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

Last updated 2026-07-11

What is a choice board and how does it work?

A choice board is exactly what it sounds like. A small 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 spoken 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 removes two barriers at once. First, 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. Second, it delivers a clear, immediate result. The child points, and the thing appears. That cause-and-effect loop is what builds communicative 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]. That framing matters. A choice board isn't a workaround or a crutch. It's communication, full stop.

Choice boards get used with late talkers, children diagnosed with autism spectrum disorder, children with apraxia of speech, and children who already use AAC devices but need a simpler bridge for specific routines.

Does research actually support using choice boards with kids?

Yes. The evidence base is 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 living only 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 says 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 a choice board. The nearest guidance comes from early intervention research, which supports introducing visual communication supports as soon as a delay shows up, rather than waiting to see if speech "catches up." Aided language supports have been introduced with toddlers as young as 18 months with no reported adverse effects ^[4].

Here's the honest read. Studies in this space often run small, with variable implementation fidelity. The direction of the evidence favors choice boards strongly. The size of the benefit hangs on how consistently adults use them. And there are essentially no documented downsides to trying one.

What should I put on a choice board for my child?

Start with two items. Two. Not six, not twelve. Two options your child actually wants and runs into every single day.

The most reliable starting categories are preferred foods, preferred activities, and sensory inputs the child seeks out. If your kid loves YouTube 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 inside one to four weeks depending on how often you present it, expand to three or four items. General SLP guidance is to stay below eight symbols on a single board until a child shows reliable choice-making across many sessions ^[5]. More than eight at once adds visual scanning demands that make the board harder to use, not easier.

Here's what to include at each stage:

Photos of the actual objects in your home beat generic clip art for most young children, especially under 4. The child's 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 the child becomes a more flexible symbol user, shift toward line-drawing symbols like Boardmaker or SymbolStix if you want to eventually bridge to a high-tech AAC device.

How do I actually use a choice board in everyday routines?

The single biggest predictor of whether a choice board works is whether adults use it every time an opportunity comes up, more than during "therapy time."

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. You don't say "Use your board" or "What do you want?" You hold it up and wait five to ten seconds. If they reach past it, gently guide their hand to the board and help them touch a symbol. Then give that item immediately and say the word out loud: "Crackers! You want crackers."

That last part, modeling the spoken word right after the point, is aided language stimulation, and it's the engine that moves a choice board toward speech ^[6]. The child sees the symbol, makes a communicative act, gets a result, and hears the word connected to that result. After dozens of reps, the spoken word starts arriving with or before the point.

Routines that fit choice boards especially well:

• Snack and mealtime (food choices)
• Morning getting-ready routine (which shirt, which shoes)
• TV or tablet time (which show or game)
• Recess or free play (which toy or activity area)
• Bedtime (which book, which stuffed animal)
• Transitions between activities (what comes next)

Transitions are underused. A "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 moment.

How do I make a choice board at home without buying anything?

You can build a working choice board in about 20 minutes with stuff most households already have.

The no-cost route: print or cut pictures from magazines or food packaging, laminate them with clear packing tape (no laminator machine, just tape over front and back), and stick them to a piece of cardboard with velcro dots or binder clips. Done. That is a real, clinician-approved AAC tool.

Want something more polished? Here are options at different price points:

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

Want a digital version? 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 a try for kids who already like a tablet, since tapping often 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?

This is the most common wall parents hit, and it usually traces back to one of five causes.

The choices aren't motivating. If neither option is something your child truly wants, they have no reason to engage. Go back to basics and pick the two things your child chases hardest. If they'd climb over the couch to reach a specific toy, that toy belongs on the board.

The board shows up too late. If your child already has the cracker box or is mid-meltdown because a transition happened with no warning, the board missed its window. It has to appear before the want turns urgent, not during the crisis.

Too many options. More than three or four items can flood a child who's new to symbols. Cut back to two and rebuild.

Too much talking. "Come look at your board. Which one do you want? This one or this one? Point to one. Show me." All that language buries the simple signal you're sending. Hold it up. Wait. Stay quiet.

The child needs hand-over-hand help to start. Some children, especially those with motor planning challenges like childhood apraxia of speech, need you to guide their hand to a symbol the first 10 to 20 times. That's not cheating. That's teaching the motor routine.

If your child has had a well-run board for four to six weeks with zero engagement, take it to a speech therapist. There may be a visual, motor, or cognitive piece that needs a professional look before the board can do its job.

Should I use pictures, words, or symbols on the board?

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

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

Line-drawing symbols (Boardmaker's PCS library or the open-source ARASAAC set) come next up the abstraction ladder ^[8]. They travel better, since you can't always print a photo of the specific object in a new place. They're also the symbols on most AAC devices, so using them on low-tech boards keeps everything consistent.

Written words alone fit only when a child already recognizes some printed words. Some children with hyperlexia, a reading ability that shows up before or without matching language comprehension, respond better to printed words than to pictures. If your child is drawn to letters and seems to read words but talks little, try printed words and watch what happens.

For most kids, the combo works best: a line-drawing symbol on top with the printed word below. That's how most AAC apps and devices display symbols, and it feeds both the visual and the emerging literacy pathways at the same time.

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 prepared. The child can't say anything you didn't put on the board. A full AAC system, whether low-tech like a communication book or high-tech like a speech-generating device, lets the child build new messages across any topic ^[1].

Picture it this way. A choice board is a menu where someone else picked the items. 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, durable, and fast to deliver a result. The goal isn't to camp on choice boards forever. The goal is to prove to the child that communication works, 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 a fuller system. A speech-language pathologist can run a formal AAC evaluation to find the right fit. 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 back 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 get frustrated when they can't say so. If that frustration exists, 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 receive early intervention services before age 3, and visual communication supports are a standard part of those services ^[7].

Older children and adults use choice boards too. They show 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. If you want AAC for older individuals, speech therapy for adults covers the 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?

Choice boards work best as a bridge, not a standalone treatment. In a typical speech therapy session, an SLP uses the board to pull out a communication attempt, models the spoken word right away, then sets up another chance for the child to try speech. The board makes 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 put 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 cognitive work.

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

For children getting services through the 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 yours at home, ask for alignment. Parents have the legal right to request this at IEP meetings ^[7].

What are common mistakes parents make with choice boards?

Introducing the board during a meltdown. 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 bad.

Switching the layout too often. If the apple always sits top left and the crackers bottom right, the child builds a spatial memory that speeds up pointing. Rearranging symbols too much wipes that out and pushes the child toward random, habit-driven pointing.

Using the board only for wants. Choice 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. Some children need four to eight weeks of daily, consistent use before they point on purpose. Two weeks of effort followed by a board in a drawer is the most common reason families say "the board didn't work."

Not fading prompts. Once a child points reliably, adults sometimes keep prompting out of habit. Ease off gradually, from hand-over-hand, to pointing near the board, to just holding it up, so the child starts on their own. That independence is the whole point.

How do I know if a choice board is helping or if I need professional support?

A working choice board shows these signs within four to eight weeks of consistent daily use. The child approaches or reaches for the board on their own. They point to symbols on purpose, not randomly and not always to the same spot regardless of what's shown. And problem behaviors tied to unmet communication needs, like hitting, screaming, or throwing, start to fade.

If none of those show up after six to eight weeks of genuinely consistent use, that's useful information. It points to either an implementation problem or something else a board alone can't touch. That's the moment for a formal evaluation by a speech-language pathologist. If your child is under 3, that evaluation is free through your state's early intervention program under IDEA Part C ^[7].

Children with significant motor challenges, including suspected apraxia of speech or other motor speech disorders, may need a different board format (eye gaze options, say) or an occupational or physical therapist to check hand and arm coordination before pointing becomes reliable.

The presence of echolalia, repeating words or phrases heard elsewhere, doesn't mean a choice board won't land. Plenty of children with echolalia use boards well and start pairing their repeated phrases with intentional pointing over time. For more on what echolalia means for communication, read our piece on echolalia meaning.

Frequently asked questions

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

Yes. Two years old sits well inside the age range where choice boards work. Start with two high-interest photos (a favorite food and a favorite toy), hold the board up before each opportunity, and wait. Clinical guidelines support visual communication supports as soon as a delay shows up, with children as young as 18 months in some early intervention programs. Pair board use with spoken models of each word.

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

No. ASHA's AAC practice portal states there's no evidence that AAC holds back speech development, and multiple studies show speech output stays the same or rises when visual supports get added. The board builds successful communication experiences. That success, plus adults modeling the spoken word alongside every point, is one of the mechanisms that moves a child toward speech over time.

How many choices should be on the board at once?

Start with two. Once your child points reliably to one of two options for about one to two weeks, add a third. Most SLP guidance says stay at or below eight symbols on a single board until the child shows clear intentional choice-making. Too many options too soon create visual overload and random pointing, which is the opposite of what you want.

Should I use real photos or drawn symbols on a choice board?

Real photos of the actual objects in your home work best for beginners, especially children under 4 who are still learning that images stand for things. Line-drawing symbols (Boardmaker, ARASAAC) are more portable and match most AAC devices, so move toward them once the child is a confident photo-symbol user. Many boards combine both: a small drawing with the word printed below it.

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

This is position bias, a very common early pattern. The child has learned that pointing produces a good outcome but hasn't yet mapped specific symbols to specific items. Switch which item sits in each position each time you present the board, and occasionally offer only one option the child dislikes to see if they reject it. Over time, give the preferred item only when they point to its correct symbol.

Can a choice board be used at school as well as at home?

Yes, and consistency across settings is one of the strongest predictors of faster learning. If your child uses one at home, tell the school team. Under IDEA, children with IEPs have the right to supplementary aids and services, which include visual supports. Ask the team to use the same symbol set you use at home. If the school runs a different system, request alignment in writing at the IEP meeting.

Are there free apps for making digital choice boards?

Yes. ChoiceBoard-Creator is free on iOS and lets you use photos you take yourself. Snap Core First and Proloquo2Go have choice board modes but need paid subscriptions. ARASAAC (arasaac.org) offers free downloadable symbols for building your own boards in any document editor. For purely digital boards, many families use Google Slides with imported photos, which runs on any tablet or Chromebook.

How long does it take for a child to start using a choice board on their own?

Most children show some intentional pointing within one to four weeks of daily, consistent use, though some take six to eight weeks. The biggest variable is how often the board gets presented, not how long each session runs. Ten brief, naturally-occurring opportunities a day beats one 20-minute practice block. If there's no sign of engagement after eight weeks of genuine daily use, consult a speech-language pathologist.

Can choice boards help with behavior and meltdowns?

Indirectly, yes. A large share of challenging behavior in young children and autistic children is communication driven. The child can't express a need, and the frustration comes out behaviorally. 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 consistently. The board doesn't fix behavior directly. It fixes the communication gap that was driving it.

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

A choice board shows options the child picks from. A visual schedule shows the sequence of activities that will happen in order, without the child choosing the sequence. Both are visual supports, and both reduce anxiety and smooth transitions. They often work together: the schedule shows what's coming next, and the choice board hands the child agency inside each scheduled activity (which book for reading time, which snack at snack time).

Does insurance cover choice boards or AAC evaluations?

Choice boards themselves are usually low or no cost and don't get billed to insurance. A formal AAC evaluation by a speech-language pathologist may be covered under Medicaid or private insurance, especially with autism or another diagnosed condition as the basis. High-tech AAC devices can be covered through Medicaid for eligible children; the process needs a prescription and SLP recommendation. Early intervention services for children under 3 are free under IDEA Part C regardless of insurance.

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

Yes. Printing the word below each symbol is consistently recommended, even for pre-readers. Every time you say the word out loud after the child points, their eye may drift to the printed word. Over time, many children start to link the letter pattern with the word before any formal reading instruction. It also readies the board for when reading emerges, and it helps any adult unfamiliar with your symbols know what each card means.

Can a choice board help a child who uses echolalia to communicate?

Often, yes. Children who rely on echolalia are already showing they understand the communicative value of language, even if the output is scripted. A choice board gives them a channel that doesn't require retrieving or producing a specific novel word. Some children begin pairing their echolalic phrases with board pointing, which helps caregivers figure out which scripts map to which wants. See our full piece on echolalia for more on this pattern.

Sources

1. ASHA, AAC Practice Portal: ASHA defines AAC as all forms of communication other than oral speech used to express thoughts, needs, wants, and ideas, and includes symbol boards; ASHA states no evidence exists that AAC inhibits speech development
2. Journal of Autism and Developmental Disorders, Ganz et al., 2021 systematic review of visual supports: Systematic review of 25 studies found consistent positive effects of visual supports including choice boards on communication initiations and reduction in problem behaviors
3. American Academy of Pediatrics, Autism Spectrum Disorder surveillance and screening policy: AAP recommends developmental and autism-specific screening at 18 and 24 months and supports visual supports as part of evidence-based behavioral intervention packages
4. Centers for Disease Control and Prevention, Learn the Signs. Act Early.: CDC Act Early supports introducing communication supports as soon as a developmental delay is identified, with visual supports appropriate for toddlers
5. Beukelman DR, Mirenda P. Augmentative and Alternative Communication, 4th ed. Brookes Publishing, 2013: Real photographs of actual objects outperform generic clip art for young children as visual-symbol referent matching; boards should stay below eight symbols until reliable choice-making is demonstrated
6. Romski M, Sevcik RA. Augmented language development and AAC. ASHA Leader, 2005: Aided language stimulation, modeling spoken words alongside AAC symbol use immediately after a child's communicative act, is the mechanism by which choice boards build toward speech
7. U.S. Department of Education, IDEA Part C Early Intervention: IDEA Part C requires free early intervention services for eligible children under age 3; Part B covers school-age children; IEPs must include supplementary aids and services such as visual supports
8. ARASAAC, Aragonese Center for AAC Symbols (free open-license symbol library): ARASAAC provides 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 related picture-exchange systems demonstrate that intentional communicative pointing and exchange can be taught systematically to children who do not use speech, starting with one-to-one exchanges
10. Centers for Disease Control and Prevention, Developmental Milestones and Early Intervention: CDC Act Early program supports early identification of developmental delays including communication delays and referral to early intervention services