Augmentative and alternative communication, usually called AAC, includes ways to supplement or replace speech. A person may use it continuously, intermittently or temporarily. Examples range from gestures and writing to picture boards and speech-generating technology.
In healthcare, the nursing task is to make communication possible during the actual encounter. Supplying a board or device is a starting point; the team still needs to establish how the patient will use it and how staff will respond.
Understand the available forms
NIDCD describes AAC devices that include picture boards, text displays and systems that convert selected words or symbols into speech. It distinguishes them from assistive listening devices, which help people hear desired sounds. These technologies address different communication needs and should not be treated as interchangeable.
A patient's useful combination may include speech alongside another method. The Communication Health Support Association's AAC resource explains that speech-language pathologists assess needs, help select appropriate tools and teach patients and communication partners how to use them.
Start with the patient's established method
Ask how the person usually communicates, what equipment they use and what assistance they want. If a familiar device is present, clarify how it works before replacing it with a generic hospital option. Seek the appropriate specialist support when the method is new, unreliable or difficult to access.
A suggested bedside review asks whether the person can reach or otherwise operate the tool, whether the needed messages are available and whether staff know how to recognize a response. Establish how the person will request help between conversations.
Avoid assuming that a difficulty producing speech answers a separate question about understanding or decision-making. Address those questions through the appropriate clinical assessment and communication support.
Allow a full exchange
In a fictional example, a patient uses a tablet to compose a question. A clinician asks another question before the message is finished, and the patient has to restart. The improvement is to agree on a conversational pace and a clear signal that the person has finished, rather than measuring the interaction by spoken speed.
Give the patient a way to initiate topics and correct the team's interpretation. A series of staff-selected yes/no questions may leave other concerns unexplored. Confirm the intended message instead of guessing and moving on.
Preserve access across the stay
A practical plan identifies the communication method, any setup assistance, the appropriate specialist contact and an alternative if a device is unavailable. Include charging, positioning and access to the tool in the local workflow, while following equipment and infection-prevention policies.
At transfer, explain the method to the receiving team and identify unresolved needs. See communication access for the organizational context and accessible patient education when visual access also affects the resource.
Sources
- Augmentative and Alternative Communication (accessed 2026-09-17) — Communication Health Support Association, ASHA's consumer affiliate.
- Assistive Devices for People with Hearing, Voice, Speech, or Language Disorders (accessed 2026-09-17) — NIDCD.
- About the Communication Health Support Association (accessed 2026-09-17) — publisher relationship with ASHA.