In one sentence
Across 69 experimental AAC studies with autistic people, most work still targets children, aided devices, behavioural teaching, and simple requesting — with very little on adults, generalisation, or quality of life.
What the researchers did
Authors systematically searched six databases for peer-reviewed experimental AAC studies with autistic children or adults published in English after 2013. Sixty-nine papers met criteria. Studies were grouped by age, AAC type, teaching approach, and outcomes; quality was rated with Scientific Merit Rating Scales. Facilitated communication–type methods were excluded.
What they found
- Most studies focused only on children; only three examined AAC outcomes with adults.
- Speech-generating devices and low-tech picture exchange dominated; behavioural techniques were common.
- Outcomes were largely proximal (for example, making requests), with few measures of skill generalisation or distal outcomes such as wellbeing, relationships, learning, or employment.
- Overall study quality was often limited by design and diagnostic ascertainment gaps.
What this means for families and therapists
- Ask whether AAC goals go beyond requesting — to commenting, protesting, social connection, and participation.
- Autistic adults with communication support needs deserve AAC offers too, not only early childhood programmes.
- Pair with our digests on communication interventions for minimally verbal autism and echolalia as communication.
Limitations and what we don't know yet
- Narrative synthesis of heterogeneous designs; many low-quality studies.
- English-only, post-2013 filter.
- Does not prove which AAC system is “best” for any one person.
This is a plain-language summary of The Predominant Focus Is Still on Teaching Children to Make Requests: A Systematic Review of AAC for Autistic Adults and Children by Mifsud S., Thomas D., Bowron R. et al., International Journal of Language & Communication Disorders (2026). Source license: CC-BY-NC-ND-4.0. It is not medical advice — talk to a qualified clinician before changing therapy.