Anjali Barretto
Let me begin with the story of a child we’ll call Ravi.
I first met Ravi when he was four years old. He had received an autism diagnosis, and his family was looking for support with his communication. At the time, Ravi communicated through pointing, vocalisations, and sounds. Over time, he began using some key words. For example, he would say “bandage” when he was hurt. It became clear, however, that he needed more ways to share his thoughts, feelings, and needs. When he could not get his message across, he sometimes expressed his distress by banging objects. Imagine knowing what you want to say but not having a reliable way to communicate it. How might that feel?
Communication is a basic human right, and it is about much more than speech. We use gestures when words are hard to find, wave to get someone’s attention, and use facial expressions to share how we feel. Books tell stories through written words. Even Tom and Jerry can make us laugh without a spoken conversation! We all communicate in different ways, yet we often expect everyone to communicate through speech.
Language allows us to share our thoughts, feelings, needs, ideas, and experiences. Speech is one way to use language, but it is not the only way. For some neurodivergent and disabled people, accessible ways to communicate can make a meaningful difference. When someone cannot easily express that they are upset, overwhelmed, confused, or need help, their distress may be misunderstood. What others describe as “difficult behaviour” may be a sign that a person needs support, understanding, a change in their environment, or another way to communicate. With Ravi, we saw this when he was upset or when plans changed unexpectedly. He sometimes shouted or slammed doors and drawers. These moments helped us recognise the importance of giving him reliable ways to express himself.
This is where Augmentative and Alternative Communication (AAC) can help. “Augmentative” means adding to or supporting existing communication. “Alternative” means offering another way to communicate when speech is not available or does not fully meet a person’s needs. AAC includes many options, such as gestures, signs, pictures, communication boards, apps, and devices that speak aloud when a person selects or types words.
AAC is not only for people who do not speak. It can also support people whose speech is difficult for others to understand, varies from one situation to another, or is not available when they need it. A person does not have to stop using speech to use AAC. In Ravi’s case, we introduced AAC to give him more ways to express himself and participate in everyday life. He continued using the words he knew while exploring additional ways to communicate.
Fast-forward five years. Ravi’s strengths in visual learning, together with access to AAC, supported him as he explored reading and spelling. Words opened up new possibilities. He could share more of what he wanted to say, rather than being limited to the words he could speak.
Today, Ravi can type words faster than he can say them. Sometimes, as he sees the words appear on the screen, he says them aloud too. Recently, I was delighted to hear that he had enjoyed tea and toast for breakfast, followed by rice, dal, paneer sabzi, and chapati for lunch. And, as if that were not important enough news, he had a KitKat waffle to look forward to! I look forward to hearing about all the things Ravi is doing, thinking, enjoying and experiencing. There is so much more he can share with us.
A common concern is that AAC might prevent or delay speech development. Research indicates that AAC does not hinder speech development; in fact, for some people, it may support the development of spoken communication. Most importantly, AAC gives a person access to communication right away. It should not be withheld while waiting to see whether speech develops.
So, what can we do? We can be patient and allow people time to respond. We can respect the words they type, the pictures they point to, the signs they use, and the devices that speak for them. We can presume competence, listen without making assumptions, and ensure people have access to communication tools that work for them. AAC should be available across everyday settings, with communication partners who know how to use it and make space for the person’s message.
(The author is a speech language pathologist and the Deputy Director of Sethu Centre for Child Development and Family Guidance.)
