October 30, 2025
Communication is fundamental to human connection, learning, and quality of life. For children with autism spectrum disorder (ASD), developing effective communication skills can be one of the greatest challenges—and opportunities—for growth. While Applied Behavior Analysis (ABA) therapy has long been recognized as an evidence-based intervention for autism, incorporating communication alternatives such as augmentative and alternative communication (AAC) within ABA programs can dramatically enhance outcomes for children who struggle with verbal speech.
Augmentative and alternative communication encompasses various tools and strategies that supplement or replace spoken language. Within ABA therapy frameworks, these alternatives include:
Research shows that approximately 30-40% of children diagnosed with autism present with little to no functional speech, making communication alternatives not just beneficial but essential for their development and well-being.
One of the most significant findings in ABA research is that communication alternatives don’t hinder speech development—they enhance it. A meta-analysis of 14 randomized control trials involving 555 participants found that ABA-based interventions showed promising results for communication and expressive language outcomes, with a standardized mean difference of d=0.30 for communication and d=-3.52 for expressive language.
Studies demonstrate that AAC actually resulted in improved speech production, debunking the myth that using communication alternatives will prevent a child from learning to speak. The evidence shows that these tools can promote spoken language development while simultaneously providing an immediate means of communication.
Children who cannot effectively communicate their needs, desires, and emotions often experience significant frustration and social isolation. Teaching communication alternatives within ABA therapy addresses this critical gap. Research indicates that aided modeling and systematic instruction using speech-output technologies may lead to gains in socio-communicative behaviors in minimally speaking autistic children.
Studies show that ABA therapy significantly affects socialization, communication, and expressive language. When children gain the ability to express themselves—whether through PECS, SGDs, or other AAC methods—they can:
Children who struggle to communicate often resort to challenging behaviors to express their needs or frustrations. By providing alternative communication methods, ABA therapy can significantly reduce these problematic behaviors. When individuals learn alternative and more adaptive ways to communicate and cope, the frequency and intensity of problematic behaviors diminish.
The connection between communication and behavior is well-established in ABA research. Effective ABA programs reduce challenging behaviors by teaching functional alternatives and increasing positive behaviors, rather than simply focusing on behavior reduction.
Communication alternatives taught within ABA therapy extend beyond simple requesting. Research shows that children with ASD who use aided AAC can learn communication functions beyond making requests for objects. AAC interventions that include time delay and prompting, and that teach skills in specific routines, are more likely to demonstrate moderate to large effect sizes.
This expanded communication repertoire enables children to:
One of the strengths of incorporating communication alternatives into ABA therapy is the individualized nature of treatment. Applied behavior analysts assess each child’s unique needs when formulating an AAC intervention plan, collaborating with speech-language pathologists to determine the most appropriate communication methods.
Different tools work for different children:
Research consistently shows that early and intensive ABA intervention can improve outcomes for children with ASD. When ABA therapy is used for more than 20 hours per week during the first few years of life (before age 4), it produces large gains in development and can even reduce the need for special services later in life.
Introducing communication alternatives early in a child’s ABA program maximizes these benefits, providing children with the tools they need to communicate during critical developmental periods.
A comprehensive scoping review of ABA’s impact on children and youth with ASD found improvements across seven of eight outcome measures, including cognitive, language, social/communication, problem behavior, adaptive behavior, emotional, and autism symptom outcomes.
The evidence base for AAC within ABA therapy continues to grow. A systematic review found growing evidence for the potential benefits of AAC for children with autism, though researchers note the need for more well-designed studies and broader, targeted outcomes.
Despite the clear benefits, some families and practitioners hesitate to implement communication alternatives. Common concerns include:
Approximately 30-50% of AAC users abandon or under-use their devices, highlighting the importance of proper training, ongoing support, and collaboration among families, therapists, and educators.
As understanding of autism and communication needs continues to evolve, the integration of communication alternatives within ABA therapy represents a crucial component of comprehensive, person-centered intervention. The goal is not to change who children are but to provide them with the tools and skills they need to connect with others, express themselves, and participate fully in their lives.
Research reinforces the need for large-scale prospective studies that compare ABA with other interventions and include comprehensive measurements of outcomes. As the field continues to advance, communication alternatives will likely play an increasingly central role in ABA programming.
Teaching communication alternatives within ABA therapy offers profound benefits for children with autism who struggle with verbal communication. From improved language development and social interactions to reduced problem behaviors and increased independence, the evidence overwhelmingly supports the integration of AAC strategies into ABA programs.
For families navigating autism intervention options, understanding that communication alternatives can enhance—not hinder—development is crucial. By combining the evidence-based principles of ABA with appropriate communication tools and strategies, therapists can help children find their voice, whatever form that voice may take.