Applying a Developmental Framework to Aided AAC Learning

This is a plain language summary of a research article by Binger, Harrington, & Kent-Walsh (2024).

WHAT THIS PAPER IS ABOUT

When a child is learning to communicate through AAC before they can read, how do we know what to target next? This paper proposes a framework — a six-phase developmental model — to help clinicians and families understand what preliterate AAC learners are typically working toward at each stage of aided language development. The authors reviewed existing research on typical language acquisition and applied it to aided communication. The goal was to give practitioners a shared structure for thinking about where a child is and what kinds of vocabulary and system design might support their development.

THE SIX PHASES

The model describes six phases of preliterate aided language development, each building on the one before. These phases are grounded in typical language development research and adapted for learners who use aided AAC:

• Phase 1 — Pre-intentional. The child reacts to their environment or feelings in ways that are not yet intended to send a message to a partner. However, familiar partners may be able to interpret these signals in context.

• Phase 2 — Intentional, not yet symbolic. The child uses eye gaze, vocalizations, body movements or gestures in ways that are meant to communicate with a partner. They are not yet using words, sign language or symbols to communicate in a meaningful way.

• Phase 3 — Early symbolic. The child begins to learn that symbols have meanings and starts to use single symbol messages to communicate with others.

• Phase 4 — Early word combinations. The child begins putting two symbols together to create simple messages (e.g., more juice, daddy go, big dog).

• Phase 5 — Grammar development. The child produces a wider variety of phrases and child-like sentences, and may tell simple stories.

• Phase 6 — Complex language. The child uses language for more complex stories, academic language and a wider range of social functions. Literacy skills become more central.

WHAT THIS MIGHT MEAN IN PRACTICE

This is a framework paper — it synthesizes existing research and proposes a model for clinical reasoning. It is not an intervention study, so it doesn't tell us which specific approaches lead to the best outcomes. That said, the authors offer these clinical implications:

• Start by identifying the phase. Before choosing vocabulary or setting goals, ask: what is this child currently doing with language? The answer to that question should shape everything else. A child in Phase 1 has very different needs than a child in Phase 4.

• Goals should target the next phase. This framework helps avoid some common pitfalls such as staying at single-symbol goals when a child may be ready to combine, or targeting multi-word structures before symbol-meaning mapping is established.

• Vocabulary selection follows the phase. Early phases call for high-salience, personally meaningful words that map to the child's immediate world. Later phases require access to more flexible vocabulary — verbs, descriptors, and grammatical words — that supports generative language.

• System design should also reflect the phase. A child in Phase 1 may benefit from a smaller, more stable layout. A child in Phase 5 needs broad, robust access to vocabulary across many contexts and communication partners.

• This model is a starting point, not a rigid checklist. Children don't move through phases in a perfectly linear way, and individual differences matter enormously. The framework is meant to support clinical reasoning — not replace it.

THE BOTTOM LINE

One of the most common challenges in AAC is knowing where to start and what to prioritize. Device features and vocabulary organization decisions can feel overwhelming without a guiding framework. This developmental model offers a way to step back from those questions and ask a more foundational one: what is this child learning to do with language right now?

Grounding decisions in that question — rather than in what a system looks like or what vocabulary is "standard" — is the central argument of this paper. It's a useful framework for SLPs, educators, and families to share a common language about where a child is and where they're headed.

CITATION

Binger, C., Harrington, N., & Kent-Walsh, J. (2024). Applying a developmental model to preliterate aided language learning. American Journal of Speech-Language Pathology, 33(3), 1193–1211. https://doi.org/10.1044/2023_AJSLP-23-00100