Starting AAC: what to expect in the first six months

The first six months with AAC look different from what most families expect — and very different from what some clinicians promise. We get a version of this question every week: “How long until they start using it?” The honest answer is longer than the marketing makes it sound, but the right milestones along the way are clearer than people think.

Here’s the version we walk new families through in session.

What “starting AAC” actually involves

AAC — augmentative and alternative communication — covers everything from a high-tech tablet running TouchChat, LAMP Words for Life, or Proloquo2Go, through to PODD books, single-message devices, core boards on the fridge, and laminated visual schedules. The first month of “starting AAC” is usually less about the kid and more about the adults: getting comfortable using the system yourselves, putting it in the rooms where communication actually happens, customising vocabulary so the system has words the kid actually wants to say.

If you skip the adult-onboarding step and put a device in front of a kid expecting them to “use” it, you’ll be disappointed. AAC is a language. Kids don’t learn a language from a tablet on the table — they learn from hearing it used around them, by people they love, in the moments that matter.

Months 1–2: exposure and modelling

Nothing dramatic happens, and that’s normal. You’ll be modelling AAC in everyday moments — hitting the words on the device as you say them. More. Banana. All done. Up. Go. You’ll hit words your kid isn’t asking for yet. That’s the whole point.

What your kid might be doing:

• Watching you use the device and not touching it themselves
• Exploring the buttons randomly (this is good)
• Pushing the device away (this is also fine — it doesn’t mean they hate AAC, it means they’re setting a boundary in the moment)
• Touching one or two words, often by accident, then noticing the effect
• Carrying it around but not using it
• Ignoring it entirely

All of those are normal. What we look for: comfort with the device being present in the room. Curiosity. The occasional accidental press that the kid notices. We are not yet looking for intentional communication. We are stocking the language environment.

What you should be doing:

• Hitting 5–15 words on the device every hour the kid is awake and with you
• Keeping it within reach, not in a drawer, not “for sessions”
• Modelling in every routine — meals, bath, getting dressed, car, park, bed
• Charging it nightly, treating it like the language tool it is
• Not asking your kid to use it. Not pointing at it and saying “use your words”. Not withholding things until they tap a word. None of that.

If you’re doing the modelling consistently, “nothing happening” at month 1 is fine. It’s not failure; it’s the necessary input phase.

Months 3–4: first meaningful uses

Often it starts with one motivating word. More. Open. Bluey. Dad. The communicator chooses it deliberately, gets the response, and the connection clicks. From there, words slowly accumulate — not always in a logical order. The fourth word a kid uses is rarely the fourth most useful one on paper. It’s the fourth one they cared about that week.

What we typically see in this window:

• One or two words used reliably to mean what they mean
• Several more words used inconsistently — sometimes on purpose, sometimes exploration
• The kid starting to look at you after they hit a word, to check whether you noticed
• Use clustered around motivating activities — snack time, bath, favourite TV
• Use absent in stressful or overwhelming moments — that’s fine; we don’t expect language during dysregulation

What to ignore in this window:

• “Shouldn’t they be using sentences by now?” — no, and sentences are a very late marker
• “But they can talk a bit already, so they don’t need it” — both are true, both belong
• “We should be reducing the device because they’re starting to speak” — no, definitely not
• “Let’s only let them have it when they ask for it” — no, this kills the language environment
• “It’s been three months and they only have one word” — that one word is huge; keep going

Most of our coaching during these months is staying the course. Families get nervous and want to add new strategies. The new strategy is the same strategy: more modelling, more access, more patience.

Months 5–6: building combinations

We start looking for two-symbol combinations and the beginning of self-initiated requests. More + bubbles. Go + park. I + want. Some communicators are well past this by month six. Many are still consolidating single words. Both are fine. The rate isn’t the point; the trajectory is.

What we look for:

• Combinations the kid generated themselves (not modelled in the last five minutes)
• Use that travels — words used in a new environment, with a new person
• The kid initiating, not just responding
• Variation in functions — not just requesting, but commenting, protesting, joking, asking
• Some sign that the kid recognises the AAC system as their system

What we don’t yet expect:

• Grammatically complete sentences
• Use during meltdowns or shutdowns
• Use with strangers
• Self-correction or vocabulary expansion without our help

The thing nobody warns you about

Around month 5–6, families often reduce modelling because the AAC user “has it now”. Don’t. Modelling continues for years. Aided language stimulation — the practice of modelling on the system at higher rates than you expect the user to produce — is the whole game. Speaking kids hear words tens of thousands of times before they produce them. AAC users deserve the same exposure, which means the adults keep modelling long past the point when it feels necessary.

If you stop modelling once your kid starts using AAC, you’re effectively saying that one word is enough now — you don’t need any more language input. Imagine doing that with a typically developing toddler. We don’t.

How sessions support all of this

Our job in the first six months is mostly to keep families on track:

• Confirming the vocabulary is set up well for this kid (not the textbook kid)
• Adding fringe words the kid keeps wanting and not finding
• Coaching the family on modelling without it feeling like a chore
• Spotting use the family didn’t notice — kids often use AAC in tiny ways adults miss
• Writing or updating the NDIS report that funds ongoing work
• Coaching educators when school is involved
• Quietly normalising the timeline so nobody panics in month 3

We rarely run “AAC drills” with the kid. Drills don’t build language. Real moments build language. Sessions are usually 45 minutes of play and conversation where AAC is present the whole time.

What “success” looks like at six months

Honestly? Comfort. A kid who trusts their AAC, who reaches for it when they want something, who uses it (some of the time) in the moments that matter, and whose family no longer feels weird about modelling in the supermarket. The word count is less important than the relationship the kid has with their system.

We have had kids hit 30 words by month six and we have had kids hit five. Both groups are doing well if the trajectory is upward and the language environment is rich. The five-word kid sometimes ends up the more flexible communicator at year two, because the foundation is steadier.

Two myths worth busting

“AAC will stop them talking.” Research is consistent — across multiple meta-analyses, AAC either supports speech or has no effect on it. It does not suppress speech. For many kids, having AAC reduces the pressure on speech and frees the speech up.

“They need to point first.” No they don’t. The prerequisite-skills model — where a kid has to demonstrate cause-and-effect, joint attention, requesting and turn-taking before they get a device — has been thoroughly debunked. Robust language access is how the prerequisite skills develop. Withholding it is the opposite of helpful.

If you’re considering starting AAC

The trial is rarely the wrong move. The risk of trying is small. The cost of not trying, measured in years of language access, is enormous. If you’d like to talk it through, a free 15-minute call is the right next step — we’ll listen to where your kid is, recommend a likely starting system, and map out what the NDIS funding pathway looks like.