AAC Devices for Non-Verbal Children With CP: How to Get Started

Communication is one of the deepest concerns parents have for non-verbal children with CP. AAC devices — ranging from picture boards to dedicated speech-generating tablets — can change a child’s life by giving them voice. This article explains what AAC is, how to get evaluated, what devices look like, how families pay for them, and how to make AAC work at home.

What AAC Is

AAC is the umbrella term for any communication method beyond standard speech. It includes:

• No-tech: gestures, facial expressions, body language, sign language
• Low-tech: picture boards, photo albums, written choices, communication books (PECS, core boards)
• Mid-tech: simple recording devices that play one or several phrases when buttons are pressed
• High-tech: speech-generating devices (SGDs) running dedicated software (Proloquo2Go, TouchChat, LAMP, Speak for Yourself, etc.) on tablets or dedicated hardware

Children typically use multiple modes at once: speech approximations and gestures plus a high-tech device. The goal is communication, not any single tool.

When to Start

The earlier the better. Research strongly supports starting AAC in toddlers as soon as a communication delay is identified. There is no minimum age, no requirement to first try speech for years, and no evidence that AAC delays speech — in fact, AAC users typically develop more language and often more spoken words than children without AAC. Many CP families start AAC in early intervention (under age 3) with simple core word boards and progress to speech-generating devices as motor skills and cognitive understanding develop.

The SLP Evaluation

A comprehensive AAC evaluation is the formal entry point. Conducted by a speech-language pathologist (often with AAC specialty training), the evaluation typically includes:

• Receptive and expressive language assessment
• Motor and access evaluation (how will the child select symbols? Touch? Switch? Eye gaze?)
• Vision and seating evaluation
• Trial of one or more device candidates
• Family routines and goals discussion
• Recommendations for device, software, vocabulary system, and training plan

The evaluation produces a written report that supports insurance and Medicaid funding requests. Most pediatric hospitals have AAC-specialty SLPs; some practices specialize in AAC.

Common Devices and Software

The major options families consider include:

• iPad-based systems with dedicated AAC apps (Proloquo2Go, TouchChat, LAMP Words for Life, Speak for Yourself, GoTalk Now). Most affordable but not always covered by insurance unless the iPad is locked into communication-only use.
• Dedicated speech-generating devices (Tobii Dynavox, PRC-Saltillo NovaChat/Accent, AbleNet) that are purpose-built for AAC. Insurance and Medicaid typically cover these when properly documented.
• Eye-gaze systems for children with limited motor control of hands and arms (Tobii, Smartbox).

The best device is the one matched to the child’s access and language abilities, with a vocabulary system the family and team can learn and grow with over time.

Insurance, Medicaid, and Funding

Most major insurance plans and Medicaid cover dedicated speech-generating devices when documented as medically necessary. The funding process typically requires:

• SLP evaluation report
• Letter of medical necessity from a physician (often the pediatric neurologist or developmental pediatrician)
• Trial documentation showing the device works for the child
• Prior authorization, often through the device manufacturer’s funding team

iPad-based AAC is sometimes harder to fund through insurance; some plans cover the AAC software but require families to provide the iPad. School districts often provide AAC devices for educational use through the IEP. State Medicaid programs cover AAC in most states. Manufacturers often have funding teams that help navigate the process.

Making AAC Work at Home

The single biggest factor in AAC success is aided language input: adults consistently using the device themselves to talk to and around the child. Practical strategies:

• Model on the device throughout the day, even for simple phrases (more, all done, mama, look)
• Keep the device available and charged at all times, not just during therapy
• Wait for the child to communicate before assuming what they want
• Add new vocabulary as the child’s interests grow
• Connect with other AAC families through online communities (CommunicationFIRST, AAC Language Lab)
• Train siblings, grandparents, and teachers on basic device use

Communication progress is often gradual but cumulative. Many children take months or years to fully use their device for spontaneous communication. The investment pays back over decades of richer life.

Starting AAC for Your Child

Steps from interest to active use.

Will using a device delay my child’s spoken speech?

No. Decades of research consistently show that AAC does not delay speech. Children using AAC develop more language and often more spoken words than children without AAC. The fear that giving a device ‘lets the child off the hook’ for speaking is not supported by evidence. AAC and speech work together; they do not compete.

What if my child uses gestures or sounds — do they still need AAC?

Often yes. Gestures and sounds are valuable communication, and AAC supplements them. A child whose only ways of communicating are limited gestures benefits from a device that lets them comment, ask questions, share thoughts beyond requests, and participate fully in conversation. AAC expands the universe of what they can communicate.

Related reading for parents

• Eye gaze technology for children with severe CP: a parent’s introduction
• The role of technology in enhancing communication for non-verbal individuals with CP
• Apraxia of speech in cerebral palsy: signs, assessment, and therapy options
• Oral motor therapy at home: exercises your SLP actually wants you to do
• IDEA and your rights: getting early intervention and school services