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Communication & AAC

Choosing an AAC system for your child: a practical guide for families

From signing and picture boards to eye-gaze devices: how AAC assessment works in the UK, what specialised NHS AAC hubs look for, and questions to ask before choosing a system.

By PURA Family Directory team · published

Information only, not medical advice. Every child with PURA syndrome is different. Please talk to your child's own doctors and therapists before making decisions about their care. In an emergency call 999; for urgent advice call NHS 111. Our disclaimer.

AAC is about giving your child a voice

Augmentative and alternative communication (AAC) means any way of communicating other than speech. Communication Matters describes two kinds. Unaided AAC uses gestures, body language and signing, such as Makaton. Aided AAC uses objects, symbols, picture boards and communication books, through to tablets and eye-gaze devices. The PURA Syndrome Foundation's clinician handout notes that many people with PURA are non-speaking, that AAC should be considered early, and that receptive language (understanding) often exceeds expressive language. Many children use several kinds of AAC at once.

Start with your local speech and language therapist

Your child's local speech and language therapist is usually the first step. They can introduce low-tech options, build early choice-making and work out what your child is ready for. It helps when they work with your child's physiotherapist or occupational therapist, because seating, head control and hand or eye movement all affect which access method will work.

Specialised NHS AAC hubs

In England, some people with complex communication and access needs are referred to a specialised AAC service funded by NHS England. Ace Centre is one of these services. Referrals are made by professionals using the national eligibility guidance. That guidance asks referrers to show that low-tech AAC has been considered and explain why it doesn't meet the person's needs. For people still developing AAC skills, it also asks for evidence that they can consistently make purposeful choices. If your child does not meet these criteria yet, that doesn't mean AAC is not for them. Their local team can keep building skills.

Questions to ask before choosing a system

How will my child access it: touch, switches or eye gaze? Has that been tried in their usual seating?

Is the vocabulary set up to grow with my child, rather than offering only a few fixed requests?

Who will programme and update it, and who trains school staff and family?

How will it be mounted on a wheelchair or table, carried and charged? What happens if it breaks?

Can we borrow or trial it first? Suppliers such as Tobii Dynavox, Smartbox and Liberator can usually arrange demonstrations, ideally with your therapist present.

Model, model, model

Children learn language by hearing it used around them, and AAC is the same. Therapists often encourage families to use the system themselves during everyday moments, without expecting a response. Ace Centre runs a free advice line (0800 080 3115).

Questions families ask

Will AAC stop my child learning to talk?

This is a very common worry. Please talk it through with your speech and language therapist, who can explain the evidence and what it means for your child.

Who pays for a communication device?

This depends on where you live and your child's needs. Funding may come from the NHS (including specialised AAC hubs for those who meet the criteria), education through an EHC plan, or charities. Your speech and language therapist can advise.

Sources

Checked 1 November 2026. Rules, rates and services change, so always check the latest version.

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