Paeds · growth-development-and-behaviour
Augmentative communication, assistive technology and adaptive equipment
Also known as AAC · Speech-generating devices · Assistive technology children · Adaptive equipment paediatric · Complex communication needs · Powered mobility children
Fellowship-level prescription and coordination of AAC, assistive technology and adaptive equipment for children with complex communication and motor needs — feature-matching, trials, partner training, powered mobility, seating, and participation outcomes.
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Target exams
RACP General PaediatricsRACP DWERACP DCERCPCH Progress+MRCPCH TheoryMRCPCH ClinicalABP General PediatricsACGME PediatricsRCPSC Pediatrics
Red flags
- Withholding AAC until speech 'fails' — participation is lost while you wait
- Removing a child's established AAC system in hospital without an alternative access method
- Device-first prescribing with no family or school training plan
- Ignoring vision, hearing or seating barriers and labelling the child 'unable to use AAC'
- Behaviour treated only as aggression when it is communicative protest from an unsupported communicator
- Powered mobility delayed solely because the child is 'too young' without developmental assessment
Life stages
infanttoddlerpreschoolschool-ageadolescentyoung-adult-transition
Care settings
preventive-medical-homecommunity-schooloutpatientwarded-acuterural-remotetelehealth
Clinical exam formats
written-onlyracp-dce-long-casemrcpch-history-managementmrcpch-communicationrcpsc-structured-oral
Board mappings
- Growth and Development
- Community Child Health
- Disability and Rehabilitation
- Renewed curriculum for first-year trainees from 2027 — Learning goal 12: Communication with patients, families, and health professionals
- Renewed curriculum for first-year trainees from 2027 — Learning goal 15: Essential general paediatrics
- Renewed curriculum for first-year trainees from 2027 — Learning goal 18: Disability and developmental care
- Renewed curriculum for first-year trainees from 2027 — Learning goal 19: Population child health and advocacy
- Clinical Applications
- Long Cases
- Short Cases
- Communication
- 4. Professional skills and knowledge: Patient management
- 5. Health promotion and illness prevention
- General Paediatrics: Supports children with disability and long-term conditions
- Foundation of Practice (FOP)
- Applied Knowledge in Practice (AKP)
- History
- Management Planning
- General Pediatrics Content Outline — Domain 1: Preventive Pediatrics/Well-Child Care
- General Pediatrics Content Outline — Domain 4: Cognition, Language, Learning, and Neurodevelopment
- General Pediatrics Content Outline — Universal Task 4: Management and Treatment
- Patient Care 5: Patient Management
- Systems-Based Practice 3: System Navigation for Patient-Centered Care
- Interpersonal and Communication Skills 1: Patient- and Family-Centered Communication
- Medical Expert
- Collaborator
- Health Advocate
- Pediatrics: Foundations EPA #8 — Communicating assessment findings and management plans to patients and/or families
Overview & Definition
A preschooler with autism is “non-speaking.” A school-aged child with cerebral palsy is intelligent and frustrated, pointing and crying in class. A family was told to “wait and see if speech comes.” Your job is to stop that wait when complex communication needs are already clear. [3] [13]
Augmentative and alternative communication (AAC) supports or replaces spoken speech. It includes unaided methods (gesture, sign, facial expression) and aided methods (picture boards, books, speech-generating devices). Assistive technology (AT) is broader: any product or system that improves function or participation. Adaptive equipment includes seating, wheeled mobility, bathroom and self-care devices, and access tools. [12] [14]
Complex communication needs (CCN) means speech alone is not meeting daily communication demands. AAC is indicated by need, not by a failed waiting period. [13]
References16ShowHide
- [1]Flippin M Effectiveness of the Picture Exchange Communication System (PECS) on communication and speech for children with autism spectrum disorders: a meta-analysis. American journal of speech-language pathology, 2010.PMID 20181849
- [2]Gevarter C Naturalistic Speech-Generating Device Interventions for Children With Complex Communication Needs: A Systematic Review of Single-Subject Studies. American journal of speech-language pathology, 2018.PMID 29971336
- [3]Therrien MCS A Systematic review of AAC interventions using speech generating devices for autistic preschoolers. Augmentative and alternative communication (Baltimore, Md. : 1985), 2025.PMID 40164143
- [4]Barbosa RTA Augmentative and alternative communication in children with Down's syndrome: a systematic review. BMC pediatrics, 2018.PMID 29751828
- [5]Barton-Hulsey A Augmentative and Alternative Communication Supports for Language and Literacy in Preschool: Considerations for Down Syndrome and Autism Spectrum Disorder. Seminars in speech and language, 2021.PMID 34311485
- [6]Pennington L Speech and language therapy to improve the communication skills of children with cerebral palsy. The Cochrane database of systematic reviews, 2004.PMID 15106204
- [7]Koopmans C Functional Communication Abilities in Youth With Cerebral Palsy: Association With Impairment Profiles and School-Based Therapy Goals. Language, speech, and hearing services in schools, 2022.PMID 34767477
- [8]Allison KM Relation of Speech-Language Profile and Communication Modality to Participation of Children With Cerebral Palsy. American journal of speech-language pathology, 2024.PMID 38215219
- [9]Logan SW Powered Mobility Device Use and Developmental Change of Young Children with Cerebral Palsy. Behavioral sciences (Basel, Switzerland), 2023.PMID 37232636
- [10]Rosenberg L Evaluating a Therapeutic Powered Mobility Camp for Children with Severe Cerebral Palsy. Canadian journal of occupational therapy. Revue canadienne d'ergotherapie, 2021.PMID 34435918
- [11]Acharya BD Effect of Adaptive Seating Systems on Postural Control and Activity Performance: A Systematic Review. Pediatric physical therapy : the official publication of the Section on Pediatrics of the American Physical Therapy Association, 2023.PMID 37747975
- [12]Hoekstra D The role of assistive devices and technologies in the activities and participation in everyday life of children with cerebral palsy - a scoping review. Disability and rehabilitation. Assistive technology, 2025.PMID 40928660
- [13]Resina P Identifying and Describing Best Clinical Practices for Children and Adolescents With Complex Communication Needs: A Scoping Review of Healthcare-Based Interventions. Journal of intellectual disability research : JIDR, 2025.PMID 40745993
- [14]Coan-Brill J Exploring augmentative & alternative communication assessment practices for children with limited functional speech & motor skills: a scoping review utilizing the Participation Model of AAC. Disability and rehabilitation. Assistive technology, 2025.PMID 39891921
- [15]Sterrett K The effect of responsiveness to speech-generating device input on spoken language in children with autism spectrum disorder who are minimally verbal. Augmentative and alternative communication (Baltimore, Md. : 1985), 2023.PMID 36267016
- [16]Livingstone RW Wheeled Mobility, Seating, and Bathroom Device Use by Children With Cerebral Palsy. Canadian journal of occupational therapy. Revue canadienne d'ergotherapie, 2026.PMID 41719113