Augmentative Communication

This service supports children and youth to develop their face-to-face and written communication skills. The team is made up of speech-language pathologists, occupational therapists, communication disorders assistants, rehabilitation technologists, and a written communication instructor. The team works closely with clients and their families, other involved therapists and educators to develop the best strategies. ACS provides assessment and consultation services for children and youth up to their 18th birthday, who are unable to communicate effectively through speech or writing.

ACS covers the Southwestern Ontario Counties of Middlesex, Elgin, Huron, Perth, Grey, Bruce, Oxford and Kent (for expanded level clients only).

ACS is an Expanded Level Clinic with the Assistive Devices Program (ADP) of the Ontario Ministry of Health and Long –Term Care. This means our clinicians can prescribe communication devices and/or mounting for individuals who meet ADP's eligibility criteria for funding assistance. Funding assistance through ADP is either to purchase or lease a recommended communication device. If both options are available to you, ACS clinicians will explain the advantages and disadvantages of each to help you decide the best option for your child.

ACS clinicians can prescribe a wide range of augmentative strategies, including technology to support face-to-face and written communication and that can be purchased or leased for home and community use. Many clients use their communication devices at school; however devices cannot be prescribed for school use only.

Access to Services

Referral Readiness

  • Face-to-Face Communication – Individuals who are non-verbal or who are verbal but are not understood and are purposefully using 20+symbols for their every day needs. A child's use of symbols indicates a willingness and understanding of the need to supplement their current communication and is a predictor of successful use of technology.
  • Face-to-Face CommunicationAccess: Individuals who are non-verbal or not understood and have difficulty physically reaching or pointing to symbols which impacts the number of symbols they use to communicate.  Individuals must have known preferences and be using symbols to intentionally communicate
  • Writing – Individuals who have a physical disability that affects their ability to write and or type. These individuals have the literacy skills to write and have home writing needs but are not able to use paper and pencil and are not able to use a standard keyboard or mouse.
  • Both – Individuals have both Face to Face and Writing needs – see above descriptions.

Why is using 20 symbols important?

  • It indicates the client is aware their speech is not well understood and they are willing to use another method to clarify communication breakdowns
  • The client gains experience using symbols
  • The client gains an understanding of symbols and that they can be used to communicate
  • It helps with initial vocabulary selection
  • It indicates a gap between what the client understands and what they can express
  • It clarifies a client’s desire to communicate

Consultation Sessions

  • If your child is using fewer than 20 symbols to express themself or is only using symbols to increase understanding (e.g., visual supports) they would not be ready for a full ACS assessment.
  • Please refer for a Consultation session so that we can help you with ideas about how to begin to use symbols to communicate or what to try next.
  • A consultation session is an opportunity for you and other team members (e.g. SLP, OT, Educator) to discuss your child’s communication skills and possible next steps to further develop their use of symbols or communication skills. For these sessions it is best to bring in your child’s current communication system if they have one.


Already a client of TVCC?: Talk with your child’s therapist about your interest in a referral to the Augmentative Communication Service (ACS). Together with your child’s therapist, fill out the ACS referral questionnaire.

Not currently receiving any services from TVCC?: Fill out a TVCC Referral Form:

  • Check the box for Augmentative Communication Service.
  • Under "Reason for Referral" please indicate if you need help with Communication, Writing or both or Consultation.
  • Together with your community therapist, fill out the ACS referral questionnaire.
  • If you have copies of medical reports, these are helpful to us (a doctor’s signature is not required).
  • If you don’t have a community therapist and you need assistance completing the questionnaire, contact us at 519.685.8700 ext 53478.


What to Expect

Augmentative Communication (AC) refers to methods (other than speech or handwriting) that are used to send a message from one person to another. We assist with two main types of communication in our service: Face-to-face communication and written communication.

Face-to-face communication refers to the range of things we do to exchange information with each other in person.  Face to face communication includes such things as speech, gestures, facial expressions, tone of voice, etc. Written communication includes the variety of ways we create and exchange written messages. When traditional methods of face-to-face and written communication are not sufficient, then alternative ways are explored to meet these needs.

We are looking forward to working together and want to share information about what you can expect from us so that you and your child can get the most from the different phases of our service.

Discovery Phase

  • You’ll have a chance to talk with a therapist in ACS about your hopes for your child’s communication.  We want to hear about what is working right now and what could be better during this “discovery” call.
  • You may also choose to meet with us in person at TVCC for a “discovery consult” to explore augmentative communication strategies to expand your child’s communication while you are waiting for a formal assessment. In order to learn more about our service and increase your understanding about augmentative communication possibilities, you’ll complete an essential online session and in person parent orientation session.

Assessment Phase

  • After you’ve completed the parent orientation, your child’s name will be added to list of children waiting for their formal assessment. You’ll be asked to complete the Student, Environment, Task and Tools (SETT) assessment forms together with your child’s therapists and daycare or school.
  • When ACS therapist(s) becomes available, they will contact you to arrange a team meeting at your child’s daycare or school. Together with you and your child’s team, we will talk about your child’s communication needs and together we will develop some clear communication goals for your child. With your child’s goals in mind, ACS therapist(s) can begin a trial of strategies/equipment with your child.
  • If your child would benefit from specific equipment to improve their face-to-face communication, the process to get funding from the Assistive Device Program will be reviewed. The suggested equipment will be reviewed by the ACS team and then funding can be authorized. 

Training & Practice Phase

  • The ACS team will provide training and technical support, as needed. As your child achieves their current communication goals, your ACS therapist can help assist you to set new goals.
  • Your child will have time to practice using the augmentative communication strategies and/or equipment to help them achieve their goals. 

Self-Reliance Phase

  • You and your child’s team are now comfortable supporting current and new communication goals.
  • The ACS team is available for technical support, as needed, and a person from ACS will continue to contact you annually to ensure that the equipment is meeting your child’s communication needs. If new needs are identified, please contact us. Depending on the needs identified, there may be a wait for an available clinician as we help other children get started with their journey through our service.

For More Information

For general ACS program information, email acs [at]


There are a number of free ACS related online e-Learning modules available on our Education / Workshops section. Check them out!

For links and handouts about augmentative communication and strategies, see our Augmentative Communication Resources