Using AAC in daily life

ByLondon Speech and Feeding
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Communication is a fundamental human right, a bridge that connects us to the world and each other. For many, spoken language is the primary mode, but for individuals with complex communication needs, Augmentative and Alternative Communication (AAC) offers a powerful pathway to expression and connection. This guide will demystify AAC, highlight the crucial role of modelling, and provide practical examples of how low-tech AAC can be seamlessly integrated into everyday activities.

What is AAC in a nutshell?

AAC encompasses a wide range of tools and strategies that supplement or replace spoken language. It’s not about replacing speech, but rather about providing additional ways for individuals to communicate effectively. Think of it as a spectrum:

  • Unaided AAC: This involves using only your body, such as gestures, facial expressions, body language, and sign language.
  • Aided AAC: This involves external tools or devices. These can range from low-tech options like picture boards and communication books to high-tech speech-generating devices (SGDs) and apps on tablets.

The beauty of AAC lies in its flexibility and personalisation. It empowers individuals to express their wants, needs, thoughts, and feelings, fostering independence and participation in all aspects of life.

Modelling is KEY: Showing, not just telling

Imagine trying to learn a new language without ever hearing it spoken. It would be incredibly difficult, right? The same principle applies to AAC. Modelling is the single most important strategy for teaching and supporting AAC users. It means actively using the AAC system yourself while talking, demonstrating how to navigate the system and express messages.

Here’s why modelling is so vital:

  • It’s how we learn language: Typically developing children learn language by hearing it constantly around them. AAC users need the same immersion.
  • It reduces pressure: When you model, you’re not asking the individual to communicate, you’re just showing them how it’s done. This takes the pressure off and makes learning more enjoyable.
  • It expands vocabulary and concepts: By modelling a variety of words and phrases, you introduce new vocabulary and demonstrate how to combine symbols to create more complex messages.
  • It demonstrates purpose: Modelling shows that AAC is a functional and effective way to communicate, not just a set of pictures.

So, how do you model? It’s simple: point to the symbols on the communication board or device as you speak the words. For example, if you say, ‘Time to eat breakfast,’ you might point to ‘time’, ‘eat’, and ‘breakfast’ on the board.

Low-tech AAC in action: Everyday activities

Low-tech AAC, such as communication boards, books, or single-page displays, is incredibly versatile and can be easily incorporated into daily routines. These can be as simple as printed pages with symbols, laminated for durability.

Let’s explore how low-tech AAC can be used throughout a typical day, with examples of symbols:

1. Getting ready for nursery

Mornings can be busy, but they also offer rich communication opportunities. A ‘Getting Ready’ communication board can help sequence activities and offer choices.

Activity example:

‘Time to get up!’ (point to GET UP). ‘What do you want to wear today, the blue shirt or the red shirt?’ (point to GET DRESSED) ‘Then, we brush teeth’ (point to TOOTHBRUSH) and so on.

AAC mornings symbol examples

2. Breakfast Time

Mealtimes are perfect for making choices, expressing preferences, and commenting. A ‘Breakfast’ communication board can focus on food items, actions, and social comments.

Example symbols:

AAC meal times symbol examples

Activity example:

‘What do you want to eat for breakfast?’ (point to EAT). ‘Do you want cereal or toast?’ (point to CEREAL or TOAST). If they finish their milk, you could say, ‘Are you ALL DONE or do you want MORE MILK?’ (point to symbols).

3. Catching the Bus

Even routine transitions like catching the bus can be communication rich. A small, portable ‘Travel’ board can be useful.

Example symbols:

AAC catching the bus symbol examples

3. Being on the playground

The playground is a dynamic environment perfect for commenting, requesting actions, and engaging in social play.

AAC playground symbol examples

Activity example:

‘Let’s PLAY!’ (point to PLAY). ‘Do you want to go on the SWING or the SLIDE?’ (point to symbols). If they are on the swing, you can say, ‘Do you want to go FAST or SLOW?’ (point to symbols) and ‘Push AGAIN!’ (point to PUSH) You can also model social language like ‘It’s MY TURN.’

Beyond the symbols: Key takeaways

  • Consistency is key: Use AAC consistently across all environments and with all communication partners.
  • Be patient: Learning a new language takes time. Celebrate small successes.
  • Make it fun: Integrate AAC into play and enjoyable activities.
  • Follow the individual’s lead: Respond to all communication attempts, even if they are imperfect.

In the video below I model how to integrate AAC into everyday activities with a few more examples and I discuss the difference between AAC and PECS.

If you need some inspiration with using AAC or would like your child assessed for the right type of AAC then please get in touch.

Sonja McGeachie

Highly Specialist Speech and Language Therapist

Owner of The London Speech and Feeding Practice.

Health Professions Council registered
Royal College of Speech & Language Therapists Member
Member of ASLTIP

Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.

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    Let us explain…

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    This way of working may seem daunting to some, but it doesn’t have to feel this way. Parents often feel if they are prepared then activities may go smoother. It might be the case, but perhaps it doesn’t give your child the opportunity for spontaneity. We’d like to suggest something that may lead to some surprises. Put out an activity that is your child’s favourite and then a completely new activity. Remember these activities don’t have to be complicated. Often, the simpler the better!

    So, no need to plan, just place two activities out and see what happens! Look out for anything which surprises you, which activity did they prefer? Do they have any sensory preferences? The freedom of choice is a wonderful thing to explore. So, just go with the flow!

    The kind of activities that are useful for child-led play can include:

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    • Small world play
    • Pretend play
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    Child-led therapy is a very useful resource. We have it at our fingertips. We don’t need special resources. You just need yourselves and your child! Sometimes, child-led therapy can be tricky to put in place. It sounds easy but is much harder in reality. So, make sure you give it time and reflect on your experiences. Ask yourselves ‘what went well’, and ‘what could be improved’. E.g., perhaps you gave your child time to lead to begin with, but you didn’t give them enough time to think about their options during the activity.

    How can parents become more child-led in the home environment?

    • Pause and use silence. This gives your child the opportunity to lead.
    • It’s perfectly natural to want to talk. Afterall, this is how adults maintain conversations. If you find yourself talking too much, count to ten! This will allow your child time to respond or initiate in the conversation or interaction.
    • Move down to your child’s level. It’s much easier to see what’s going on if you’re at the same height.
    • Videoing you and your child can really help you to see where your strengths lie. You’ll also be able to make minor tweaks to improve your communication during child-led play.

    Contact Sonja for more advice on speech, language and communication during child-led play.

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    Milestones of autistic children: Crawling, walking, and talking

    ByLondon Speech and Feeding
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    For all children every milestone achieved is a testament to the unique and intricate process unfolding within each young mind. For autistic children, this journey may present a distinct pattern, with some reaching developmental milestones like crawling, walking, and talking later than their neurotypical peers. Let’s have a look into the fascinating realm of Autism and explore why some autistic children might crawl, walk, and talk later, shedding light on the underlying factors contributing to this unique way of developing.

    1. Individual Pacing:

    Child development is not a one-size-fits-all journey. Each child, whether neurotypical or autistic, has a unique timeline for achieving milestones. Autistic children, like any other children, follow their own pacing. This individual rhythm might lead them to focus on one set of skills before they progress to others. Like some neurotypical children might focus on talking earlier than walking, autistic children might prioritise other areas before crawling or talking.

    2. Neurodevelopmental Complexity:

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    2. Sensory Processing Differences:

    One of the hallmarks of autism is altered sensory processing. Autistic children often experience sensory stimuli differently than their neurotypical peers. This heightened or diminished sensitivity can influence a child’s desire or ability to engage in activities like crawling and walking. The sensation of movement while crawling or walking, for instance, might be overwhelming for some autistic children, causing them to either avoid or delay these activities.

    3. Visual-Spatial Abilities:

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    4. Communication Challenges:

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    5. Executive Functioning and Motor Skills:

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    Do get in touch if you would like to book an appointment where we can explore how to help your child develop and thrive

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    An orange speech bubble with a testimonial

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    Increase confidence and reduce frustration in children with speech and language and communication difficulties today. Please feel free to contact me if you need any support or tips on maximising these opportunities.

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    The hidden impact of mouth breathing and open mouth posture on speech and feeding

    ByLondon Speech and Feeding

    When most people think about speech or feeding difficulties, they picture the tongue, lips, or chewing skills, but how a child breathes at rest plays a surprisingly big role too.

    Mouth breathing and open mouth resting posture can quietly influence everything from how a child’s face grows to how clearly they speak, to how confidently they chew and swallow. It’s something many parents never think about, until they start noticing the subtle signs.

    Let’s explore why this happens, what to look for, and how to gently support better breathing and oral posture.

    Recent research supports this link between mouth breathing and speech difficulties. For example, a 2022 study by Alhazmi et al., published in the Journal of Pharmacy and Bioallied Sciences, found that 81.7% of children aged 9–17 who breathed primarily through their mouths presented with speech sound disorders. The study highlights how mouth breathing can significantly influence orofacial development and articulation patterns.

    💨 Why we’re designed to breathe through our nose

    Our bodies are made for nasal breathing. When we breathe through the nose, the air is filtered, warmed, and humidified before reaching the lungs. The tongue naturally rests against the roof of the mouth, the lips close gently, and the jaw stays relaxed, all of which encourage healthy oral development.

    In contrast, mouth breathing often means the tongue rests low in the mouth and the lips stay apart. Over time, this posture can subtly reshape how the muscles and bones of the face grow.

    Children who breathe through their mouths most of the time may develop:

    • A longer face and narrower palate
    • Forward head posture
    • Slightly open lips and low tongue position at rest
    • A tendency toward drooling or noisy breathing
    • A dry mouth and consequently bad breath
    • At times the tongue pushes constantly against the front teeth causing them to grow forward (buck teeth)

    These changes are not anyone’s fault, as they often start because of blocked noses, allergies, enlarged adenoids, low facial muscle tone or habits formed when a child was younger. But understanding the pattern helps us know how to support change.

    🗣 How mouth breathing affects speech

    Speech depends on precise coordination between the lips, tongue, and jaw. The resting position of these structures affects how ready they are to move.

    1. Reduced tongue strength and placement, i.e. the tongue rests low in the mouth (as it does in mouth breathing), it’s harder for children to lift it efficiently for sounds like /T/, /D/, /N/, /L/, and /S/. This can lead to speech that sounds slightly slushy or unclear, or a frontal lisp.
    2. Open mouth posture and resonance: An open mouth at rest may affect how air vibrates in the oral and nasal cavities. Children might have speech that sounds a bit ‘muffled’ or lacks crispness because the lips and jaw aren’t fully supporting articulation.
    3. Fatigue and breath control: Mouth breathing can lead to drier mouths and less efficient breath support. That can make longer sentences or conversations feel tiring, especially in noisy environments.

    🥄 How mouth breathing affects feeding and chewing

    Feeding involves the same structures that control speech, so posture and breathing patterns matter here, too.

    1. Chewing efficiency: Children who habitually keep their mouths open often have low tongue tone and reduced jaw stability. They may prefer softer foods, chew slowly, or struggle with mixed textures.
    2. Swallowing pattern: A tongue that rests low may push forward when swallowing. This ‘tongue-thrust swallow’ can interfere with efficient chewing and even affect dental alignment over time.
    3. Breathing while eating: Since it’s hard to chew, swallow, and breathe through the mouth simultaneously, children who can’t comfortably nasal breathe may rush bites or pause to catch their breath. This can contribute to coughing, choking, or food refusal.

    Common signs to watch for

    Parents often notice subtle clues before realising mouth breathing is a pattern. Some red flags include:

    • Lips habitually open at rest
    • Drooling after the toddler years
    • Snoring or noisy breathing during sleep
    • Preference for soft foods or grazing eating habits
    • Dark circles under the eyes due to allergies
    • Frequent colds, congestion, or mouth odour
    • Speech that sounds slushy or unclear despite good effort

    If several of these sound familiar, it’s worth mentioning them to your child’s GP, dentist, or speech and language therapist.

    👩‍⚕️ What can help

    1. Address the underlying cause: If nasal blockage, allergies, or enlarged adenoids are making nasal breathing difficult, a medical assessment is the first step. ENT specialists can rule out or treat physical causes.
    2. Encourage closed mouth rest: Gentle reminders like ‘Lips together, tongue up, breathe through your nose’ can help older children become aware of their resting posture. For younger ones, visual cues (stickers or mirrors) can make it a game.
    3. Build oral-motor strength and awareness: Speech therapists can design activities to strengthen the tongue and lips, improve jaw stability, and encourage balanced breathing. This might include blowing games, tongue-tip lifts, use of dental-palatal devices or oral-motor exercises disguised as play.
    4. Support good posture: Sometimes mouth breathing goes hand-in-hand with forward-head posture. Encouraging upright sitting during meals and screen time helps keep the airway open and supports better breathing habits.
    5. Make nasal breathing part of daily routines: Gentle nose-breathing practice during calm times (reading, bedtime, car rides) helps normalise it. Avoid making it a battle: calm, consistent reminders work best.

    🌱 A gentle note on change

    Patterns of mouth breathing develop over time, and change doesn’t happen overnight. It’s important to approach this with curiosity, not criticism. The aim isn’t ‘perfect breathing,’ but to give your child the tools and awareness to breathe comfortably and efficiently.

    Small improvements in nasal breathing and resting posture can lead to big gains in speech clarity, eating confidence, and even sleep quality.

    💡 The takeaway

    Breathing seems automatic, and it is! but how we breathe matters. Mouth breathing and open-mouth posture can quietly shape how a child speaks, eats, and grows.

    By noticing early signs, addressing underlying causes, and building supportive habits, you can help your child move toward stronger, clearer speech and more comfortable mealtimes.

    Just like every area of development, progress starts with connection, patience, and gentle consistency, one calm breath at a time.

    Sonja McGeachie

    Highly Specialist Speech and Language Therapist

    Owner of The London Speech and Feeding Practice.

    References

    Alhazmi, A., Alshamrani, A., Alhussain, A., et al. (2022). Mouth Breathing and Speech Disorders: A Multidisciplinary Study. Journal of Pharmacy and Bioallied Sciences 14(5):911. https://www.researchgate.net/publication/361978128_Mouth_breathing_and_speech_disorders_A_multidisciplinary_evaluation_based_on_the_etiology

    Health Professions Council registered
    Royal College of Speech & Language Therapists Member
    Member of ASLTIP

    Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.

    2
  • · ·

    Using AAC during play with your child

    ByLondon Speech and Feeding

    Playtime! It’s a magic time for exploration, learning, and connection.

    If your child is struggling to use words with his/her mouth, we can always use a robust Augmentative and Alternative Communication (AAC) device to help find their words. We know that using such a device does never stop or delay children to speak with their mouths. On the contrary it helps, enormously!

    Can playtime still be a blast? Absolutely! In fact, incorporating AAC into play can be a powerful way to boost communication skills, build confidence, and create a truly inclusive play experience. Here’s how to make it happen, with a focus on core words and core scripts for our GLP’s (the building blocks of communication used by everyone). In this video I am using the core word ‘IN’ and ‘MORE’.

    The Magic of Core Words

    Core words are the most frequently used words in everyday communication. They might be verbs like ‘want’, ‘more’, ‘go’, or ‘stop’, or adjectives like ‘happy’, ‘sad’, and ‘hot’. These words are the foundation for building sentences and expressing needs and desires. They’re perfect for children using AAC because they’re simple to understand and use.

    Let’s Play! Here’s How

    1. Choose Your AAC System

    Many options exist! It could be a low-tech picture board with core words, such as the one you see pasted on my cabinet door in the background, or it can be a dedicated AAC app on your tablet. Here I am using the GRID app but I also love using others, such as LAMP Words for Life.

    2. Make it Fun and Functional

    No pressure! Integrate your AAC system seamlessly into your play routine. Here are some ideas:

    • Car/trains: Use core words to describe what the cars are doing: (‘down’, ‘go’, ‘stop’, ‘again’ ‘fast’ ‘slow’).
    • Dress-up: Use core words to choose clothes (‘want’, ‘hat’, ‘shoes’).
    • Tea Party: Use core words to ask for and share (‘more’, ‘juice’, ‘give’).
    • Building Blocks: Use core words to describe what you’re building (‘tall’, ‘big’, ‘house’).
    • Dolls/Stuffed Animals: Use core words to act out scenarios (‘sleep’, ‘eat’, ‘cry’).
    • Arts and Crafts: Use core words to describe colours (‘red’, ‘blue’), actions (‘draw’, ‘paint’), and feelings (‘happy’, ‘sad’).

    If your child is a Gestalt Language Processor you will want to model meaningful, fun scripts instead of single words! As above, but use phrases:

    • Car/trains: Use scripts to describe what the cars are doing: (‘it’s going down’, ‘let’s go’, ‘make it stop’, ‘want it again’, ‘that was fast’, ‘it’s so slow’).
    • Dress-up: Use scripts to choose clothes (‘I’m gonna wear this’ ‘that’s a lovely hat’, ‘let’s choose shoes’).
    • Tea Party: Use scripts to ask for and share (‘I want more’, ‘more juice’, ‘give me this’).
    • Building Blocks: Use scripts to describe what you’re building (‘a tall one’, ‘that’s so big’, ‘it’s a house’).
    • Dolls/Stuffed Animals: Use scripts to act out scenarios (‘it’s time to sleep’, ‘let’s eat’, ‘he’s crying’).
    • Arts and Crafts: Use scripts to describe colours (‘a red crayon’), actions (‘let’s draw’, ‘I’m gonna paint’), and feelings (‘I’m happy’, ‘that’s so sad’).

    3. Model, Model, Model

    This is key! As you play, constantly model using your child’s AAC system.

    • Point to the picture or word or script you’re using.
    • Speak clearly and slowly while pointing.
    • When using core words for either Analytical or Gestalt Language Processors, try using good phrases. For example, instead of just saying ‘juice’, say, ‘you want more juice?’

    4. Make it a Team Effort

    Get everyone involved! Encourage siblings, grandparents, and caregivers to use the AAC system with your child during playtime. The more consistent the approach, the faster your child will learn and feel confident using their voice.

    5. Celebrate Progress, Big and Small!

    Every step counts! Acknowledge and celebrate your child’s efforts, whether it’s reaching for their AAC system or successfully using a core word. This positive reinforcement will keep them motivated.

    Remember

    • Playtime should be fun, not stressful. Don’t force your child to use their AAC system. Let them lead the way and follow their interests.
    • Every child develops at their own pace. Celebrate your child’s unique communication journey.
    • Seek professional help when needed. Your SLT can provide tailored strategies and resources to support your child’s development.

    By incorporating AAC and core words into playtime, you’re not just fostering communication; you’re creating a space for your child to thrive, explore, and build strong connections.

    So, grab those toys, power up your AAC system, and get ready for a playtime adventure filled with fun, connection and, therefore, communication!

    Don’t hesitate to contact me!

    Sonja McGeachie

    Early Intervention Speech and Language Therapist

    Feeding and Dysphagia (Swallowing) Specialist The London Speech and Feeding Practice

    The London Speech and Feeding Practice

    Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.

    1

  • When ‘star’ sounds like ‘dar’: Understanding speech sound disorders and the path to clearer speech

    ByLondon Speech and Feeding

    If your child says ‘dar’ instead of ‘star’, you might be wondering if they will simply outgrow it or if they require specialised support. While ‘cluster reduction’—dropping one of the sounds in a blend—is a normal part of learning to talk, we typically expect these sounds to lock into place by age four years. If these errors persist as a child approaches school age, it often signals a speech sound delay that may now no longer pass without help. As a Speech and Language Therapist, I specialise in helping children bridge this gap using evidence-based techniques like backward chaining.

    This isn’t about constant correction; it’s about providing the right clinical scaffolding to move a child from ‘frustrated’ to ‘fluent’ before they hit those critical early school years.

    Dropping sounds from words is a common feature of speech sound difficulties, and while it can look small on the surface, it can have a big impact on how clearly a child is understood. In this short video clip, I’m working with a child on an /ST/ sound cluster, demonstrating how I use an evidence-based speech therapy technique called backward chaining to help children build clearer speech with confidence.

    What’s actually happening when a child drops the ‘S’?

    Clusters like /ST/, /SP/, and /SK/ are tricky. They require:

    • precise timing
    • careful airflow
    • and the ability to blend sounds smoothly

    For many children, especially those with speech sound difficulties, this is a big ask.

    So instead of hearing:

    ‘star’

    we might hear:

    ‘tar’ or ‘dar’

    This isn’t laziness or refusal. It’s the child simplifying the word to make it manageable.

    Why I don’t start by saying ‘say star’

    Telling a child to ‘just add the S’ rarely works.

    Instead, I meet them where they are already successful.

    In this clip, the child can already say ‘dar’ clearly. That’s our starting point.

    Backward chaining: building speech from success

    Backward chaining means we:

    1. Start with the part of the word the child can already say
    2. Gradually add the missing sound
    3. Keep the child feeling successful at every step

    So rather than jumping straight to ‘star’, we:

    • secure the ending
    • gently introduce the /S/
    • and blend it in a way that feels achievable

    This approach reduces frustration, builds confidence, and helps the sound stick not just in the therapy room, but out in the real world.

    Why this matters beyond one word

    This isn’t just about saying ‘star’.

    It’s about:

    • teaching the mouth a new movement pattern
    • giving the brain time to organise the sound sequence
    • and helping the child feel capable, not corrected

    When therapy feels safe and successful, children are far more likely to generalise their new sounds into everyday speech.

    Speech therapy works best when children feel supported not tested.

    If your child struggles with speech clarity

    If your child:

    • drops sounds from words
    • avoids longer or trickier words
    • or becomes frustrated when they’re not understood

    This is the kind of work I do every day building speech step by step, in a way that respects each child’s pace and strengths.

    Support can be gentle, effective, and empowering.

    If you’d like to learn more about how speech therapy can support your child, you’re always welcome to get in touch.

    Sonja McGeachie

    Highly Specialist Speech and Language Therapist

    Owner of The London Speech and Feeding Practice.

    Health Professions Council registered
    Royal College of Speech & Language Therapists Member
    Member of ASLTIP

    Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.

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