By: Chelsi Hansen, MS, CCC-SLP; Stephanie Fuqua, MS, CCC-SLP; and Nadine Welch, MS, CCC-SLP
Who do you connect with? Is it your family, your colleagues, friends from your faith community, or friends you share a hobby with? Connection happens across many contexts and many settings. We connect by sharing interests, experiences, and stories. We laugh with our people, cry with them, reminisce with them, and sometimes even argue with them. We do much more than simply communicate with them. We connect with them! No matter our mode or method of communicating, the heart of communication, even communication through augmentative and alternative methods, is connection. As speech-language pathologists, remember we are communication specialists, and we all share the same goal—to improve the communication of our patients, clients, and students. But how well are we connecting our augmentative and alternative communication (AAC) users to their people and places? How can we, as clinicians, shape our practices to support people who use AAC in sharing experiences, expressing identity, participating more fully, and building meaningful relationships and truly connecting?
Communication through AAC, like communication in any form, serves many purposes. It allows people not only to express wants and needs but also to reject, protest, ask questions, share information and experiences, express opinions and emotions, advocate for themselves, and build relationships with others.
Focusing on wants and needs can be a natural starting point in AAC intervention, especially when we hear the urgent and understandable plea from parents, caregivers, and educators: “We just want to know what my child/student wants or needs.” And so we begin there. We teach words such as want, more, and help. We identify preferred items and activities, model vocabulary on AAC systems, and create opportunities for meaningful communication. These practices quickly build the understanding that communication has power. Having the ability to express a need, reject something unwanted, ask for assistance, or influence what happens next is fundamental to autonomy. But what happens once that need is met? The goldfish cracker is delivered. The song is played again. The chair is adjusted. The communication ends. How can we perpetuate the communication exchange? What if we make AAC communication less about requesting and more about connecting? As interventionists and communication partners, can we facilitate communication that allows people not only to influence their world but also to connect with the people in it?
Take a moment to consider this example: Jill is a 12-year-old who communicates using speech, gestures, facial expressions, and a speech-generating AAC app on her iPad. During an interaction, she uses her device to ask for help, but she also says, “That’s funny,” tells her communication partner, “I don’t like that,” and shares about the play she is joining in on at school. When she communicates “No” to an offered activity, her communication partner accepts her response and offers another choice. Jill’s clinician recently helped her add “bro” to her device so she can chime in when her friends are chatting. Each message serves a different purpose—requesting assistance, sharing an experience, expressing an opinion, connecting with another person, or refusing something she does not want.
Moving Beyond “I Want”
If you are sinking back in your chair and feeling a little seen over the “I want” reference, you are not alone. Spencer et al. (2026) noted in a recently published systematic review that the majority of AAC interventions reported in the literature have focused on requesting. As noted above, requesting is powerful. We ask; we receive. Communication based on requesting produces tangible results. While we don’t want to abandon requesting, we do want to vary the communication intents we model and target. Spencer et al. (2026) help explain this. Their systematic review examined 14 studies targeting commenting in children who use AAC and highlighted commenting as an important communicative function related to social engagement, social closeness, and information transfer. Commenting is one way communication can shift from primarily getting something from another person to sharing something with another person.
Consider the difference between requesting and commenting. A request typically has an obvious outcome. Someone communicates “more,” and the activity continues. A person selects “coffee,” and someone gets them a coffee. They communicate “help,” and assistance arrives. The communication partner has a clear and immediate way to respond. Now imagine that a person using AAC communicates, “That’s funny.” With this exchange, there is an absence of a tangible item to hand over, open, or turn on. The natural response is social. We might laugh, agree, add our own comment, or even disagree. Perhaps the comment becomes an inside joke that comes up again later. In this case, the interaction itself becomes meaningful. Connection is formed over something far more lasting than the coffee that was delivered as a result of the request. (Although, who can deny the delight coffee brings?!)
Commenting is only one example of the many purposes communication serves beyond requesting. We ask questions, share information, tell stories, express opinions and emotions, greet, encourage, complain, and they all connect us with the people in our world. Recent intervention research is also examining language development beyond requesting, turn-taking, and vocabulary acquisition. Binger et al. (2026), for example, conducted a randomized controlled trial of an AAC generative language intervention with children with developmental disabilities. Their intervention addressed the development of generative language, teaching developmentally appropriate syntax and morphology. Children receiving the intervention demonstrated significantly greater growth in aided expressive grammar.
The study results should not surprise any of us. Syntax and morphology are of course, part of language development. What should surprise us is that it is often left unaddressed with our AAC users. We have to ask ourselves, with each individual we serve: What are we ultimately preparing them to do with communication? Hopefully, the answer is connection!
Connection changes what we notice. If we solely focus on requesting, we become very good at noticing what a person wants but cannot access. However, when we look through the lens of connection, we begin to notice different things. We pay closer attention to what has captured a person’s attention, what makes them laugh, what they repeatedly return to, what they seem curious about, and what surprises, frustrates, excites, or interests them. We may also become more attentive to what they are already attempting to communicate through speech, facial expressions, vocalizations, body movements, gestures, signs, eye gaze, an AAC system, or another mode.
This leads us to a question we have increasingly considered in our own clinical practice: Are we sometimes so busy creating reasons for a person to communicate that we miss the reasons they are already giving us? This does not mean abandoning environmental arrangement, direct instructional strategies, or other approaches that intentionally create communication opportunities. Rather, it means balancing those opportunities with responsive interaction. Sometimes, instead of interrupting a meaningful experience to create a reason to communicate, we should enter the experience and bring language with us.
Imagine a person who is captivated by watching a ball travel down a ramp. We could certainly model words such as "ball," "want ball," or "more," but beyond this, the context also gives us opportunities to model words and phrases such as “fast,” “down,” “big,” “wow,” “uh-oh,” and “That’s funny!” The person who uses AAC does not necessarily have to imitate each model for the interaction to have value. Aided Language Stimulation gives exposure to language that can enrich a shared experience and demonstrate how words connect us in meaningful ways. Maybe it also creates an opportunity for a reciprocal and contingent response from our AAC users.
One thing we know is that no two individuals are alike in their interests, and across the lifespan, the shared experience will look different. It might involve music, sports, cooking, photographs, a television show, work, family, a hobby, current events, or something happening in the immediate environment. The principle is less about the activity itself and more about our orientation toward the person. We are asking not only what a person might want from an interaction but also what matters to that person and what they might have to say about it. The International Classification of Functioning, Disability and Health (ICF) model provides an excellent framework for considering this perspective. Rather than focusing solely on the physical aspects of a disability, the model encourages us to examine how those factors interact with a person’s ability to participate meaningfully in everyday life. It also reminds us to consider the contextual influences surrounding the individual, including environmental supports and barriers as well as personal factors that shape experiences and outcomes.
Noticing what matters to a person is only part of the equation. We also have to consider whether people have access to the language and vocabulary needed to communicate about it. Have we provided the level of robustness needed to not only provide a way to request, reject and advocate but to do it in a way that is unique to them and reflects their own personalities? A person may want to communicate messages such as “Amazing!,” “No way!,” “That’s weird,” “I remember,” “I don’t agree,” “Spill the tea,” “Please don’t do that,” or “I miss her.” Depending on the individual and their relationships, access to slang, sarcasm, teasing, humor, shared references, storytelling, and opinions also may be required.
Although their study was limited to a small sample of typically developing male adolescents, Cox et al. (2024) found that vocabulary played an important role in social belonging, peer relationships, and everyday interactions. These findings suggest that AAC vocabulary selection should extend beyond words that meet functional needs to include language that supports engagement, connection, and meaningful participation with peers. Have you programmed “six-seven,” “fire,” or “no cap” into any AAC devices lately? Hats off to those of you shaking your head yes!
Connection Is a Shared Responsibility
If connection is relational, successful communication cannot be the responsibility of the person who uses AAC alone. Hanley et al. (2024) conducted an integrative review examining factors that influence communication partners’ use of AAC with people with severe or profound intellectual disability. Across the 15 studies included in the review, meaningful communication and communication partner preparedness emerged as major themes. The authors emphasized the importance of communication partners recognizing individuals’ communication attempts and remaining sensitive to the different ways those attempts may be expressed.
Light et al. (2025) examined societal barriers that limit people who need or use AAC. Together, lived experiences and research findings were found to emphasize that communication partners and broader societal structures influence both access to AAC and opportunities for people who use AAC to communicate and participate. This shifts some of the responsibility away from continually asking how we can change the person who uses AAC and toward examining the environments and interactions we create around them.
These findings should prompt reflection in our own practice. Do we give the person enough time to communicate and recognize communication expressed outside of the AAC system? Do we respond to communication attempts even when they do not look the way we expected? Do we model language without turning every model into a demand for imitation? When someone comments, do we respond with genuine interest, or do we immediately turn the interaction into another teaching trial? Does the available vocabulary reflect the person’s age, interests, relationships, culture, experiences, and identity? Perhaps most importantly, we might ask ourselves whether we are communicating with the person or continually testing their ability to communicate with us. That distinction can be subtle, but it may profoundly change an interaction.
What Are We Working Toward?
Perhaps one of the most important developments in AAC research is increased attention to Patient-Reported Outcome Measures (PROMs). Broomfield et al. (2026) called attention to this, noting that there is currently no tool to measure PROMs to evaluate what outcomes are important to our AAC users. Broomfield et al. are working to establish this tool. This work encourages us to think beyond whether someone successfully produced a message during intervention and more toward the patient's perspective on which outcomes matter most.
Similarly, McNaughton et al. (2025) brought together the lived experiences of adults with developmental disabilities who use AAC and current research on meaningful participation in adult life. Among the areas they identified were meaningful activities, access to needed services, friendships, meaningful relationships, and personal identity. Our goal of "The client will successfully communicate a request for a preferred item on 80% of trials over three consecutive sessions" does not really match these PROMs. These perspectives invite us to consider the larger outcomes behind the skills we teach.
Translating these broader outcomes into everyday clinical practice may begin with the questions we ask ourselves when planning intervention. Next time you are planning a session with a person who uses AAC, consider the ICF model and use this checklist to ensure you are considering connection first:
☐ Vocabulary: Am I only teaching the person where to find words, or have I considered what they will be able to dowith those words?
☐ Agency: Am I teaching that communication can change what happens next while also considering what the person wants to change?
☐ Participation: Does this intervention create opportunities for the person to participate more fully in the activities they participate in daily, rather than simply produce more messages?
☐ Influence: Can the person use AAC to influence what happens to them, make choices, disagree, or express an opinion?
☐ Sharing: Does the person have the vocabulary and opportunities to tell someone what happened, share something unexpected, express an emotion, or introduce their own topic?
☐ Connection: Can the person use AAC to make someone laugh, connect with others, and build and maintain relationships?
☐ Identity: Does the person have access to language that allows them to express their personality, interests, preferences, and more of who they are?
☐ Independence with purpose: As AAC use becomes more efficient and independent, am I also considering what that independence makes possible in the person’s life?
☐ Is this important to my client: Does this goal relate to a stated outcome my patient desires?
Making Connection Part of the Goal
None of this means that we should stop teaching people to request. Requests matter. Wants and needs matter. So do rejection, directing others, asking for assistance, and self-advocacy. These forms of communication can provide critical access to autonomy and control. Rather, we are asking ourselves whether connection deserves a place alongside those priorities from the beginning.
When we consider connection as a cornerstone of AAC, our clinical lens expands. We notice not only what a person wants but what interests them. We model not only how to obtain something but how to share something. We consider not only whether a person can operate an AAC system but whether that system and the people around them provide meaningful opportunities to participate.
Perhaps, then, one of the most useful questions we can ask when supporting a person who uses AAC is not only, “What does this person need to communicate?” but also “What does this person want to say?” Are we measuring success primarily by the production of messages or by what communication allows the person to do, influence, experience, and become part of? That question asks us to watch, wait, listen, model, respond, and become genuinely curious about the person in front of us.
Augmentative and alternative communication is not simply a means of getting a message across. It is one of the ways people can share experiences, express identity, influence their world, participate in life, and connect with one another. Some of our most meaningful communication happens when we are not asking for anything at all. We are simply connecting.
References
Binger, C., Harrington, N., Hahs-Vaughn, D. L., & Kent-Walsh, J. (2026). Augmentative and alternative communication generative language intervention: A randomized controlled trial. Journal of Speech, Language, and Hearing Research, 69(6), 2654–2678. https://doi.org/10.1044/2026_JSLHR-25-00516
Broomfield, K., James, D., Jones, G. L., & Judge, S. (2026). Defining outcomes: Exploring the perspectives of people who use aided augmentative and alternative communication to develop the content for a patient-reported outcome measure. Augmentative and Alternative Communication, 42(3), 241–254. https://doi.org/10.1080/07434618.2025.2524363
Cox, L., Ingles, M., & Wylie, K. (2024). Guys, like…yeah…this stuff might actually be pretty important. Teenage vocabulary in peer interactions. Implications for teen AAC users. Journal of Clinical Practice in Speech-Language Pathology, 26(1), 42–57. https://doi.org/10.1080/22000259.2024.2317470
Drager, K. D. R., Muttiah, N., & Holyfield, C. (2025). The feasibility of just-in-time programming of visual scene displays on mobile technology in AAC intervention for adult beginning communicators. Augmentative and Alternative Communication. Advance online publication. https://doi.org/10.1080/07434618.2025.2462059
Griffen, B., Holyfield, C., Lorah, E. R., & Caldwell, N. (2024). Increasing linguistic and prelinguistic communication for social closeness during naturalistic AAC instruction with young children on the autism spectrum. Augmentative and Alternative Communication, 40(3), 168–181. https://doi.org/10.1080/07434618.2023.2283846
Hanley, E., Lehane, E., Martin, A.-M., & Dalton, C. (2024). Factors influencing communication partners of persons with severe/profound intellectual disability use of augmentative and alternative communication: An integrative review. Disability and Rehabilitation: Assistive Technology, 19(7), 2454–2470. https://doi.org/10.1080/17483107.2024.2313079
Light, J., Fager, S. K., Gormley, J., Hyatt, G. W., & Jakobs, E. (2025). Dismantling societal barriers that limit people who need or use AAC: Lived experiences, key research findings, and future directions. Augmentative and Alternative Communication, 41(3), 230–244. https://doi.org/10.1080/07434618.2025.2508490
McNaughton, D., Rackensperger, T., & McLemore, L. (2025). Supporting meaningful participation in society by adults with developmental disabilities who need and use AAC: Lived experiences, key research findings, and future directions. Augmentative and Alternative Communication, 41(3), 250–263. https://doi.org/10.1080/07434618.2025.2504497
Spencer, T. D., Tönsing, K., & Dada, S. (2026). Augmentative and alternative communication (AAC) interventions that promote commenting: A systematic review. Augmentative and Alternative Communication, 42(3), 285–298. https://doi.org/10.1080/07434618.2025.2477694
American Speech-Language-Hearing Association. (n.d.). International Classification of Functioning, Disability, and Health (ICF). https://www.asha.org/practice/icf/
AI Use Disclosure: Generative AI was used to support the development and refinement of this article, including brainstorming, drafting, editing, and research support. The authors reviewed and verified the final content and references.