Minimally speaking

Also called Minimally verbal, Limited speech, Unreliably speaking

People who have some words but can't rely on speech for most of what they want to say, and why a few words are not a reason to withhold AAC.

What it is

Minimally speaking describes someone who uses some speech, often a handful of words or set phrases, but can't rely on it to say most of what they mean. The words may be clear to family and lost on strangers, may come on a good day and vanish on a bad one, or may be echolalia that carries meaning only to people who know the source.

It sits between speaking and non-speaking, and it's the group most often left without support. The logic runs: they can talk a bit, so they don't need a device. That logic is wrong.

Who it can help

Children and adults with autism, Down's syndrome, childhood apraxia of speech, cerebral palsy, a learning disability or an acquired condition, whose speech covers a small part of what they need.

It's also useful for people whose speech is reliable only in some settings. Selective mutism is a different thing, anxiety rather than ability, and needs a different response.

How it works

AAC is augmentative as well as alternative. It adds to speech. It doesn't replace it, and the research consistently finds that it doesn't stop speech developing. If anything, people often speak more once the pressure of speech being the only route is gone.

In practice a minimally speaking person uses whatever works fastest in the moment: a word for "no", a sign for "toilet", a device for a sentence, a point for "that one". Everyone around them needs to accept all of it.

Getting started

List every word the person uses and what each one means to them. That becomes a communication dictionary that new staff can read.

Then list what they can't say. The gap is the case for AAC. Try something low-tech straight away, a core board on the fridge, and model it as you talk.

Don't make speech the gate. Asking "say it properly" before handing over a drink teaches that communicating is a test.

Where to get help

Ask the GP, school or learning disability team for a speech and language therapy referral that names AAC. Communication Matters and the ACE Centre both publish free guidance on starting AAC with people who have some speech.