Supporting communication for autistic people
As part of Autism Acceptance Month, our Clinical AAC Specialists, Becky and Ailsa, have taken time to pause and reflect on their clinical experiences, sharing insights into some important considerations when supporting autistic people with AAC.
A difference to be understood and supported
April marks Autism Acceptance Month, so I have taken some time to pause, reflect, and consider what might be most helpful to share from our clinical experience.
I keep coming back to words that have stayed with me for years – that autism is “a natural variation in human neurology, not a disease that needs curing.” Alongside Judy Singer’s powerful reminder that it is “a difference to be understood and supported.”
There has been a real and positive shift in recent years – from awareness to a world that is beginning to value autistic people, support self-advocacy, and move away from deficit-based narratives. Change is happening, which is encouraging, but there is still more to do.
This month, I’m joined by Ailsa, our Clinical AAC Specialist in Scotland, to reflect together on what we continue to see in practice.
Meet Alisa
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I am a Speech and Language Therapist and have worked in the world of AAC for most of my 18-year career. I was first introduced to AAC as an undergraduate student at Strathclyde University back in the early 2000s and instantly fell in love with the use of technology to support people with communication difficulties, albeit the technology back then was significantly bigger, heavier and slower.
I am a strong advocate for people being given the opportunity to communicate at every stage in their lives, no matter their disability, and have supported users to access education, employment, remain in work, and continue to be a vocal member of their families.
I have a special interest in working with adults with acquired and progressive diseases and have supported many individuals to continue to communicate with loved ones toward the final stages of their lives.
Starting with the ‘why’
In a world where there is often a request for evidence, we have chosen to share reflections from our clinical experiences – grounded in real conversations, observations and relationships.
Across our experiences, a few consistent themes help to shape meaningful AAC journeys:
- Regulation – checking in on what lies beneath.
- The power of modelling – and understanding what it is and isn’t.
- Valuing all forms of communication.
- Personalisation – the foundation for connection, and something not to be underestimated.
These themes all help us ladder up to our goal, or the ‘why’ we do what we do, which is active and meaningful participation in everyday life.
Before we go further, a mindful pause around the word “success.” This means different things to different people. What matters most is what success looks like for the AAC user themselves.
Some simple truths
One thing that is certain: Communication is not a performance; it is a human right. This is something that we will continue to stand by, always.
Our shift is not necessarily in the activities we use, but in how we see the person, moving away from purely behavioural lenses and towards understanding, connection and respect.
Regulation: communication starts with safety
We know that regulation comes before communication and learning. When someone feels anxious or
overwhelmed, their focus is on safety – not language, and certainly not on meeting someone else’s expectations.
For many autistic people, anxiety can be ongoing. Sensory differences, unpredictability and past communication breakdowns can all contribute to this. If we consider an autistic person who uses AAC, communication is something that happens all day, every day, and is therefore directly impacted by how regulated and safe they feel.
If we focus too early on outcomes – more words, quicker navigation, longer sentences – we can unintentionally increase pressure. Instead, when we prioritise regulation, we create the conditions where communication can happen more naturally.
If we prioritise regulation first:
- Communication becomes a response rather than a reaction.
- Exploration feels safer.
- Trust can grow.
- Initiation increases.
- Communication becomes more meaningful.
Participation lives in everyday moments – saying “no,” sharing joy, expressing discomfort, or connecting with others. These moments require more than vocabulary; they require safety, understanding, and support.
When we start with regulation, we shift our thinking from “What can they say?” to “What matters to them, and how can we support that?”
The power of modelling
Modelling is one of the most evidence-based and impactful strategies we have in AAC, but it’s important to clarify what it is, and what it isn’t.
It is not:
- Testing.
- Prompting for imitation.
- “Say this” or “tell me on your device” or “show me with your communication book.”
- About getting it ‘right.’
These approaches can quickly turn communication into pressure, particularly for autistic AAC users.
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Instead, modelling is:
- Language offered without demand or expectation.
- Sharing experiences together.
- Showing what’s possible.
Modelling also doesn’t need to be exclusively using the AAC device; it can be with any kind of AAC tool. For example, we might model:
- “I like this” during a shared moment.
- “Let’s…” as a start to a conversation.
- “That’s not what I meant” if a message starts to be misinterpreted.
- “Too loud” may be used in a busy environment.
- “I need a break” when things feel overwhelming.
These examples all occur without expecting the person to copy. This reduces pressure, creates safety, and allows language to develop naturally over time.
Understanding echolalia
Some autistic people communicate using echolalia, which refers to the repeating of words or phrases they’ve heard before.
This is meaningful communication and is part of who the person is and therefore, is not something we should ignore or dismiss. Echolalia can support:
- Processing language.
- Regulating emotions.
- Expressing meaning or intent.
When we listen with curiosity, we often find meaning underneath. A familiar phrase might mean:
- I’m nervous.
- I’m excited.
- This feels like a lot.
- I’m loving this.
Responding to the meaning, rather than the form, helps us connect and offers a bridge to new language, without removing what already works.
Personalisation as a pathway to connection
AAC should feel like an extension of the person. When communication tools reflect someone’s interests, humour, needs and experiences, they become more meaningful and engaging. Personalisation is often the ‘hook’ – the thing that draws someone in and supports connection.
This might include:
- Incorporating vocabulary that reflects real life and is linked to interests. This could include adding certain symbols, photos or images to represent these too.
- Adding meaningful phrases or scripts, if it feels beneficial to the person.
- Building layers around preferred topics to enable more opportunities to build, maintain and end interactions.
When this happens, communication becomes more natural, more motivating, and more reflective of the individual.
As we reflect during Autism Acceptance Month, we would like to leave with you this: AAC is not about achieving targets – it is about supporting someone to live their own life.
For autistic AAC users:
- Regulation creates the conditions for communication.
- Modelling without expectation builds confidence.
- Echolalia is meaningful communication.
- Personalisation supports engagement.
This is not about lowering expectations – it is about raising them. We are not aiming for perfect sentences; we are aiming for autonomy, identity and belonging.
