Augmentative and Alternative Communication for Speaking Autistic Adults: Overview and Recommendations
Open accessAbstract
In recent years, technologies used for augmentative and alternative communication (AAC) have seen increasing development and availability. As a result, more and more autistic people are using AAC. With the increased use of AAC by autistic people, research on autism and AAC has also increased. However, the vast majority of this research focuses on nonspeaking autistic children. AAC use by autistic adults and by speaking autistic people has received limited academic attention. Speaking autistic adults often use AAC and many have publicly shared information about their strategies and experiences. In this article, we provide an overview of the speech differences autistic adults choose to support through AAC, including varying difficulties with speech depending on environment and content. We also discuss the technologies and strategies adopted by autistic adults, including free or low-cost tools that are not specific to AAC, mobile technologies, and signed languages or gestures. We explore barriers to AAC use, including a lack of awareness of relevant options, misconceptions about who AAC supports are for, and the cost of dedicated AAC applications or devices. We then provide suggestions for autistic adults, people supporting autistic adults, and researchers. Overall communication—rather than speech—should be prioritized. Mainstream communication technologies can support communication for autistic adults and a variety of tools can support communication across contexts. Further research into the use and effectiveness of AAC for autistic adults is needed, as is research on barriers to AAC use.
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Many non-speaking or minimally speaking autistic people use augmentative and alternative communication (AAC) methods, including visual cards, writing or electronic devices.
“Many non-speaking or minimally speaking autistic people use augmentative and alternative communication (AAC) methods, including visual cards, writing or electronic devices, which should be facilitated (Zisk and Dalton, 2019).”
From Autistic SPACE: a novel framework for meeting the needs of autistic people in healthcare settings (2023) · cites this paper as Zisk and Dalton, 2019
The Speech for autistic adults section describes communication cards, writing and mobile AAC applications, and the recommendations say AAC should be encouraged when it supports communication. But those examples primarily concern speaking autistic adults; the paper does not establish that many nonspeaking or minimally speaking autistic people use the listed methods. (LLM, conf=0.84)
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Cited by
Sorted by citations
Autistic SPACE: a novel framework for meeting the needs of autistic people in healthcare settings
Doherty, M., McCowan, S., & Shaw, S. C. (2023) · British Journal of Hospital Medicine · doi:10.12968/hmed.2023.0006 · Cited by 188 · see citing works
“Many non-speaking or minimally speaking autistic people use augmentative and alternative communication (AAC) methods, including visual cards, writing or electronic devices, which should be facilitated (Zisk and Dalton, 2019).”
Background
- Authors
- Zisk, A. H., & Dalton, E.
- Affiliations
- University of Rhode Island (US)
- Corresponding author
- Zisk, Alyssa Hillary
- Venue
- Autism in Adulthood
- Publisher
- SAGE Publications
- Published
- 2019-04-13
- Volume
- 1
- Issue
- 2
- Pages
- 93-100
- ISSN
- 2573-9581 (ISSN-L)
- 2573-959X
- PMC
- PMC8992808
- OpenAlex
- W2922206321
- Cited by
- 66
- References
- 19
- Citations by year
- 2026: 10 · 2025: 16 · 2024: 12 · 2023: 11 · 2022: 6 · 2021: 6 · 2020: 4 · 2019: 1
- FWCI
- 9.07
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Autism in Adulthood (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › Occupational Therapy › Assistive Technology in Communication and Mobility
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Social Sciences › Human Factors and Ergonomics › Digital Accessibility for Disabilities
- Keywords
- augmentative and alternative communication, autistic adults, speaking difficulties, sign language, gesture, mobile communication technology, communication support
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