than eight at once adds scanning demands that make the board harder to use, not easier.

Photos of the actual objects in your home beat generic clip art for most young children, especially under 4. The brain has to match the symbol to the real thing, and a photo of your specific brand of crackers does that faster than a cartoon cracker ^[5]. As your child becomes a more flexible symbol user, you can shift toward line-drawing symbols like Boardmaker or SymbolStix, which helps if you're eventually bridging to a high-tech AAC device.

Putting it to work in daily routines

The biggest predictor of whether a choice board works is whether adults use it every time an opportunity comes up, not just during set "practice" moments.

Here's what that looks like in a real kitchen. Your child heads for the pantry. You get there first, pick up the board, and hold it at their eye level before they can grab anything. Then you wait, five to ten seconds, without saying "Use your board" or "What do you want?" If they reach past it, gently guide their hand to the board and help them touch a symbol. Then hand over that item right away and say the word out loud: "Crackers! You want crackers."

That last step, saying the word right after the point, is called aided language stimulation, and it's what moves a choice board toward actual speech ^[6]. The child makes a communicative act, gets a result, and hears the word tied to that result. After enough repetitions, the spoken word starts showing up with or before the point.

Snack time, the morning routine (which shirt, which shoes), tablet time (which show), free play, bedtime (which book, which stuffed animal), and transitions between activities all fit choice boards well. Transitions especially are underused: a simple "what's next" board with two activity symbols helps kids who struggle with sudden changes, because it hands them information and a sense of control at the same time.

Building one at home, for free

You can put together a working choice board in about 20 minutes with stuff most households already have. Print or cut pictures from magazines or food packaging, laminate them with clear packing tape over front and back (no laminator needed), and stick them to a piece of cardboard with velcro dots or binder clips. That's a real, clinician-approved AAC tool, no purchase required.

If you want something sturdier, here's how the options stack up:

For velcro, put the scratchy (hook) side on the board and the soft (loop) side on the cards, so you can reposition or swap cards without a fight.

If you'd rather go digital, ChoiceBoard-Creator is free on iOS and lets you photograph real objects and drop them into a grid your child can tap. It's worth trying for kids who already like a tablet, since tapping sometimes comes more naturally than pointing to a physical card. ARASAAC also offers free line-drawing symbols you can pull into any document editor ^[8].

What if my child ignores the choice board or pushes it away?

Almost every parent hits this wall, and it usually comes down to one of five things.

The choices might not be motivating enough. If neither option is something your child actually wants, there's no reason for them to engage. Go back to basics and pick the two things they chase hardest. If they'd climb over the couch for a particular toy, that toy belongs on the board.

Timing matters too. If your child already has the cracker box in hand, or is mid-meltdown because a transition happened with no warning, the board has missed its window. It needs to show up before the want turns urgent, not once the crisis is underway.

Sometimes there are simply too many options. More than three or four items can overwhelm a child who's new to symbols, so cut back to two and build from there.

Too much talking can bury the message as well: "Come look at your board. Which one do you want? This one or this one? Point to one. Show me." All that language drowns out the simple signal you're trying to send. Hold the board up, wait, and stay quiet.

And some children need hand-over-hand help to get started, especially those with motor planning challenges like childhood apraxia of speech. Guiding their hand to a symbol for the first 10 to 20 times isn't cheating, it's teaching the motor routine.

If you've run a well-built board consistently for four to six weeks with no engagement at all, it's worth a visit to a speech therapist. There may be a visual, motor, or cognitive factor that needs a professional look before the board can do its job.

Pictures, words, or symbols: what belongs on the board?

It depends on where your child sits developmentally, and often a mix works best.

For children who aren't reading yet and are under about 5, real photographs of household objects are the easiest starting point. They ask the least of a child's symbolic understanding, since a photo of your child's actual cup looks exactly like the cup.

Line-drawing symbols, like Boardmaker's PCS library or the open-source ARASAAC set, sit a step up the abstraction ladder^[8]. They travel better than photos, since you can't always print a picture of the exact object in a new setting, and they're also what most AAC devices use, so sticking with them on low-tech boards keeps things consistent.

Written words alone make sense only once a child already recognizes some printed words. Some children with hyperlexia (a reading ability that shows up before, or without, matching language comprehension) actually respond better to printed words than pictures. If your child gravitates toward letters and seems to read but talks little, try printed words and see what happens.

For most kids, though, the combination wins: a line-drawing symbol on top with the printed word underneath. That's how most AAC apps and devices present symbols anyway, and it feeds both the visual and the emerging literacy pathways at once.

How is a choice board different from a full AAC system?

A choice board is one piece of an AAC toolkit, not the whole kit. Its limit is that it only lets a child respond to a closed set of options you've already prepared. They can't say anything that isn't on the board. A full AAC system, whether it's a low-tech communication book or a high-tech speech-generating device, lets a child build new messages on any topic^[1]. Think of it this way: a choice board is a menu someone else wrote. A full AAC system is a kitchen where the child can cook anything.

For a lot of children, especially early on, a choice board is the right tool precisely because it's simple, sturdy, and quick to deliver a result. The goal isn't to stay on choice boards forever, it's to prove to the child that communication works, and then expand from there.

A child who points to symbols on purpose, not randomly, and produces two to four different communicative messages a day is often ready to move toward something fuller. A speech-language pathologist can run a formal AAC evaluation to find the right fit, and for children with autism spectrum disorder, that evaluation usually includes a trial period with several device types before anyone buys anything.

At what age should a child start using a choice board?

There's no minimum age. Research and clinical guidelines both support starting as soon as a communication delay shows up. In practice, choice boards work with children as young as 18 months. The readiness signal isn't age, it's whether the child shows they want something and gets frustrated when they can't say so. If that frustration is there, a board can help.

The AAP recommends screening for communication delays at 18 and 24 months and referring for services when concerns come up^[3]. Under IDEA Part C, eligible children get early intervention services before age 3, and visual communication supports are a standard part of that care^[7].

Older children and adults use choice boards too, showing up in special education classrooms through high school and in adult day programs. There's no age where they stop being appropriate, they just change shape: a teenager's lunch board might use photos of actual menu items, while an adult's might pair text labels with small symbol supports. For AAC use in older individuals, speech therapy for adults covers that wider picture.

The one caution for the youngest children, under 2, is to pair board use with plenty of spoken language. You're not replacing speech, you're adding a scaffold while speech keeps developing.

How does a choice board work alongside speech therapy?

A choice board works best as a bridge, not a standalone treatment. In a typical speech therapy session, an SLP uses the board to draw out a communication attempt, models the spoken word right away, and sets up another chance for the child to try speech. The board creates a low-stakes moment where communication succeeds, and speech follows that success over time.

If your child is in therapy, ask the therapist which exact symbols to use on your home boards. Matching the clinic board to the home board speeds up generalization: a child who has to learn that a photo means "snack" at home and a line-drawing means "snack" at therapy is doing twice the work.

Some families bring Little Words into daily routines for therapy-aligned practice. The app runs on the same aided-language-stimulation principles behind choice board use, and it's meant to sit alongside what a therapist is working on, not replace it. You can start the quiz at littlewords.ai/start to see whether it fits your child's current communication level.

For children getting services through public schools under IDEA Part B or Part C, choice boards belong in the IEP or IFSP as a supplementary aid and service when they're in use. If the school runs a different symbol system than the one at home, ask for alignment: parents have the legal right to request this at IEP meetings^[7].

Common mistakes parents make with choice boards

Introducing the board during a meltdown is a frequent one. The board needs to belong to calm, predictable moments first. Once a child links it to good outcomes across dozens of low-stakes interactions, it can start working in the hard moments too. Debuting it during distress teaches nothing except that a confusing card shows up when things are already bad.

Switching the layout too often is another. If the apple always sits top left and the crackers bottom right, the child builds a spatial memory that speeds up pointing. Rearrange the symbols too much and you wipe that out, pushing the child toward random, habit-driven pointing instead.

Using the board only for wants leaves a lot on the table. Boards can offer emotion choices (happy face or sad face), activity transitions (bath or pajamas first), and social choices (blocks or a book). Reserving the board for food requests misses two thirds of what it can do.

Giving up after two weeks is probably the most common mistake of all. Some children need four to eight weeks of daily, consistent use before they point on purpose, and two weeks of effort followed by a board shoved in a drawer is usually why families end up saying it didn't work.

And there's the habit of not fading prompts: once a child points reliably, adults sometimes keep prompting anyway. Ease off gradually, from hand-over-hand, to pointing near the board, to just holding it up, so the child starts doing it on their own. That independence is the whole point.

How do I know if a choice board is working, or if we need more help?

Give it four to eight weeks of consistent daily use, then watch for three things: your child starting to approach or reach for the board on their own, pointing to symbols on purpose instead of randomly or always at the same spot, and fewer of the behaviors that come from not being able to communicate, like hitting, screaming, or throwing.

If none of that shows up after six to eight weeks of genuinely consistent use, that tells you something too. Either the board isn't being implemented in a way that's reaching your child, or something else is going on that a board alone won't fix. That's the point to ask for a formal evaluation from a speech-language pathologist. If your child is under 3, this evaluation is free through your state's early intervention program under IDEA Part C ^[7].

Kids with significant motor challenges, including suspected apraxia of speech or other motor speech disorders, may do better with a different format, such as eye gaze, or may need an occupational or physical therapist to look at hand and arm coordination before pointing can become reliable.

And if your child has echolalia, repeating words or phrases picked up elsewhere, that doesn't rule out a choice board working well. Many children with echolalia use boards successfully and gradually start pairing their repeated phrases with intentional pointing, a pattern covered in more depth in our piece on echolalia meaning.

Can a choice board work for a 2-year-old who isn't talking yet?

Yes, two falls right in the range where these boards tend to work well. Start small: two photos of things your child likes a lot (a favorite food, a favorite toy), hold the board up before each opportunity, and wait for a response. Clinical guidelines support introducing visual communication supports as soon as a delay appears, and some early intervention programs start with children as young as 18 months. Say the word out loud each time your child points.

Will a choice board stop my child from trying to talk?

No. ASHA's AAC practice portal is clear that there's no evidence AAC holds speech back, and several studies show spoken output stays the same or improves once visual supports are added. The board gives your child a way to communicate successfully, and that success, combined with hearing the word spoken every time they point, is part of what moves a child toward talking.

How many choices should be on the board at once?

Start with two. Once your child is pointing reliably to one of the two for about one to two weeks, add a third. Most speech-language pathologists recommend staying at eight symbols or fewer on one board until choice-making is clearly intentional. Loading it up with options too soon just causes visual overload and random pointing, which undoes the whole point.

Real photos or drawn symbols?

Real photos of the actual objects in your home work best for beginners, especially under age 4, when kids are still learning that a picture can stand for a real thing. Drawing-based symbols like Boardmaker or ARASAAC travel better and match most AAC devices, so they're worth moving toward once your child is confident with photos. Plenty of families end up combining both: a small drawing with the printed word underneath.

My child always picks the same item no matter what's on the board. What now?

That's position bias, and it's extremely common early on. Your child has figured out that pointing gets a good result, but hasn't yet connected specific symbols to specific items. Rotate which item sits in each spot every time you present the board, and once in a while include only an item your child dislikes to see if they reject it. Gradually, only hand over the preferred item when they point to its actual symbol.

Can a choice board work at school as well as at home?

Yes, and using it consistently across both settings tends to speed up learning. Tell the school team if your child already uses one at home. Under IDEA, kids with IEPs have a right to supplementary aids and services, and visual supports fall under that. Ask the team to match the symbol set you use at home, and if the school uses something different, ask in writing at the IEP meeting for the two to line up.

Are there free apps for building digital choice boards?

Yes. ChoiceBoard-Creator is free on iOS and lets you use your own photos. Snap Core First and Proloquo2Go both have choice board modes but require paid subscriptions. ARASAAC (arasaac.org) has free downloadable symbols you can drop into any document editor. A lot of families just use Google Slides with photos they've imported, which works on any tablet or Chromebook.

How long before a child starts using a choice board on their own?

Most kids show some intentional pointing within one to four weeks of daily use, though some take six to eight. What matters most is how often you present the board, not how long each session lasts. Ten quick, natural opportunities a day beats one long 20-minute practice session. If eight weeks of genuine daily use hasn't produced any engagement, it's worth talking to a speech-language pathologist.

Can choice boards help with meltdowns?

Indirectly, yes. A lot of challenging behavior in young children, and in autistic children especially, comes from not being able to express a need, with the frustration spilling out as behavior instead. A 2021 review in the Journal of Autism and Developmental Disorders found consistent drops in problem behavior when visual supports, including choice boards, were used regularly. The board isn't treating the behavior itself. It's closing the communication gap that was causing it.

What's the difference between a choice board and a visual schedule?

A choice board offers options for your child to pick from. A visual schedule lays out the order activities will happen in, without any choosing involved. Both are visual supports, and both help ease anxiety and transitions. Often they work side by side: the schedule shows what's coming next, and the choice board gives your child a say within each activity, like which book to read or which snack to have.

Does insurance cover choice boards or AAC evaluations?

Choice boards themselves are usually cheap or free to make and aren't typically billed to insurance. A formal AAC evaluation from a speech-language pathologist may be covered by Medicaid or private insurance, particularly with autism or another diagnosis behind the referral. High-tech AAC devices can be covered through Medicaid for kids who qualify, though it requires a prescription and an SLP recommendation. Early intervention for children under 3 is free under IDEA Part C no matter what insurance you have.

Should I label pictures with words even if my child can't read yet?

Yes. Printing the word underneath each symbol is standard advice, even before a child can read. Every time you say the word aloud as your child points, their eyes may land on the printed text. Over time, a lot of kids start recognizing the word's shape before they've had any formal reading instruction. It also sets the board up for when reading does click, and it helps anyone unfamiliar with your symbols understand what each card means.

Can a choice board help a child who communicates through echolalia?

Often, yes. Kids who lean on echolalia are already showing they understand that language does something, even when what comes out is scripted. A choice board gives them a way to communicate that doesn't depend on retrieving a brand-new word on the spot. Some start pairing their scripted phrases with pointing to the board, which can help you figure out which phrases map to which wants. Our full piece on echolalia goes into this pattern in more detail.

Sources

1. ASHA, AAC Practice Portal: ASHA defines AAC as any form of communication other than spoken speech used to express thoughts, needs, wants, and ideas, including symbol boards, and states there's no evidence that AAC holds back speech development.
2. Journal of Autism and Developmental Disorders, Ganz et al., 2021 systematic review of visual supports: A review of 25 studies found visual supports, including choice boards, consistently helped children initiate communication more and reduced problem behaviors.
3. American Academy of Pediatrics, Autism Spectrum Disorder surveillance and screening policy: The AAP recommends developmental and autism-specific screening at 18 and 24 months, and backs visual supports as part of evidence-based behavioral intervention.
4. Centers for Disease Control and Prevention, Learn the Signs. Act Early.: The CDC's Act Early program encourages introducing communication supports as soon as a delay is identified, noting visual supports work well for toddlers.
5. Beukelman DR, Mirenda P. Augmentative and Alternative Communication, 4th ed. Brookes Publishing, 2013: Real photographs of actual objects work better than generic clip art for young children matching symbols to meaning, and boards should stay under eight symbols until a child shows reliable choice-making.
6. Romski M, Sevcik RA. Augmented language development and AAC. ASHA Leader, 2005: Aided language stimulation, saying words aloud alongside AAC symbol use right after a child communicates, is what helps choice boards build toward spoken language.
7. U.S. Department of Education, IDEA Part C Early Intervention: IDEA Part C guarantees free early intervention for eligible children under 3, Part B covers school-age kids, and IEPs must include supports like visual aids.
8. ARASAAC, Aragonese Center for AAC Symbols (free open-license symbol library): ARASAAC offers free downloadable line-drawing symbols for building low-tech communication boards.
9. Frost L, Bondy A. The Picture Exchange Communication System Training Manual, 2nd ed. Pyramid Educational Products, 2002: PECS and similar picture-exchange systems show that intentional pointing and exchange can be taught step by step to children without speech, starting with simple one-to-one exchanges.
10. Centers for Disease Control and Prevention, Developmental Milestones and Early Intervention: The CDC's Act Early program supports catching communication delays early and referring families to early intervention services.