Use of AAC Devices for Individuals with Autism Spectrum Disorder

Augmentative and Alternative Communication (AAC) devices have emerged as crucial tools for enhancing communication and interaction among individuals with Autism Spectrum Disorder (ASD). AAC encompasses a wide array of strategies and technologies designed to facilitate effective communication in individuals who face challenges in speech and language development.

What are AAC Devices?

AAC devices are communication tools that aid individuals with limited or no verbal speech in expressing their thoughts, needs, and desires. These devices serve as alternative means of communication for individuals with ASD, helping them overcome communication barriers and enabling meaningful interaction with their environment and peers.

Why are AAC Devices Used?

The utilization of AAC devices is pivotal for individuals with ASD who struggle with speech and language development. These devices offer a means to bridge the communication gap, reduce frustration, and enhance social interaction. AAC devices empower individuals with ASD to communicate effectively, promote language development, and facilitate engagement in social and educational settings.

Science Behind AAC Devices:

Recent meta-analyses (Aydin & Diken, 2020) have highlighted the effectiveness of AAC interventions for individuals with ASD. A study by Ganz, Davis, Lund, Goodwyn, and Simpson (2012) has demonstrated the positive impact of AAC interventions on communication skills and challenging behaviors. Contrary to concerns, AAC interventions have not impeded speech development; in some cases, they have even improved speech skills (Ganz, Mason, et al., 2014). The research also emphasizes the importance of addressing various communicative functions beyond requesting, including social interactions and joint attention (Ganz, Earles-Vollrath, et al., 2012).

Types of AAC Devices Available:

AAC devices encompass a spectrum of options ranging from low-tech to high-tech solutions.

Low-Tech AAC Devices: These devices include communication boards with pictures, symbols, or words that individuals can point to. For instance, a child with ASD can use a picture board to communicate basic needs like “eat,” “drink,” or “go.”

High-Tech AAC Devices: These devices utilize technology to facilitate communication. Speech-generating devices (SGDs) are an example, allowing users to select symbols or words on a screen, which the device then vocalizes. Another example is mobile AAC apps, such as Proloquo2Go, which offer similar functionality on portable devices like smartphones and tablets.

Considerations for Selecting an AAC Device:

Individual Characteristics: Factors such as age, cognitive abilities, sensory preferences, and motor skills should be considered when selecting an AAC device.

Communication Needs: The specific communication goals of the individual, including the types of messages they need to convey, play a crucial role in device selection.

Context and Environment: The settings in which the AAC device will be used, such as home, school, or community, impact the device’s portability and features.

Multimodal Approach: A combination of AAC modes, including speech approximations, gestures, and facial expressions, may be effective for facilitating communication.

Preference and Choice: Involving the individual with ASD and their family in the selection process helps ensure the device aligns with their preferences and needs.


AAC devices offer a transformative solution for individuals with Autism Spectrum Disorder, empowering them to communicate effectively and engage meaningfully with their surroundings. Supported by scientific research and a range of available options, AAC interventions hold the potential to unlock communication barriers, enhance language development, and promote social interaction for individuals with ASD. By considering individual characteristics, communication needs, and contextual factors, stakeholders can make informed decisions when selecting an appropriate AAC device, ultimately fostering improved communication outcomes and enriching the lives of individuals with ASD.


Aydin, O., & Diken, I. H. (2020). Studies Comparing Augmentative and Alternative Communication Systems (AAC) Applications for Individuals with Autism Spectrum Disorder: A Systematic Review and Meta-Analysis. Education and Training in Autism and Developmental Disabilities, 55(2), 119-141.

Beukelman, D. & Mirenda, P. (2013). Augmentative and Alternative Communication: Supporting Children & Adults with Complex Communication Needs 4th Edition. Baltimore: Paul H. Brookes Publishing.

Ganz, J. B., Davis, J. L., Lund, E. M., Goodwyn, F. D., & Simpson, R. L. (2012). Meta-analysis of PECS with individuals with ASD: Investigation of targeted versus non-targeted outcomes, participant characteristics, and implementation phase. Research in Developmental Disabilities, 33(2), 406–418.

Ganz, J. B., Mason, R. A., Goodwyn, F. D., Boles, M. B., Heath, A. K., & Davis, J. L. (2014). Interaction of participant characteristics and type of AAC with individuals with ASD: A meta-analysis. American Journal on Intellectual and Developmental Disabilities, 119(6), 516–535.

Ganz, J. B., Earles-Vollrath, T. L., Heath, A. K., Parker, R. I., Rispoli, M. J., & Duran, J. B. (2011a). A meta-analysis of single case research studies on aided augmentative and alternative communication systems with individuals with autism spectrum disorders. Journal of Autism and Developmental Disorders, 42(1), 60–74.

Clinic-Based Therapy Versus Home-Based ABA Therapy for Autism Spectrum Disorder

Autism Spectrum Disorder (ASD) is a complex developmental condition that requires specialized interventions to support individuals in reaching their full potential. Two prominent intervention models are clinic-based and home-based Applied Behavior Analysis (ABA) therapy. In this blog post, we will compare these two approaches. We will explore the benefits and challenges of each model and provide a comprehensive understanding of their differences. These comparisons are drawn from research by Leaf et al. (2017) and Dixon et al. (2016).

Clinic-Based ABA Therapy

Clinic-based ABA therapy involves delivering behavioral interventions within a specialized center or office setting. This model offers several advantages:

Staff Collaboration and Support

One of the primary benefits of clinic-based therapy is the opportunity for staff members to collaborate, learn from each other, and receive continuous support from supervisors. The consistent interaction among staff members fosters skill development and job satisfaction.

Structured Learning Groups

Clinic-based therapy allows for structured learning groups, promoting social interactions and skill development within a group setting. This approach efficiently mirrors real-world environments and prepares individuals for social interactions outside the clinic.

Social Opportunities

Individuals with ASD often struggle with social interactions. Clinic-based therapy provides ample opportunities for peer interactions during breaks, group activities, and therapy sessions. These interactions can lead to the development of meaningful friendships.

Supervised Training and Consistency

Supervisors can provide immediate training and supervision, ensuring treatment fidelity and consistent intervention delivery. This supervision promotes efficient skill acquisition and behavior modification.

Challenges of Clinic-Based ABA Therapy

Limited Generalization

Skills acquired in a clinic setting may not generalize well to other environments, potentially limiting the practical application of learned behaviors in natural contexts.

Parent Involvement

Clinic-based therapy might restrict parental involvement due to logistical challenges such as commuting. This limitation could hinder parents from being actively engaged in the intervention process.

Cost Factors

Running a clinic incurs higher costs for rent, maintenance, and materials, which may indirectly affect the cost of therapy.

Home-Based ABA Therapy

Home-based ABA therapy involves delivering interventions directly within the individual’s home environment. This model has its own set of advantages:

Parental Involvement

Home-based therapy encourages active parental involvement, allowing caregivers to be closely engaged with the therapy process. Parents receive training and support, which can enhance the overall effectiveness of interventions.

Ecological Validity

Assessment and intervention occur within the individual’s natural environment, enhancing the ecological validity of the intervention outcomes. This setting allows for targeting real-life challenges and behaviors.

Generalization to Daily Life

Skills learned in the home environment are more likely to generalize to daily life situations, enabling individuals to apply learned behaviors effectively.

Challenges of Home-Based ABA Therapy

Logistical Pressures

Home-based therapy may require therapists to travel extensively between locations, potentially reducing the variety of experiences for therapists and learners.

Dual Relationships

Continuous presence within the home can lead to the development of dual relationships between therapists and families, which requires clinical skills to maintain objectivity.

Cost and Space Concerns

While home-based therapy avoids clinic-related costs, it may require additional investments in materials and training resources.


Both clinic-based and home-based ABA therapy models offer distinct advantages and challenges. Clinic-based therapy fosters staff collaboration, structured learning groups, and social opportunities, while home-based therapy promotes parental involvement, ecological validity, and generalization of skills. A hybrid approach that combines elements from both models might provide the best of both worlds, capitalizing on the strengths of each while mitigating their respective challenges. At Eastwood Psychologists we attempt to overcome the parental involvement challenges of clinic-based therapy by making parental observation of therapy and parent training a regular part of our programming. We also maximize generalization opportunities by using the community space around our centre such as the library, recreational spaces and retail spaces.  Ultimately, the choice between clinic-based and home-based therapy should be based on the unique needs of the individual with ASD, the preferences of the family, and the guidance of professionals in the field. By understanding the differences between these models, families and professionals can make informed decisions to ensure the most effective and tailored intervention for individuals with ASD.


Dixon, D. R., Burns, C. O., Granpeesheh, D., Amarasinghe, R., Powell, A., & Linstead, E. (2016). A Program Evaluation of Home and Center-Based Treatment for Autism Spectrum Disorder. Behavior analysis in practice10(3), 307–312.

Leaf, J.B., Leaf, R., McEachin, J. et al. Advantages and Challenges of a Home- and Clinic-Based Model of Behavioral Intervention for Individuals Diagnosed with Autism Spectrum Disorder. J Autism Dev Disord 48, 2258–2266 (2018).

The Connection Between Autism and Apraxia

Autism and apraxia are two complex developmental conditions that often intersect, presenting unique challenges for affected individuals and their families. In this blog post, we will delve into the intricate relationship between autism and childhood apraxia of speech, exploring their definitions, connections, and available treatment options.

What is Autism?

Autism, or Autism Spectrum Disorder (ASD), is a neurodevelopmental disorder characterized by difficulties in social communication and interaction, as well as restricted and repetitive behaviors. It affects individuals across a wide spectrum, leading to diverse patterns of behavior, communication, and cognitive abilities. With an estimated prevalence of 1 in 54 children in the United States, autism has garnered significant attention from researchers and clinicians alike.

What is Childhood Apraxia of Speech (CAS)?

Childhood Apraxia of Speech (CAS), also known as apraxia of speech (AOS), is a speech disorder that impacts an individual’s ability to plan and coordinate the precise muscle movements necessary for clear speech. Unlike other speech-related issues caused by physical limitations, individuals with CAS can physically produce speech sounds but struggle to sequence them effectively. This leads to inconsistent speech patterns, making it challenging for others to understand them. CAS exists on a spectrum, ranging from mild to severe and can significantly impact communication abilities. Someone may just struggle with stuttering but someone else may have extreme difficulty with speaking including groping for sounds such that they may have to attempt multiple times to move their articulators correctly to produce a target sound.


How Are Apraxia and Autism Connected?

The connection between apraxia and autism is multifaceted and has been a subject of scientific investigation. Research has shown a notable comorbidity between the two conditions, indicating that a substantial proportion of individuals diagnosed with autism also exhibit symptoms of apraxia. A 2015 study by Tierney et al. examined the potential overlap between autism and CAS. The study found that as much as 65% of children with autism also exhibited speech apraxia. This suggests that children diagnosed with autism should be screened for apraxia, as the two conditions frequently co-occur. The study emphasizes the importance of accurate diagnostic assessments and targeted interventions to address the communication challenges faced by these children.

Echolalia and Autism

Many children with autism initially show signs of echolalia, the repetition of words or phrases, as they learn to navigate language. This repetition serves as an essential step in language development, enabling them to internalize and process linguistic patterns. In children under three years of age, echolalia is a natural part of language development. However, in older children, especially those with autism, echolalia can serve as a communication tool. While they may not fully comprehend the meaning of the repeated words, they associate them with specific contexts and experiences. This allows them to express needs, engage in self-talk, or cope with challenging situations.

The Triad of Interaction:

The interaction between autism, apraxia, and echolalia creates a triad of challenges in communication. Echolalia, often observed in children with autism, can be intertwined with both conditions. While echolalia aids language acquisition, it may also mask underlying apraxia symptoms, making it challenging to diagnose both conditions accurately. This underscores the need for comprehensive evaluations by speech-language pathologists (SLPs) to differentiate echolalia related to language learning from that stemming from apraxia. Intervention strategies for individuals facing this triad of challenges require a multidimensional approach.

Treatment Options for Autism and Apraxia:

Addressing the complex communication needs of individuals with both autism and apraxia requires a comprehensive and personalized approach. Treatment options often involve a combination of therapies and strategies to support language development and communication skills.

  1. Speech Therapy:

Speech-language pathologists (SLPs) play a crucial role in diagnosing and treating apraxia in individuals with autism. SLPs use various techniques to improve speech production, including helping individuals learn to plan and sequence movements for clear speech. Therapy may involve exercises to strengthen oral motor skills and enhance coordination of speech-related muscles. Additionally, visual supports and speech devices, such as picture cues or voice-generating tablets, can aid individuals in communicating their needs.

  1. Behavioural Therapy:

Behavioural therapy is a cornerstone of autism treatment, focusing on improving social skills, communication abilities, and behaviour management. Applied Behaviour Analysis (ABA) is a widely used approach that tailors interventions to an individual’s specific needs and strengths. ABA can be adapted to address both autism-related challenges and the communication difficulties associated with apraxia.

  1. Early Intervention:

Early intervention is key for children with autism and apraxia. Detecting and addressing these conditions in their early stages can lead to improved outcomes. Comprehensive evaluations, conducted by a team of professionals, can help identify the unique communication profile of each child and guide the development of targeted intervention plans.

  1. Visual Supports and Gesture Cuing:

Visual supports, such as picture cards and gesture cuing, are effective tools to aid communication for individuals with both autism and apraxia. These strategies help bridge the gap between understanding language and producing speech. Visual supports provide a visual representation of words or concepts, while gesture cuing involves physical cues that guide speech production.

  1. Core Vocabulary Building:

Focusing on core vocabulary—selecting a set of essential words—can facilitate language development. Practicing these core words through structured activities and incorporating them into daily routines enhances an individual’s ability to communicate effectively.

  1. Parent and Caregiver Involvement:

Parents and caregivers play an integral role in the treatment process. Learning and implementing strategies at home can reinforce progress made during therapy sessions. Activities such as using sound effects, offering choices, and engaging in interactive play can create meaningful opportunities for language practice and communication.


American Speech-Language-Hearing Association. (n.d.). Childhood apraxia of speech. American Speech-Language-Hearing Association.

Tierney, C., Mayes, S., Lohs, S. R., Black, A., Gisin, E., & Veglia, M. (2015). How valid is the checklist for autism spectrum disorder when a child has apraxia of speech? Journal of Developmental & Behavioral Pediatrics, 36(8), 569–574.

What is the connection between apraxia, echolalia and autism?. RDIconnect. (2022, June 27).