Communication beyond speech
Information about Augmentative and Alternative Communication (AAC) and other forms of communication for people who do not use speech as their primary means of expression.
Speech and communication are not the same thing
Some autistic people do not use spoken language, use only a few words or have speech that does not meet all of their communication needs. Terms such as “nonspeaking,” “minimally speaking” and “nonverbal” are used in different ways; when known, the person’s own preference should be respected.
Little or no speech does not allow conclusions about intelligence or comprehension. At the same time, it is also unsafe to assume that a person understands everything. Communication assessment should consider expression, comprehension, motor access, vision, hearing and opportunities for participation.
Reference: Tager-Flusberg, H., & Kasari, C. (2013). Minimally verbal school-aged children with autism spectrum disorder. Autism Research, 6(6), 468-478.
Augmentative and Alternative Communication (AAC)
AAC is a set of strategies and tools that support or replace speech. It is called “augmentative” when it supplements existing speech and “alternative” when it replaces speech.
Low-tech systems
Boards with symbols or words, photos, objects, gestures and manual signs. PECS (Picture Exchange Communication System) is a specific picture-exchange teaching system, not a generic name for communication cards.
High-tech systems
AAC apps and software, speech-generating devices, voice-output devices and dedicated equipment. Products, prices, languages, privacy features and compatibility change over time, so the Project does not recommend a single brand on this page.
Selecting a system should consider communication goals, comprehension, vision, hearing, motor access, settings of use, communication partners and the person’s preferences. Speech-language pathology often plays a central role in communication assessment; occupational therapy and other professionals may contribute especially to access, participation and motor or sensory factors within their scopes.
Reference: Ganz, J. B. et al. (2012). AAC interventions for individuals with autism spectrum disorders. Research in Autism Spectrum Disorders.
Strategies for Families
Respect different forms of communication
Gestures, vocalizations, facial expressions, writing, symbols, devices and other actions can all be part of communication. A behavior may indicate a need, but its meaning should not be assumed without context.
Do not delay AAC out of fear that it will interfere with speech
Available reviews do not indicate that AAC interventions harm speech production. Some studies report speech gains, but results vary, and AAC should also be valued for its own role in communication.
Observe the child’s interests
Use the child’s specific interests as a bridge to communication. If they like dinosaurs, dinosaur images can be incorporated into the AAC system.
Model use of the system when appropriate
Communication partners can use symbols or the communication system itself while speaking. This type of input may support learning for some users, but it should be adapted to the system and the person.
Create natural communication opportunities
Offer choices, pauses and opportunities to comment, request, refuse, ask questions or share interests without withholding basic needs, essential items or help as a way to force communication.
Use tentative language when talking about emotions
Instead of stating what the person feels, try phrases such as “it seems that was difficult” or offer communication options. When they can express it, the person is the best source about their own state.
Myths and Facts
"“If they use AAC, they will never speak”"
FALSE. Systematic reviews do not show reduced speech caused by AAC. Some participants show speech gains, usually modest and variable, while communication through AAC remains an important outcome in its own right.
"“They understand everything, they just do not want to speak”"
INACCURATE. Comprehension and expression are different abilities. A child may understand far more than they can express verbally.
"“People who do not speak do not communicate”"
FALSE. Communication can occur through gestures, symbols, writing, devices, vocalizations and other forms. It is important not to assume comprehension, intent or preference solely from the absence of speech.
"“It is caused by a lack of stimulation at home”"
FALSE. Autism is a neurodevelopmental condition, not the result of insufficient stimulation. Blaming parents is unfair and not supported by science.
Important notice: This content is strictly educational and informational. It does not replace assessment or follow-up by qualified health professionals.
Clinical and editorial review: August 18, 2026
Comunicação Aumentativa e Alternativa no autismo
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