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AAC Devices and OT

An Augmentative and Alternative Communication (AAC) device is a device that enables

communication for individuals that otherwise find it difficult or impossible. The complexity of AAC devices can vary greatly. There are low tech options such as the picture exchange communication system (PECS), pictured below. Then there are high tech devices such as those from Smartbox and Tobii Dynavox. Each have their own functionalities to best serve those who need them. For example, Smartbox and Dynabox can be hooked up to an eye gaze system enabling individuals who lack the ability to move their bodies to communicate instead with their eyes.

Speech-language pathologists are usually the ones to make AAC recommendations however, an occupational therapist (OT) can provide their own professional input to increase the effectiveness of the AAC device.

Such recommendations might include:

● Device access - how will the user interact with the device. Will they use their own body or a tool such as a stylus? Does the user need a keygaurd? This limits errant undesired inputs

● Device positioning - how can the device be placed to enable the most effective use

● Device tweaking - during occupational activities an OT might notice that the way a device is setup is not the most effective for an individual. An OT can suggest changing the timing windows to select desired speech option if the device is setup as a switch access device*, or which selection should be made available in a given window.

Ideally SLPs and OTs should aim to work collaboratively when assigning an individual an AAC device

*A switch access device is a functionality where a selecter cycles through items displayed on screen one at a time. The user then triggers a switch, like a button, to make their selection. This process repeats until the desired output is achieved. If the timing of the selector is too fast, the user may miss their desired selection. If the timing is too slow the communication process can be too long or be a frustrating experience for the user.


Trujillo, C., Monte, B. D., Conatser, M., Norris, G., Malmgren, T., Westcott, C., & Moritz, K. (2020). Establishing OT’s Distinct Value in AAC Evaluations for Children With Disabilities. The American Journal of Occupational Therapy, 74(4_Supplement_1), p. 1.

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