What is augmentative and alternative communication?
Augmentative and Alternative Communication (AAC) refers to communication methods that supplement or replace speech or writing. These can include non-verbal communication techniques such as facial expressions, eye gaze and gestures, as well as systems and devices such as:
- communication displays with pictures/symbols/words
- electronic devices with voice output
- adapted computer systems
About the Clinic for Augmentative Communication (CAC)
CAC may provide communication services to children and youth (0-18 years of age):
- with limited speech or whose speech is hard to understand to meet daily needs at home and/or
- who have difficulty producing written work at home
The CAC is designated as an expanded level clinic by the Assistive Devices Program (ADP) and therefore is able to prescribe a range of AAC devices and obtain funding for lease or purchase, as appropriate.
Our team
The CAC team members have specialized skills in the area of AAC. They include:
- speech-language pathologists (SLP)
- occupational therapists (OT)
- program assistants
- technician
- ADP associate
Our services
- Assessing to match an individual's needs and abilities to an AAC system.
- Developing recommendations and strategies to help communication skills.
- Obtaining and setting up recommended equipment.
- Initial training to the client, family and other team members to help them learn to use the system.
Please note that our clinic does not provide ongoing therapy.
Make a referral
To make a referral, the client/family must call CHEO Access Team at 613-737-2757 or 1-800-565-4839.
If the client has previously been served by CAC, the client/family can request a reassessment by calling the CAC Manager at (613) 737-7600, extension 2379.
Eligibility
We strongly recommend that you discuss your AAC needs with your speech-language pathologist or cccupational therapist before making a referral to our clinic. More information on eligibility for:
| Face to Face Communication |
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To be eligible for Face to Face Communication, the client must require the use of AAC in the home and meet criteria for one of the following:
- have a severe motor or visual impairment that limits use of communication symbols (i.e. unable to see or physically point to pictures)
- able to use 20 or more symbols (i.e. pictures, PECS, symbols, or signs) independently to express themselves (i.e. request, comment, share information, etc.) and has a need for a more complex communication system (i.e., lots of vocabulary, spelling, combining symbols to produce novel ideas, a need to take multiple turns in a conversation)
- able to use speech and has a large spoken vocabulary, but speech is difficult for others to understand (i.e. may have a diagnosis of apraxia, dysarthria or motor planning difficulties)
Note: In exceptional circumstances, clients who use a limited number of symbols (i.e. 10 to 20 symbols) and whose SLP is not an ADP Individual Authorizer may be eligible.
| iDevices |
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Many families are interested in exploring the iPad as a communication device for their child with special needs. The iPad with an appropriate communication app can be a very valuable communication tool for many children, but it is not necessarily the best tool for everyone. Some clients may need a device that requires less controlled movement than an iPad. Others may have more success with a simpler device, or with a means of communication that does not use technology at all, such as a communication board or book. Some clients may do better with a device whose only function is communication, rather than a device that serves many different purposes, such as the iPad.
Talk to your child’s speech-language pathologist if you are not sure about the best augmentative communication approach for your child. Therapists can request consultation through our All About AAC service to find out about different options. Eligible clients can be assessed in CAC to determine the best AAC approach to meet their needs.
If you do wish to explore the use of the iPad for augmentative communication, and are considering making a referral to CAC, it is important to understand the role of the CAC team in recommending and supporting iPads:
- CAC can only recommend an iPad and communication app after a thorough assessment of the client’s communication needs and abilities. Depending on what we find during this assessment, we may recommend an iPad, another communication device, or no device at all.
- If you purchase a communication device (including an iPad with a communication app) before your CAC assessment, you will not be able to receive funding for it through the Assistive Devices Program (ADP). If the device you purchased is meeting your child’s basic communication needs, you may not be eligible for ADP funding for other communication devices, and CAC involvement may be limited. We are unable to provide support or training for devices we did not recommend, but we would be happy to share some written resources with you or provide you with links to on-line resources.
- ADP will only provide funding for an iPad and communication app together as a bundle. If you already own an iPad, there is no ADP funding available to purchase just a communication app.
- CAC can only recommend an iPad with a communication app that is approved by ADP. At present, the following apps are ADP-approved: Proloquo2Go, Proloquo4Text, Predictable, Compass and Compass/PODD, TouchChat, TouchChat with WordPower, LAMP Words for Life, Grid Player, Snap + Core First (full). This list could vary from time to time. CAC staff may be able to provide you with some information about other apps, but we cannot assess these apps with your child or prescribe them for you.
- CAC can only prescribe a communication device (including the iPad with an approved app) to meet every day, functional communication needs at home or in the community. We cannot prescribe communication devices for use solely at school.
- CAC cannot prescribe an iPad if it will be used primarily as a tool for language development, learning or recreation. To find out more about using an iPad for functions other than communication, you can talk to our Adaptive Toys and Tech Resource Centre team.
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| Writing Aids funding |
To be eligible for Writing Aids funding through CAC the client must:
- have a long-term physical disability or fine motor impairment that precludes written communication without the use of specialized equipment.
- require an augmentative or alternative communication aid to enhance or replace written output required to perform Activities of Daily Living for a period of six (6) months or longer.
- have regular and ongoing needs at home to independently perform writing related tasks.
- be able to generate basic ideas independently using a formal symbolic representational system and must have a demonstrated need and potential to transfer ideas to written form.
Note: Eligibility may be extended to children under the age of 6 with severe physical limitations who can:
- recognize some letters
- have some sight words
- who have great difficulty with age-appropriate pen and paper tasks
- who are not able to access a standard keyboard and mouse
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Other services
| All About AAC |
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The CHEO Clinic for Augmentative Communication (CAC) is pleased to offer a consultation service to help you learn more about augmentative and alternative communication (AAC).
All About AAC is open to speech-language pathologists and occupational therapists working with children who use or may need to use AAC, either for face-to-face communication (eg: picture boards or voice output devices for children who are unable to speak) or for written communication (eg: adapted computers for children who are physically unable to write). A CAC speech-language pathologist, occupational therapist and/or program assistant will be available for one-on-one consultation. We can:
- share ideas about putting AAC into practice
- discuss possible referrals to CAC
- guide you in planning interventions for your clients using AAC
- demonstrate particular AAC equipment of interest
- consult regarding potential school equipment prescriptions
Please note that this is not an assessment service and the client should not attend with you, although parents, caregivers, educators and other service providers are welcome to accompany you.
All About AAC runs from September to June. Consultations can be scheduled at your convenience, for approximately one hour, at our sites in Ottawa, Renfrew, or Cornwall (NB: consultations in Cornwall are provided by a speech-language pathologist only). Telephone consultation or videoconference can also be arranged.
To book an appointment for All About AAC, please call 613-688-2126, ext.0
Your call will be directed to a CAC speech-language pathologist or occupational therapist who will discuss your needs and book an appointment with you. We are able to provide a limited number of appointments each month.
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| Warrick AAC Library |
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This is a service provided by the Clinic for Augmentative Communication (CAC) to support literacy development for children who use augmentative and alternative communication systems. The Warrick AAC Library provides adapted readng for children with special needs.
What’s available?
- Adapted books & materials
- Text resources
- Single message voice output devices
- Multiple message voice output devices
- Boardmaker Symbol making software
Who can use this service?
Anyone interested in supporting literacy development for children with special needs.
More information
For more information or to make an appointment, visit or call:
2211 Thurston Drive, Ottawa ON.
CAC Program Assistant: 613-688-2126 ext 4935
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