Typically at each child's first session, I ask the parents to create a list of the child's favorite foods and favorite objects (e.g., TV shows, movies, favorite toys). I also ask parents to send me pictures of themselves and other family members/friends that are part of the child's life. I then create picture boards with all of the people/objects that are kept within a communication binder for the child. The picture boards are used as both a means of alternative communication where the child is encouraged to point to the picture to make a request, and also for the purpose of building progressive word approximations to verbally request the people/items.

Other forms of AAC are typically used in my sessions based upon the specific needs and abilities of each child. For example, I have used PECS with some children rather than a static picture board. I have also used more high tech AAC devices such as the NovaChat speech generation device. I am currently using the NovaChat with a child to work on goals including answering questions, commenting, and engaging in basic social exchanges with family members and peers. We also frequently refer children to Boston Children's Hospital for AAC evaluations (particularly if we think they could benefit from a high tech device) and consult with the staff there based on the recommendations provided.