A child who uses augmentative and alternative communication (AAC) should be able to connect with the people in their life. If family conversations happen in Spanish and school activities happen in English, an English-only system may leave the child without a way to participate fully at home. Bilingual AAC means planning for communication across the languages, people, and settings that matter to that individual. [1, 2]
What is AAC?
AAC includes ways to communicate in addition to or instead of speech: gestures, signs, pictures, communication boards, and speech-generating devices. People may use several methods together. An AAC system should offer ways to do more than request items: a person also needs to greet, comment, ask questions, refuse, tell stories, and express feelings. [1]
Why do home languages belong in the plan?
ASHA recommends considering the languages a person uses when assessing and selecting AAC. A system that cannot express the family's language may limit communication at home and connection with that language community. The team should ask the AAC user and family who they communicate with, where they communicate, and which language or dialect is used in each relationship. [1, 2]
For example, a child might want to tell a grandparent about school in Spanish, participate in an English classroom discussion, and use a familiar family expression that does not translate neatly. The plan should reflect those real purposes, not assume that every important message has a direct equivalent in two languages. [1, 3]
What should a bilingual AAC team consider?
| Consideration | Questions to ask |
|---|---|
| People and places | Which languages does the AAC user need with family, peers, teachers, and community members? |
| Vocabulary | Are names, routines, cultural experiences, social phrases, and meaningful topics available? Can the user express more than requests? |
| Language structure | Does each language have a usable way to build messages, including its own grammar? |
| Access | Can the user find and select words in each language? Is switching practical for this person? |
| Voice and partners | Are the available voices appropriate? Can family and school partners model and respond in the languages they use? |
These are discussion points for an individualized assessment. An app's “Spanish option” or a translated list of English buttons does not, by itself, establish that the system meets a person's communication needs. Research comparing core vocabulary lists across English, Korean, Spanish, and Sepedi cautions that lists from one language cannot simply be translated and assumed equivalent. [1, 3]
How can adults support bilingual AAC use?
Model during real interactions. A communication partner can point to AAC words or select them while speaking in the language used together. Give the AAC user time to respond and treat their message as meaningful, whether it comes through speech, a device, gestures, or a combination. ASHA emphasizes training communication partners and using AAC across everyday environments. [1]
Coordinate home and school. Families can share names, routines, expressions, and priorities; educators can identify classroom language demands; the SLP can help customize and review the system. In a study involving 15 school-based AAC providers, collaboration with families and colleagues and bringing home language into school activities were among the strategies used to implement bilingual AAC. The study also documented practical barriers, so planning and ongoing support matter. [4]
Observe what works for the user. Consider how easily the person moves between languages, locates vocabulary, and participates with different partners. In one experimental study of 58 Spanish-English bilingual children, switching between Spanish and English AAC layouts did not produce slower responses than staying in one language on that study's task. This finding does not mean every user or system will work the same way; an individual trial remains important. [5]
Questions families can bring to an AAC meeting
- “Can my child communicate with our family in the language we use at home?”
- “Who will help us add the words and phrases that matter to our child?”
- “How will adults model the system in each setting and language?”
- “Can we try the system in real conversations before deciding what works?”
- “How will we review and update the vocabulary as my child grows?”
Our approach at Culturally Speaking SLPs
We believe communication access includes a person's relationships and identity. A bilingual AAC plan starts by listening to the AAC user and family, then building and adjusting supports for the conversations they want to have.
This article is educational. AAC selection and programming should be individualized with the AAC user, family, and qualified team.
References and further reading
1. American Speech-Language-Hearing Association (ASHA). (n.d.). Augmentative and alternative communication (AAC). Practice Portal.
2. ASHA. (n.d.). Multilingual service delivery in audiology and speech-language pathology. Practice Portal.
3. Soto, G., & Tönsing, K. (2024). Is there a “universal” core? Using semantic primes to select vocabulary across languages in AAC. Augmentative and Alternative Communication, 40(1), 1–11.
4. Soto, G., & Clarke, M. T. (2025). Experiences of school-based professionals delivering AAC to bilingual students in the US: Challenges and strategies. Augmentative and Alternative Communication.
5. King, M. R., Romski, M., & Sevcik, R. A. (2021). Language differentiation using augmentative and alternative communication: An investigation of Spanish-English bilingual children with and without language impairments. American Journal of Speech-Language Pathology, 30(1), 89–104.