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Speaking in Pictures - A guide to Alternative & Augmentative Communication

August 20, 2016   Contributed by Vivian Yau, Stephanie DeCiantis

Have you ever heard the term AAC before? It stands for Alternative and Augmentative Communication and it refers to any method of supporting someone's ability to communicate with others. A few examples are: a book with pictures, an iPad application, or a dedicated device with a voice output function. A child who has significant difficulty with his or her pronunciation skills or who may be non-verbal for other reasons may benefit from the support of an AAC system.

An AAC system may be needed as their main form of communication or it can serve to support them for when their message is not clearly understood by others.  Our own Smile Speech Therapy's Stephanie DeCiantis created a communication book for one our young clients who needed support with his expressive communication. It is called a "Flip and Talk" and is organized by functional categories such as: quick messages, questions, people, activities, places, activities, foods/drinks, feelings, actions.  

Here is a photo of the full version of the individualized "Flip and Talk” below:


Parents participated in designing the book by helping identify vocabulary that is motivating and integral to the child's daily life. The communication system should allow a child to communicate for a variety of reasons (requesting, greeting, commenting, asking questions, rejecting, etc.). Parts of the book can be hidden and revealed as the child learns to recognize and use more and more icons to communicate.

Here is a photo of the "Flip and Talk" with parts of the pages masked to make it easier for them as they are learning:


In addition, family members are responsible for keeping the AAC support always accessible. These are the child's words and you wouldn't take their words away from them and put them on a shelf! Our therapist will teach parents how to model the use of the book, just as a parent would model words for a child who is learning to talk.

If you feel like your child would also benefit from AAC support and you reside in Toronto, you can inquire if he or she would qualify for government-funded services through the AAC clinics at Holland Bloorview Kids Rehab Hospital or The Surrey Place Centre. (Click on the links below for more information).

Holland Bloorview Kids Rehab AAC Service
Surrey Place Centre Augmentative Communication and Writing Aids Program 

Of course, we would be happy to discuss your child's communication needs by contacting us at Smile Speech Therapy.  Hope you have gained some valuable information about helping your child develop into the best communicator he or she can be with the support of AAC!

Clinic location:
532 Eglinton Avenue East
(Lower Level),
Toronto, ON M4P 1N6 

Phone: (416) 488-7807

Fax: (416) 488-7815