How to Navigate and Support AAC Communication as a Teletherapist

Working with Augmentative and Alternative Communication (AAC) can be both rewarding and complex, particularly for speech-language pathologists (SLPs) using virtual therapy. Many mistakenly believe AAC only benefits individuals who are nonspeaking, but its range spans simple, low-tech tools to advanced high-tech systems. AAC is not simply about device use—it’s about providing reliable and meaningful communication opportunities.

Teletherapy introduces its own barriers, such as selecting effective tools, adapting strategies for users’ needs, and coordinating with communication partners like caregivers or educators. However, it also enables SLPs to extend support beyond the therapy room. With the right approach, teletherapy can offer dynamic, real-world learning that promotes lasting communication growth.

In this article, we explore essential teletherapy tools, strategies, and models to empower AAC sessions. We cover basic AAC classifications that work well in virtual settings, explain why extended AAC exposure is critical, and address common barriers and challenges while highlighting actionable strategies for success.

What Types of AAC Are Used in Virtual Settings?

AAC includes a broad spectrum of tools that help individuals with communication disorders interact effectively. The goal is not merely to use a device but to create opportunities for functional communication. AAC can be classified into several categories:

No-Tech AAC

No-tech AAC uses innate communication methods—gestures, facial expressions, and signs . These can be integrated seamlessly during teletherapy, with the SLP prompting a nod for “yes” or a sign for other responses.

Low-Tech AAC

Low-tech solutions include picture boards, paper-based core boards, or other visual aids. These tools are simple, inexpensive, and easily integrated into virtual sessions. Digital versions can be shared onscreen or printed by families.

Mid-Tech AAC

Mid-tech devices are basic speech-generating tools with prerecorded messages.Although they offer limited flexibility, these systems offer users a defined vocabulary of high-need words. Their consistent output can be valuable when combined with teletherapy coaching.

High-Tech AAC

High-tech AAC systems are dynamic devices or apps that adapt to users’ evolving language needs. Advanced features—such as touchscreen navigation and customizable vocabulary—allow SLPs to tailor support precisely. In teletherapy, SLPs can share their screen to demonstrate device features or guide a facilitator through the interface. Meanwhile, speech-generating tools provide alternative ways for users to communicate effectively.

Regardless of the system, the ultimate aim is to build an environment where AAC fosters clear, purposeful communication. In a virtual setting, SLPs can train facilitators to integrate AAC naturally into daily routines rather than confining it to therapy sessions.

Why AAC Exposure Beyond Sessions Matters

The impact of AAC is magnified when its use extends beyond occasional therapy sessions. Research estimates that by 18 months, an average child may be exposed to roughly 4,380 hours of spoken language. Although actual figures can vary, this estimation illustrates the immense quantity of everyday language input that most children receive. In contrast, if an AAC user only experiences 20–30 minutes of therapy twice weekly, it could take 84 years to see comparable input in AAC.

This discrepancy emphasizes the need for ongoing, naturalistic AAC modeling. Creating an environment that is truly AAC-rich means:

• Shared Responsibility: Families, educators, and peers can all contribute to modeling vocabulary and communicative behaviors.
• Consistent Exposure: Embedding AAC into day-to-day routines—whether at mealtime or during play—reinforces its role as a functional communication tool.
• Natural Learning: When communication partners use AAC regularly, it becomes a familiar and integral part of everyday interactions.

As an SLP, your role is to train and support communication partners so that AAC becomes a living part of the user’s world, not just a device used during therapy sessions.

Common Barriers to Virtual AAC Therapy

Teletherapy offers new opportunities to support individuals who use Augmentative and Alternative Communication (AAC) beyond the walls of traditional therapy rooms. However, despite the advantages, several challenges can hinder its effectiveness. The virtual space introduces unique hurdles that practitioners, families, school support staff  and caregivers must navigate to create a seamless experience for AAC users. Identifying and strategizing against these barriers is important for successful AAC implementation in a virtual setting.

• Technology Access and Reliability – Stable internet and appropriate hardware are essential. Preparing for telepractice involves ensuring families or schools have updated devices and connections.
• Comfort and Familiarity with Technology – Not every caregiver or support staff is comfortable with new technologies. SLP’s need to be prepared with helpful resources that provide step-by-step instructions and strategies to help caregivers or teachers build their confidence.
• Limited Access to Materials – A shortage of physical materials like printed core boards or specialized apps can constrain sessions. Offering printable resources or creative household and classroom solutions can mitigate this barrier.
• Facilitator Role and Availability – In a virtual setting, facilitators in telepractice—whether parents, teachers, or aides—play a major role. Their availability and confidence in using AAC can vary, affecting outcomes.
• Environmental Distractions – Home or classroom sessions might be interrupted by background noise or daily activities. However, these realistic environments can be harnessed as opportunities to embed language learning.
• Adapting to Virtual Dynamics – SLPs must rely on verbal guidance and remote observation instead of physical assistance, requiring flexibility and adjusted expectations.

Successfully overcoming these common barriers involves proactive planning and strategic adaptation. It requires collaboration among SLPs, communication partners, school professionals, and families to ensure a supportive virtual environment. By acknowledging these challenges and crafting deliberate solutions, teletherapy can effectively serve AAC users, facilitating meaningful communication and supporting long-term growth.

Challenges of Providing AAC Services Through Teletherapy

Providing Augmentative and Alternative Communication (AAC) services through teletherapy introduces unique challenges that require innovative solutions. Teletherapy alters the dynamics of traditional speech-language therapy by leveraging digital tools and remote connectivity. While this approach offers increased accessibility and flexibility, it also demands significant adaptation from both speech-language pathologists (SLPs) and communication partners. It’s essential to recognize these hurdles to craft effective strategies that ensure productive therapy sessions and meaningful communication for AAC users in a virtual environment.

• Facilitator Buy-In and Commitment – Consistent and active involvement by facilitators is essential. If caregivers or educators are not engaged, on-site support for AAC use diminishes.
• Relinquishing Direct Control – Virtual sessions often shift the hands-on tasks to facilitators. Effective stepwise coaching supports facilitators until they gain confidence.
• Limited Access to Devices – AAC devices or apps might not always be on hand. Workarounds—such as simulators—help bridge the gap temporarily.
• Technology and Connectivity Issues – Technical glitches and lag can interrupt therapy. Have backup strategies ready if sessions experience disruptions.
• Data Collection Difficulties – Gathering comprehensive data remotely can be challenging. Facilitators can use observation logs or built-in device features to record and share progress.

Even with potential hurdles, virtual AAC therapy can be highly successful through proactive problem-solving, adaptability, and thorough training for facilitators. Initial resistance, technical difficulties, or data collection challenges can be addressed by fostering strong communication, demonstrating flexibility when issues arise, and developing innovative progress-tracking methods. While these challenges warrant consideration, the ultimate advantages of teletherapy are significant.

Furthermore, keeping abreast of current research and professional guidelines is crucial for addressing doubts or skepticism about its efficacy. ASHA’s official stances on telepractice can be valuable in these situations, particularly when parents, educators, or administrators have inquiries about the validity of teletherapy.

Advantages of Teletherapy

Teletherapy has transformed the landscape for delivering AAC interventions by offering countless opportunities to enrich the experience of users and those facilitating their communication. The virtual platform not only circumvents geographical limitations but also promotes the seamless integration of therapy into daily life. By blending traditional speech-language therapy with modern technology, teletherapy extends its reach and efficacy, especially for individuals previously considered inaccessible due to location or resource constraints.

Here’s how teletherapy empowers AAC interactions:

• Empowering Communication Partners: The virtual setting offers real-time guidance and feedback for facilitators, enhancing their capacity to support AAC users
• Promoting Skill Generalization: Conducting therapy sessions in natural environments aids in the seamless transfer of AAC skills to everyday interactions, ensuring functional and relevant communication growth.
• Expanding Access: By dismantling geographic barriers, teletherapy ensures that specialized AAC services reach individuals residing in remote or underserved areas, thereby ensuring access to speech-language interventions.
• Flexible Service Delivery: Virtual sessions provide the chance to tailor therapy approaches. Whether the focus is on direct intervention or coaching for caregivers and educators, services can be personalized to fit individual needs and circumstances.
• Developing Facilitator Capacity: Regular demonstrations and ongoing support enable facilitators—be they parents, teachers, or aides—to continuously practice AAC strategies, ensuring that they remain effective and consistent over time.

Teletherapy’s advantages extend far beyond logistical conveniences. It fosters an inclusive and adaptive approach to AAC learning, empowering both users and facilitators. As the implementation becomes more prevalent, the potential for innovative, life-changing communication solutions via teletherapy only grows, promising enriched lives and broader conversational capabilities for individuals with communication challenges.

Practical Strategies and Approaches for SLPs During Teletherapy

Implementing AAC through teletherapy presents speech-language pathologists (SLPs) with distinctive challenges and opportunities, requiring innovative strategies to foster effective communication. Teletherapy for AAC requires adapting service delivery methods:

Direct Model

The SLP works directly with the AAC user for immediate instruction and feedback. This approach can be effective when the user can engage in real time without significant onsite support.

Coaching Model

The SLP observes and advises while a facilitator guides the AAC user. Coaching suits younger or less independent users who rely on continuous, real-life support.

Whether through direct interaction or the coaching model, the key to success lies in leveraging both digital and hands-on resources. By providing personalized experiences tailored to individual AAC users, SLPs can create an engaging and supportive virtual environment that encourages active participation and meaningful communication. Below are essential strategies and approaches to enhance teletherapy sessions:

• Model Functional Communication: Integrate key words and gestures seamlessly into daily contexts. For example, use practical expressions like “Help,” “Stop,” and conversational comments such as “Cool” and “Yum” to develop functional communication skills.
• Personalize to User Interests: Align therapy activities with the user’s interests, such as incorporating favorite games or snacks. Customized activities boosts motivation and ensures active engagement during sessions.
• Employ Multi-Level Activities: Structure activities to support varying vocabulary levels according to the user’s needs. Utilize diverse scenarios, like a cooking exercise, to incorporate requests, comments, and descriptions comprehensively.
• Collaborate Actively with Facilitators: Foster aided language stimulation and advocate for consistent modeling in daily routines. Engage facilitators in ongoing dialogue to seamlessly integrate AAC use.
• Adapt to the Natural Environment: Utilize spontaneous occurrences, for example, when a sibling unexpectedly enters the room, as teachable communication opportunities.
• Facilitate Questioning: Encourage inquisitiveness by modeling and motivating users to ask and answer questions such as “What is that?” “Who’s coming?” and “Where is Mom?”
• Ensure Consistent Modeling: Consistent language modeling during predictable routines enhances word recognition, device navigation, and builds users’ confidence in AAC.
• Establish a Safe Therapy Environment: Ensure that a supportive, safe, and suitable setting is available for teletherapy, with an onsite facilitator present to aid in supervision and participation.
• Leverage Digital Resources: Enrich sessions by integrating digital tools such as YouTube videos, e-books, online games, and interactive platforms like Google Slides to engage and aid learning.

Implementing these strategies facilitates a richer, more interactive teletherapy experience, allowing AAC users to thrive within a virtual setting. By tailoring therapy to meet individual needs and integrating AAC into natural everyday environments, SLPs can nurture an inclusive approach that drives language development and supports continuous learning.

Essential Tools and Technology for Virtual AAC Therapy

To conduct effective AAC teletherapy sessions, it is essential to equip yourself with the appropriate tools and technology. To deliver effective AAC teletherapy, certain tools are non-negotiable:

• Reliable Device: Your primary device for conducting sessions.
• Strong Internet Connection: Crucial for uninterrupted communication.
• Microphone & Camera: Integrated or external for clear audio and visual interaction.
• Secure Video Conferencing Platform: Compliant with HIPAA and/or FERPA to ensure privacy.

While not strictly required, the following can significantly enhance your sessions:

• Personal iPad with AAC Apps: Useful for modeling when direct client device access isn’t possible.
• Printed or Virtual Core Boards: For visual communication support.
• Desk View/Document Camera or External Webcam: To clearly display your modeling on devices or core boards.
  • Expert Tip: A desk-view camera (sometimes integrated) or an external webcam/document camera positioned above your materials serves as a valuable tool for clear modeling.

• Screen Share/Mirroring Capabilities: To show AAC systems, interactive activities, or core boards to the client and facilitator.
• Remote Control Features (if available): Allowing the client or facilitator to interact with your screen for increased engagement.
• Green Screen or Virtual Background: To minimize distractions and to display a static communication board behind you, and you can model by interacting with your virtual background.

Defining Roles in AAC Teletherapy: SLP vs. Facilitator

In AAC teletherapy, understanding and defining the roles of both the Speech-Language Pathologist (SLP) and the facilitator is vital to fostering effective communication and maximizing the potential of each therapy session. The SLP acts as the professional expert, providing guidance, education, and resources, while the facilitator serves as the essential onsite partner, handling practical aspects of therapy and ensuring the smooth execution of strategies within the client’s environment. This dual approach ensures a cohesive and supportive framework, enabling AAC users to benefit fully from therapy and facilitating continuous communication progress beyond virtual sessions.

Understanding the distinct yet collaborative roles of the SLP and the facilitator is crucial for successful AAC teletherapy.

The SLP:

As the teletherapist, your role encompasses:

• Modeling: Demonstrating AAC use to guide the facilitator’s modeling.
• Coaching and Feedback: Providing instruction and feedback to facilitators on implementation.
• Goal Development: Establishing appropriate communication goals for the client.
• Determining Supports: Identifying necessary AAC strategies and tools.
• AAC System Management: Selecting, trialing, and recommending suitable AAC systems.
• Guiding Interventions: Addressing specific AAC needs and challenges.
• Facilitator Capacity Building: Empowering facilitators with the knowledge, confidence, and competence to support AAC effectively.

The Facilitator:

In the remote therapy environment, the facilitator acts as our vital link to the client:

• Observation and Reporting: Monitoring and reporting the client’s engagement with AAC.
• Strategy Implementation: Applying the techniques and strategies coached by the SLP.
• Narration and Feedback: Describing client interactions and providing feedback to the SLP.
• Device Management: Ensuring the AAC device is charged and readily accessible.
• Device Positioning: Assisting with proper device placement for optimal client access.
• Carryover of Strategies: Extending AAC use beyond therapy sessions into daily routines.

Even though facilitators take on more direct support in teletherapy, the SLP’s role as the expert, coach, and guide is still central. Through comprehensive coaching, clear modeling, and structured feedback, we equip facilitators to boost our clients’ communication skills beyond therapy, into everyday life. This collaborative approach is what makes virtual AAC therapy so impactful, creating a strong support network that extends beyond our sessions.

How to Coach and Train Facilitators

Coaching and training facilitators are vital components of successful AAC teletherapy. Employing strategic approaches can help answer essential questions such as “When should coaching occur?” “How should it be delivered?” and “What should practical application look like?” Effective coaching provides clear and actionable guidance tailored to the unique dynamics of teletherapy, ensuring that facilitators—whether parents, educators, or aides—are equipped to reinforce communication strategies consistently and proficiently.

Coaching facilitators can extend the benefits of AAC well beyond sessions with these strategies:

• Real-Time Demonstrations: Use screen sharing to show how to navigate an AAC app or board.
• Focused Feedback: Reinforce effective strategies with specific, supportive observations and provide real time feedback during sessions so the facilitators can apply.
• Emphasize Modeling: Encourage the use of aided language stimulation or core word modeling regularly.
• Foster Collaboration: Create a safe space for questions and mutual problem-solving.
• Tailor Intensity: Adjust the level of support based on each facilitator’s progress and comfort.
• Encourage Daily Integration: Consistent use of AAC in daily life nurtures user confidence.

Through structured demonstrations, real-time feedback, and collaborative dialogues, facilitators are empowered to extend AAC usage beyond therapy sessions, fostering a supportive  communicative environment within everyday scenarios.

Measuring Progress: Effective Virtual Data Collection

In AAC teletherapy, accurately tracking the progress of users is essential for tailoring interventions and celebrating milestones. As teletherapy occurs remotely, collecting data can pose unique challenges. However, these challenges can be effectively navigated with strategic methods that make data gathering efficient and insightful. Through leveraging a mix of observation, technology, and structured tools, Speech-Language Pathologists (SLPs) and facilitators can gather meaningful data to guide therapeutic decisions and illustrate user progress over time.

Strategies for Virtual Data Collection

• Facilitator Logs:
  • Utilize simple rating scales or checklists to systematically monitor and document user interactions and engagement levels during sessions.
  • Ensure that logs are user-friendly to encourage regular and thorough completion by facilitators, capturing key observations.

• Session Recordings:
  • With appropriate consent, record therapy sessions to allow for retrospective analysis of user communication efforts, interaction quality, and areas of improvement.
  • Use recordings to verify progress, assess session dynamics, and provide targeted feedback to facilitators.

• Rubrics and Checklists:
  • Implement standardized assessment tools to track specific skills and behaviors, facilitating detailed comparisons over time.
  • Develop custom rubrics to align with individual therapy goals and programs, ensuring they reflect user-specific objectives.

• Observational Insights:
  • Engage facilitators in regular discussions to gather nuanced insights into the user’s performance outside of formal sessions, filling in gaps that remote observation might miss.
  • Encourage facilitators to note any spontaneous communication moments or challenges in various settings, providing a holistic viewpoint.

• Technology-Enhanced Tracking:
  • Leverage built-in tracking features of AAC devices and apps, which can automatically log interaction data and highlight areas of frequent usage or neglect.
  • Integrate digital tools that allow for real-time tracking of device usage, giving an immediate snapshot of user interaction patterns.

Effective data collection in virtual AAC therapy is more than a task—it’s an essential element of personalized and responsive service delivery. By adopting robust strategies, including systematic logs, session recordings, and engaging technology-enhanced tools, SLPs can ensure comprehensive progress tracking. This informed approach not only aids in refining therapy plans but also empowers AAC users by acknowledging their achievements, thereby fostering motivation and continued growth in their communication journey.

Embracing the Future of AAC Through Teletherapy

Teletherapy is a powerful tool for bridging clinical AAC interventions with everyday communication. Whether using low-tech boards or advanced high-tech devices, consistently integrating AAC into daily routines is the key to progress. By addressing barriers, leveraging practical technology, and partnering with facilitators, you can extend and enrich therapy in meaningful ways.

If you’re ready to elevate your AAC teletherapy approach or need specialized guidance, consider reaching out to our SLP Empowerment team. For more information about the QuickTalker Freestyle™ high-tech speech generating device and how it might support your practice, schedule a consultation today.