CVI and AAC: Supporting Communication Access
For a child with cerebral/cortical visual impairment (CVI), finding an effective augmentative and alternative communication (AAC) system involves more than choosing an app, device, or set of pictures. The team also needs to understand how the child communicates now, how they use vision, how they move and are positioned, what kinds of information are meaningful to them, and how they can most reliably access communication across everyday activities.
Communication support does not need to wait until a child demonstrates a particular set of skills. At the same time, not every AAC system will be accessible or appropriate for every child. A thoughtful AAC assessment asks how well the communication system and its supports fit the individual child, then uses trial, observation, and adjustment to learn what works.
This 20-page guide is designed to be used one page at a time. Families can choose the pages that are useful now and bring them to appointments, AAC evaluations, or team meetings.
What this guide covers
Notice how your child communicates now.
Observe what makes seeing and accessing AAC easier or harder.
Consider different ways to access AAC, not only direct touch.
Look for possible reasons when an AAC system is hard to use.
Prepare useful information for an AAC evaluation.
Ask questions that can help the team decide what to try next.
Communication access is more than choosing a device
A good AAC match starts with understanding the child. How do they communicate now? How do they use vision and movement? What information is meaningful to them? What do they need to say?
These questions help a team choose what to try and what to adjust over time.
Seeing and selecting are different jobs
A child may see an AAC choice but have difficulty reaching or selecting it. They may also access a system successfully for a short time but have more difficulty as they become tired.
It can help to look separately at seeing, selecting, and sustaining access and notice what changes across activities and environments.
When AAC is hard, ask why
A missed selection can have many possible causes. The problem might involve visual or motor access, understanding a symbol, finding a word, too much complexity, missing vocabulary, or the communication situation itself.
Instead of assuming what the difficulty means, ask: What might be getting in the way, and what could we change to find out?
Who this guide is for
This guide is for families and the professionals who support them, including SLPs and AAC specialists, teachers of students with visual impairments (TVIs), other vision professionals, educators, occupational and physical therapists, and other team members.
Each person sees a different part of the picture. Family observations from everyday life are an important part of understanding what works.
Difficulty with one AAC setup does not tell you what a child is capable of communicating. Try, observe, adjust, and keep looking for a better match.
CVI and AAC: Supporting Communication Access
Haley Dayel, MS, CCC-SLP, CBIS
Lindsay Cheng, MS, CCC-SLP
Published by Cadence AAC Speech Pathology Corporation
Updated August 2026
