Augmentative and Alternative Communication

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Duke speech pathologists use augmentative and alternative communication (AAC) to help adults and children who have difficulty producing speech or whose speech is very difficult to understand. We support people with a wide range of communication problems including tracheostomy and ventilator dependence, traumatic brain injury, cerebral palsy, amyotrophic lateral sclerosis (ALS), and autism. Whether your need is temporary or long-term, we work closely with you to identify the best intervention to positively impact your quality of life.

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Communication Methods and Services

Our speech pathologists offer guidance and training on the full spectrum of communication options, from sophisticated devices that provide a voice to your ideas, to a simple, individualized communication notebook that helps you use your own speech to start a conversation. We help children who need to request simple actions or items in school, and we assist adults who need hands-free computer access via eye tracking.

Low-Tech Options
Low-tech options include sign and body language, pen and pencil communication, and picture and/or symbol communication books. We teach you flexible skills that can adapt to your communication needs.

High-Tech Options
Electronic speech-generating devices allow you to produce more complex messages through synthesized speech and often involve several layers of screens and buttons tailored to your conversational needs and abilities.

Promote Further Speech and Language Development
AAC methods are not meant to replace your current way of communicating, nor are they intended to inhibit your speech production. Research shows that AAC promotes further speech and language development. We teach you to use these methods so you can make your wants or needs known and experience more successful communication exchanges.

Improved Social Interaction
AAC can also help you interact socially and more successfully with your family, medical providers, friends, and in your community. AAC can reduce frustration and help you become a more confident communicator.

Our Locations

Duke Health offers locations throughout the Triangle. Find one near you.

Why Choose Duke

Personalized Appointments
Our services range from a full evaluation with the goal of starting therapy, to a one-time consultation that provides additional information about the services you already receive.

Comprehensive Evaluation
Your provider will consider your communication interests and needs, provide hands-on coaching for your family to help you use the techniques that are appropriate for you, and evaluate your motor abilities. These evaluations typically last from one to two hours.

Family Involvement
We encourage your family to participate in the assessment and therapy sessions. Their involvement can help ensure you use AAC tools and methods successfully.

Rehabilitation Engineer Addresses Motor Needs
We are one of the few facilities with a rehabilitation engineer who can address your motor needs as well as your ability to use AAC. If you have physical limitations, the rehabilitation engineer can help you manipulate equipment such as your computer, television, kitchen appliances, and telephone.

Experiment with Different Devices 
We have many different types of AAC systems in our clinic with which you can experiment. This ensures that you choose the device that is best suited to your needs.

Help with Funding and Acquiring Devices
Our services also include assistance obtaining funding and acquiring the devices we recommend.

Consistently Ranked Among the Nation’s Best Hospitals

Duke University Hospital is proud of our team and the exceptional care they provide. They are why we are once again recognized as the best hospital in North Carolina, and nationally ranked in 11 adult and 9 pediatric specialties by U.S. News & World Report for 2023–2024.

This page was medically reviewed on 06/21/2022 by