ABA, AAC and non-speaking children: PECS, devices and the right to communicate

'Non-verbal' is the term most families hear first, and it is what many people type into a search box. Many autistic people prefer 'non-speaking' or 'minimally speaking', because a child who does not speak may still understand a great deal of language and may communicate in other ways. 'Non-verbal' can wrongly suggest the child has nothing to say.

In this guide we use 'non-speaking' for children who use little or no spoken language. It covers a wide range: a toddler who has not started talking yet, a child with a few words used now and then, a child who speaks in calm moments but loses words when stressed, and a teenager who types fluently but rarely speaks. Each needs a different plan, which is why assessment matters.

Not speaking tells you nothing about intelligence, understanding or what a child may go on to do. Avoid talking about your child in front of them as though they cannot follow; many children understand far more than they can show.

AAC stands for augmentative and alternative communication: anything that adds to speech (augmentative) or stands in for it (alternative). Most children who use AAC use more than one kind, depending on where they are and what they want to say.

Which type, which symbols or words, how many to start with and how they are arranged are clinical decisions. They belong with your child's speech-language pathologist, made with you and, as your child grows, with your child.

The Picture Exchange Communication System (PECS) was created in 1985 in the United States, and it is based on Skinner's Verbal Behavior and on ABA, so it is behavioural in origin. A child learns to hand a picture to an adult to ask for something, and gets the item straight away. Teaching moves in planned stages, from exchanging a single picture towards building simple sentences and making comments.

Because PECS starts with requesting, it fits naturally with the verbal behaviour approach, and many families first meet it through an ABA programme or a special school.

PECS is one option, not the default for every child. Some children move on to a device; some use pictures for some things and speech for others; some find signing faster. The speech-language pathologist should decide with you whether PECS suits your child, and anyone teaching it should be trained in it.

This is the question parents ask most often, and it is a fair one. Many families are told to wait for speech, or worry that a picture board or tablet will become a shortcut the child never moves on from. A grandparent may say that a cousin did not talk until four and turned out fine.

The right person to answer it for your child is the speech-language pathologist, who can explain what the current research says and what they expect for your child in particular. Ask them directly. What can be said plainly is this: AAC gives a child a way to communicate now, and good practice keeps speech welcome alongside it. Adults keep talking, high-tech devices say words aloud, and every sound or word the child attempts is noticed and answered.

Waiting has its own cost. A child with no reliable way to communicate may become frustrated, and frustration can show up as crying, hitting or withdrawing. A child who can ask for a drink, say 'stop' or show that something hurts is safer and calmer, whatever happens with speech.

Before any formal system, your child is already communicating: leading you by the hand to the fridge, pushing a plate away, bringing you their chappals because they want to go out, making a particular sound when happy, covering their ears. A good ABA programme treats all of these as communication and builds from them, rather than accepting only words or only the 'correct' picture.

This matters for dignity and for behaviour. If a child's way of saying 'no' is ignored until they find the right card, they learn that communicating does not work. If it is respected, they learn that it does. The BACB's Ethics Code requires analysts to obtain a client's assent when applicable, assent meaning behaviour that shows willingness to take part. A child who can communicate 'stop' or 'break' can show when they are not willing, and a good programme listens.

• The child's AAC goes everywhere with them: to school, in the van, to Nani's house, to a wedding.
• It is never taken away as a punishment or kept back until the child 'behaves'.
• Words for 'no', 'stop', 'help', 'break' and 'finished' are available from the start, and are respected when used.
• Adults model the system by using it themselves while they talk, in the way the SLP shows them.
• Nobody insists on speech before giving the child what they have clearly asked for in another way.
• The child is talked to, not about, even when they do not answer in words.

AAC works best when everyone around the child uses the same system in the same way. That needs clear roles.

The analyst and the SLP should agree which words are being taught and how. Teaching a child to request with picture cards in ABA sessions while the SLP builds a device-based system confuses everyone, so ask for one joint plan. Functional communication training, the ABA method most often used to replace hitting or screaming with a request, works best when it uses the system the SLP has chosen.

Make sure the school knows the system too. A short note and a five-minute demonstration for the class teacher can make the difference between a device that stays in the school bag and one that is used.

Some autistic self-advocates and families have described programmes that treated speech as the only acceptable goal, demanded compliance before a child could communicate, or targeted behaviour the child used to regulate themselves. The Autistic Self Advocacy Network argues that assent is seldom sought in ABA. These criticisms point to real risks, especially for children who cannot easily tell anyone what they think of their therapy.

Good practice answers them by treating communication as a right, not a reward: the child does not have to earn access to their AAC, and what the child communicates shapes the programme. Goals focus on helping the child be understood and have more say over their own day. Ask your analyst how your child's assent is watched for, and how your child's own communication changes the plan.

Special Minds provides BCBA-supervised ABA therapy at home, at school with the school's agreement, online and at a centre. We do not provide speech therapy or AAC assessment, so your child's speech-language pathologist leads on communication assessment and AAC decisions, and the supervising analyst should build the ABA goals around the system the SLP recommends. Read more on the ABA therapy in India hub or the ABA therapy at home page.