What AAC Therapy Looks Like: A Seattle SLP's Guide

May 22

If you're a parent in the Seattle area getting ready for AAC speech therapy with your child, you might be wondering what actually happens in a session. What does AAC speech therapy look like? What will your child do? Are you supposed to participate or stay out of the way?

I'm Haley, a Seattle-based AAC-focused Speech Therapist and the founder of Say Their Way, where I offer in-home speech therapy across Seattle and virtual sessions across Washington state. Here's what early sessions of AAC therapy with me tend to look like - and the ways I support both your child and you.

This post is for families whose child already has an AAC device. But if your child doesn't have one yet, we can still start working together! I'll help you through the evaluation process and getting a device in hand. Reach out and we'll figure out next steps.

My Approach: Curiosity, Meaning, & Connection

The core of how I run AAC therapy is curiosity. I'm curious about every way your child already expresses themselves - their actions, their interests, their movements, their scripts, their silences. That curiosity is how we find the meaning in what your child is already doing, and how we show them that their AAC device can hold that meaning too.

Because here's the thing: we can't teach a child to use AAC if they don't believe it's meaningful. When a kid sees that the device can hold the things they love and the things they want to say, AAC stops feeling like a task and starts feeling like a way to connect.

The same curiosity extends to you. AAC works best when the adults around a child feel confident with the device, and a lot of families have been handed a device without ever being shown how to actually use it. Early sessions are about helping both of you find your way in.

Here's what that looks like in practice.

Part 1: Things You'll See Me Do with Your Child

Let Your Child Lead

If your kid is into something, we go there. Special interests aren't a distraction from therapy, they're often the richest possible context for language. We might spend the entire session playing with one toy, lining up the same set of figures, or talking about the same topic. What a gift to be able to communicate about something you love!!

Letting your child lead also means assuming everything they do has intent. If they pull out all the red toy cars, could there be a message in there? “You love red, red cars go together, these cars are so red and angry!” If they line them up, “you like things organized, we're getting ready to race, all the cars are gathering!” If they say something that sounds like a script or a gestalt, I'll get curious about how it connects.

Get Curious About Repetitive Activations

If your kid is pressing the same icon or word over and over, I always wonder…what would happen if I just lean in to this word?! Repetitive activation often gets dismissed as "not really engaging with the device.” But, if we use that curiosity lens we can often find meaning. Is your child telling us they love this thing? Is this the way in we've been looking for? Did they just learn this new word at school? Does another kid at school activate this word all the time? There are so many possibilities.

So, when we see repetitive button tapping, I often explore what it looks like to press the word alongside them. In those moments, by actions communicate that what they're doing matters and that is how we build meaningful connections.

Explore the Fun Features of the Device Together

Most AAC apps have features parents and kids don't know exist - animal noises, sound effects, visual scenes, drawing pages, or unique vocabulary buttons. Many kids have never been shown what's actually on their device. Early sessions are a great time to explore that with them. Sometimes a kid's first real spark of interest in their device comes from a button that quacks!

Record Your Child's Voice on the Device

If your child is a speaker as well as an AAC user, recording their own voice on certain buttons can be a turning point. I've seen kids light up the first time they hear their own voice come out of their device. It's a powerful way to make the device feel like theirs.

Add Icons On the Fly

If your child is obsessed with something specific that isn't already on their device, I'll add it during the session. I have enough AAC experience to make quick, linguistically sound decisions about where new icons should go. (Later, I'll teach you those principles too - more on that below.)

Program the About Me Page Together

Building out your child's About Me page can be so valuable during therapy. We can add the foods they love, the people in their life, the songs they're obsessed with, and the things they want others to know. It gives them a ready-made way to share who they are.

Model AAC Frequently

You'll see a lot of AAC modeling. I bring my own AAC device to sessions, so I can model language alongside them.

There's research showing that AAC users receive most of their language input through speech, but we expect their output to be AAC. No one shows them the input method we're asking them to use. Part of my job is to level that scale. So you'll see me pressing icons on my device, pressing icons on theirs, searching for new words, trying to spell, and making mistakes. Modeling is about showing your child that AAC is meaningful and powerful - and that it's okay to explore and get it wrong. (If you want to dig deeper into modeling, check out some of my other blog posts like The First Thing Parents Should Learn About AAC or Real Life Modeling Examples for Home.)

Use Silence and Wait Time

This one is important! You'll see me not talking that much sometimes, and using AAC to model instead.

Well-intended adults often fill silence with repeated instructions and heavy spoken input. But when we fill the wait time, we're always the one initiating. The silence is where kids get a chance to show us what they want to say. So you'll see me wait, gesture, point, write, and model on the device instead of speak. Let’s give the kids a chance to initiate!

Keep the Device Present, Even if You Child Doesn’t Directly Use

If your child has had no real interest in their device yet, you might see me playing with them while keeping the device out and active nearby - modeling on it as we play, or activating words on my own device. The device doesn't have to be in their hands to be doing something. Sometimes the work of an early session is helping your child see, over and over, that the device is part of a meaningful exchange just through its presence.

Part 2: Things You'll See Me Do with You

I always ask that a parent be home for sessions, and my goal is to build in dedicated time to work with you directly. AAC isn't something that happens in a one-hour session - it's something that happens in the other 167 hours of your child's week. So my goal is that part of every session is making sure you feel less intimidated by the device.

Every family is different, and what parent coaching looks like depends on what you want and need from our time together. Some families might love being part of the session start to finish; others want more of a debrief at the end. I'll meet you where you are. That said, here's what you might see me do with you:

Hand You the Device

A lot of parents have never really held their child's device with intention. So I'll hand it to you, and we'll explore it together. Where are the core words? What's hidden in the categories? What feature have you never noticed before? It’s important to get hands-on time with the device to increase your own fluency with how it works.

Ask You to Model

I'll ask you to model AAC with me during the session, so you can practice in real time and ask questions as they come up. Sometimes that means I am telling you exactly what word to press. Sometimes I’ll encourage you to decide what buttons to activate. You modeling alongside someone who can answer your questions (me!) is one of the fastest ways to build confidence.

Teach You Where to Add Icons

If we're adding new words to your child's device, I'll show you the linguistic logic behind where to put them. By the time we've worked together for a while, you'll feel confident adding icons on your own when your child gets into something new. AAC apps have very intentional organization structures. It’s important for your to learn this structure so you can add icons in places that make sense (without accidentally editing over another key word!).

Bring You Into the Conversation

A big part of parent coaching is making sure you're part of the communicative exchange, not on the sidelines watching. I'll narrate what I'm noticing about your child, ask what you've been seeing at home, and check in about what's working and what's not. The session is collaborative because you know your child better than I ever will.

These Are Some of My Ideal Therapy Practices

Everything above represents some of my ideal therapy practices - the tools and approaches I bring to my work with families. Of course, building real rapport with a kid and a family takes time. Not every session will hit every note, and what we do together will evolve as I get to know your child. These are some of the things you might see me try, and if any of them resonate with how you imagine therapy could go for your family, I think we could be a great fit.

Why Families in Seattle Choose In-Home AAC Therapy

I want to be upfront about something: I also work part time as a school SLP, and I absolutely love it. School-based AAC therapy is meaningful, important work, and I'm grateful to do it. The reason I built Say Their Way alongside my school role wasn't because I wanted to leave school work behind - it was because I wanted a way to support families more directly. To really dive in with parents, to be connected with the family unit, to spend time in the home where AAC actually has to live.

That's why I do in-home AAC therapy in Seattle. The device lives in your home. The routines live in your home. The real communication moments - breakfast, the car, the chaos of an afternoon - happen in your home. Doing therapy in that environment lets us optimize for your life, with your family, in the spaces where your child needs AAC to work.

I see families across Seattle for in-home AAC speech therapy and offer virtual sessions for families across Washington state. If you're searching for an AAC SLP near you, a Seattle speech therapist who specializes in AAC, or a private speech therapist who can come to your home, I'd love to talk.

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Common Questions About AAC Therapy in Seattle

Below are some helpful FAQs specific to my speech therapy practice, Say Their Way. I offer in-home AAC focused speech therapy, parent coaching, and trainings in Seattle, WA and online across WA State.

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How long is a typical AAC therapy session with Say Their Way? Sessions are about 45-50 minutes, including dedicated time at the end to coach and debrief with you.

What if my child doesn't have an AAC device yet? I can support you through the evaluation process, help determine which device is the right fit, and guide you through getting one. Reach out and we'll talk through where you are.

Do I need to be involved during the session? I ask that a parent be home, and I like build in real time to work with you directly. Every family's level of participation looks a little different, and we'll find what works for yours.

What happens before therapy starts? Before ongoing therapy, I do an assessment that includes a more structured parent interview and information-gathering, so I can build a thoughtful therapy plan for your child.

How is in-home AAC therapy different from clinic-based therapy? Both have real value. In-home AAC therapy lets us use your child's actual environment, routines, and motivators - which matters a lot for AAC specifically, because the device needs to work in everyday life.

Do you serve my area of Seattle? I see families across Seattle for in-home AAC therapy, including Ballard, Queen Anne, Magnolia, Fremont, Wallingford, Green Lake, Greenwood, Phinney Ridge, Ravenna, Capitol Hill, Madrona, West Seattle, Beacon Hill, and Shoreline. If you don't see your neighborhood listed, reach out - I'm happy to talk about whether it's a fit.

Do you travel to the Eastside? It depends on time of year. I work part time as a school SLP during the school year, which makes my in-home schedule tighter; but summers are more flexible, and I can sometimes accommodate families in places like Kirkland, Redmond, Bothell, Kenmore, and Bellevue depending on the day and time. Reach out and we'll see what's possible.

Do you offer virtual AAC therapy in Washington state? Yes. I provide virtual AAC therapy and coaching for families across Washington state when in-home isn't a fit.