The Role of AAC Devices in Early Development: a Thoughtful Approach to Social-Emotional Learning

In the world of autism intervention, Augmentative and Alternative Communication (AAC) devices have revolutionized the way many children are able to communicate. These tools, whether through picture exchange systems, speech-generating devices, or communication apps, have proven invaluable for children who struggle with verbal communication. However, I believe it's important to approach the use of AAC devices with caution, especially when it comes to younger children with autism.

As someone deeply committed to developmental therapy that prioritizes social-emotional learning, I have found that before an AAC device becomes a necessary tool, it’s crucial that a child has the foundational ability to engage in reciprocal, back-and-forth non-verbal communication. As Jake Greenspan from The Greenspan Floortime Approach® discusses in his article, non-verbal gestures and emotional expression give communication meaning and expression. In my experience, fostering these early, subtle forms of interaction such as gestures, facial expressions, and body movements lays the groundwork for successful communication that is much more dynamic and interactive in the long run. 

Before a child uses an AAC device to request an item, share a thought, or convey a need, they first need to learn the basics of communication: the ability to initiate and respond to others in a back-and-forth, conversational manner. 

These early interactions, known as "proto-conversations," are essential for building social skills. Proto-conversations are the subtle, non-verbal exchanges where a child might point to an object, make eye contact, or use other gestures to show interest or seek interaction. Through these small cues, they begin to understand the rhythm of communication: that their actions can lead to a response, and that engaging with others is rewarding and meaningful.

I firmly believe that these early, non-verbal communication skills are foundational before introducing AAC. When a child has had the opportunity to engage in proto-conversations, they not only understand that communication is a two-way process, but they also begin to internalize the importance of social cues and emotional responsiveness which are skills that are vital when building meaningful relationships.

While it is not uncommon for people to believe that there are no pre-requisite skills for AAC, my professional experience has led me to a different conclusion. Introducing an AAC device too early, before a child has developed these early communication skills, may limit the potential for meaningful, reciprocal interactions. When children can only use AAC to request objects or engage in basic communication, they miss out on a more expansive and interactive experience with language. The richness of conversation where children not only request but also share ideas, advocate for themselves, offer empathy, and give advice comes with the ability to engage in the give-and-take of dialogue, something that is deeply rooted in social-emotional learning.

When AAC is introduced after a child has developed these proto-conversational skills, they are not limited to simply requesting or labeling things. They are empowered to engage in more complex forms of communication. They can share thoughts, express feelings, discuss experiences, and most importantly, engage with others in a way that promotes meaningful social relationships. This level of conversational competence is not simply about learning words it’s about understanding the social dynamics of communication, the rhythm of a back-and-forth exchange, and the ability to use language to connect with others on a deeper level.

I understand that there are many professionals and families who disagree with this perspective, especially those who see AAC devices as essential from the start for all children who experience challenges with verbal communication. For some children, an AAC device can be a lifeline that facilitates basic communication needs. However, I do think that for many children, particularly those in the early stages of development, waiting until the child has begun to engage in proto-conversations can create a stronger foundation for long-term success with an AAC device.

By focusing on social-emotional learning and fostering reciprocal communication through gestures, body language, and eye contact, we are teaching children the deeper meaning of interaction before they even begin to use symbols or words. Once these non-verbal cues are in place, introducing an AAC device becomes a natural extension of the child’s developing social skills. They are no longer just learning to request, they are learning to participate in the world of conversation by sharing their thoughts, making connections, and engaging emotionally with others.

In my experience, when children learn to communicate through both non-verbal cues and later through an AAC device, they become empowered to advocate for themselves in ways that are far more complex than simply asking for things. With the right foundation, children can express desires, engage in discussions, offer advice, show empathy, and participate in the rich social fabric of their environment. This self-advocacy and emotional communication are invaluable skills that go beyond basic communication needs. They help children connect meaningfully with others and understand their own emotions in relation to the world around them.

While AAC devices are undeniably life-changing for many children with autism, I believe that the key to successful communication development lies in the timing and the preparation that occurs before their introduction. If we prioritize the early stages of communication by focusing on non-verbal, reciprocal interactions and social-emotional learning, children are better equipped to use AAC devices in a more meaningful and dynamic way when the time is right.

In my opinion, the best approach is one that builds from the ground up: fostering proto-conversations, helping children understand the rhythm of communication, and then, once those foundational skills are in place, introducing AAC as an enhancement to their growing communication abilities. This way, children not only learn to request and label, they learn to connect, share, and build relationships, all of which are essential for their long-term development.