Our Stories: AAC and my Grandmother

Megan Zecher
Dec 29, 2025
4 min read

My grandmother is a small, tough woman from Virginia. She loves fancy chocolate and watching birds and getting her nails done. She used to love going shopping for hours and eating at restaurants for a long steak lunch.

In her early 90s, my grandmother had a small series of strokes. Anyone who has had loved one knows that strokes vary greatly in their damage and can lead to any number of difficulties after, whether its with eating, speaking, coordination, or anything else. We noticed immediately that her speech and language had been affected by her strokes - she went from having full conversations to struggling to find the words she needed, getting stuck in the middle of her sentences. Sometimes we could guess what she needed, or she would use yes or no questions, or the most disheartening, she’d simply give up, shrug her little shoulders, and say “I don’t know” with a defeated tone.

Years out from those strokes, my grandmother has been doing better with her language skills, though she still struggles to find words and keep up in conversation. She was never too interested in speech therapy, which would target these skills and help her regain the ability to communicate effectively. It’s ironic, given that I, her granddaughter, am a speech therapist!

However, at 92, it is difficult to convince her to attend and really try to participate in regular speech therapy sessions. She gets tired frequently, and she’s not really motivated. While the best answer is speech therapy, regular sessions didn’t work for her. That doesn’t mean she’s just fine without them, mind you: she struggles to communicate, she gives up often in speech, and she has limited social interactions due to struggles to keep up in conversation.

Recently, it became an even bigger problem: my mother visited her and discovered her completely exhausted and out of it, struggling to answer any questions. After talking to the staff, we found out that her physical therapist had pushed her a bit too much. I’m not calling out the physical therapist at all, but what happened was a communication issue: the therapist asked my grandmother if she wanted to keep going and my grandmother, still struggling to communicate, couldn’t say much but “yes.”

If you knew my grandmother, you’d know that she wants little more than to sit in her chair, listen to the television, watch the birds and animals at her window, and eat little fancy chocolates my mom provides her. The odds that she was really and truly interested in continuing to bike and then use her walker to pace around the facility are little to none - which this therapist could not have known. In addition, she had a small accident in front of my mother after being unable to communicate her needs due to exhaustion.

This is when I suggested to my mother that we make her a communication board. My grandmother may struggle with regular therapy, but that doesn’t mean she can’t communicate at all - before this incident, we knew she could communicate somewhat verbally, even if it wasn’t fully dependable. Now, with my mother concerned for her health and myself concerned for her ability to easily communicate, I brought up the use of alternative and augmentative communication (AAC). *add embedded link

Alternative and augmentative communication (AAC) is used for those who may have difficulties communicating verbally and is common in our everyday lives! If you text, write, and use emojis, you’re using alternative communication skills. It can be as simple as sticky note or as advanced as a dedicated device with eye gaze or switch capabilities.

For my grandmother, with her difficulties and overwhelm at her age, we decided a page with a simple 12 options to start with would be best. She may want more than 12 things, but too many options may overwhelm her, and we want her to really use it! I told my mom I could always add to the board and change any of the icons or options if she wanted to add vocabulary.

The goal with this? My grandmother does need speech therapy support, but while those skills improve, her communication board allows her to communicate. If she can't think of a word, we can have a visual option for it. If she can’t speak because she’s too tired, she can point to an option instead. It’s not perfect, and I’d love to give my grandmother a whole book to use, but we have to start with function for her. As she uses it, I can keep tabs on it and change anything she or my mom need.

Alternative and augmentative communication is for everyone, and everyone deserves a voice - our communication is the way we can meet our needs, show others who we are, display our thoughts, and more.

Author: Megan Zecher, M.S.,CCC-SLP, certified speech therapist, and loving granddaughter