Augmentative-Alternative Communication (AAC) | Speech Language Pathology | MedStar Health

People who cannot communicate effectively through speech still have a lot to say. The role of Augmentative and Alternative Communication (AAC) is to provide a way to communicate WHAT you want to say WHEN you want to say it. Our team of experienced, highly skilled speech-language pathologists (SLPs) matches individuals to the devices, tools, and strategies that fit them best, ranging from simple systems such as picture boards to complex systems such as computers accessed by eye gaze.

Why AAC?

AAC strategies are flexible and can, and we believe should, be used in all stages of recovery and disease, from the early days following a new event such as a stroke through the late stages of progressive diseases such as ALS. Communication is a basic human right and connects us to each other and the world - for example, our clients have used AAC strategies to organize surprise parties, sell cosmetics, teach college courses, and tell their families that they are loved and appreciated.

Examples of Devices, Tools, and Strategies

  • Picture boards and books with printed words or pictures
  • Single recorded messages
  • iPad apps that speak messages connected to words or pictures
  • Software for your current computer or laptop including text readers
  • Use of a head mouse or eye gaze technology to spell or select messages on a computer
  • Speech Generating Devices (SGDs) – durable medical equipment with flexible programming and access options

Diagnoses that we see

AAC services are appropriate for adults who are not able to meet their communication needs through speech, including those with:

  • Neurodegenerative diseases such as ALS, multiple sclerosis, and spinal muscular atrophy
  • Parkinson’s disease
  • Progressive Supranuclear Palsy (PSP)
  • Cerebral palsy
  • Stroke
  • Traumatic brain injury
  • Aphasia Apraxia
  • Severe voice disorders
  • Head and neck cancer


Before the assessment, the client or family completes an intake questionnaire to determine if other services such as occupational therapy, seating clinic, or rehabilitation engineering are needed in addition to SLP services.

In a first visit, a client meets with a speech-language pathologist to determine current and future communication needs and participates in trials with tools, equipment, and strategies. This appointment typically lasts about two hours. At the end of the assessment, the SLP will make recommendations for acquiring and implementing the device and/or strategies.

Training and implementation

It takes practice (and patience) to learn a new way to communicate. Once the initial assessment is completed, the SLP can work with the client and caregivers to know how to operate and modify a device and make good decisions about message content and other tools/strategies. The goal of training is to allow the user to be as independent as possible; this is addressed through individual sessions with an SLP and may include group treatment sessions for those who would benefit from varied practice opportunities.

Our providers

Senior adult patient undergoing rehabilitiation care from the specialist

Expert rehabilitation care

Getting the care you need starts with seeing one of our rehabilitation specialists.

Our locations

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MedStar Health: Physical Therapy at Mitchellville

12158 Central Ave.
Mitchellville, MD 20721

NRH Rehabilitation Network at Rockville

6001 Montrose Rd.
Ste. 402
Rockville, MD 20852

MedStar Health: Physical Therapy at Olney

18109 Prince Philip Dr.
Ste. 155 & 355
Olney, MD 20832

MedStar Health: Physical Therapy at McLean

6858 Old Dominion Dr.
Ste. 200
McLean, VA 22101

Additional information

For more information, contact:

Brooke Hatfield, MS, CCC-SLP

Patty Fletcher, MS, CCC-SLP