How do you capture the “why” behind communication?

Using the Pragmatics Profile for People who use AAC in practice 

When we work in AAC, it’s easy to get pulled towards how someone communicates, focusing on the access method, the device, the vocabulary, the system. But do we pause and ask why is this person communicating? And how do we capture that? This is where the Pragmatics Profile for People who use AAC comes in.

Our AAC Consultants, Sam McNeilly and Rachel Stevens, reflect on using the tool in practice. 

What is the Pragmatics Profile for People who use AAC? 

The original Pragmatics Profile, developed in the 1980s, explored how and why people communicate in everyday life. In practice, however, it often required clinicians to adapt questions on the spot when working with people who use AAC.  

Recognising the limitations of these ad hoc changes, Rachel, alongside Ace Centre colleagues Suzanne Martin and Katherine Small, created a systematically adapted version in 2017, making the tool more accessible, relevant, and consistent for AAC users. As she explains, “We were working with multimodal communicators, people using gesture, signing, eye pointing, speech, and we needed a way to capture all of that.” 

The Pragmatics Profile for People who use AAC, a freely downloadable resource from our website, builds on the original while reflecting modern AAC practice. It works across all ages, incorporates AAC-relevant examples and prompts, recognises multiple communication methods, and offers a structured yet flexible guided conversation. Rather than relying on in-the-moment adjustments or rigid assessment formats, it focuses on understanding real-life, functional communication. 

A tool for conversations, not checklists 

One of the most powerful aspects of the Pragmatics Profile for People who use AAC is how it supports and structures conversations. If you’ve ever come away from a discussion with a parent or teacher thinking, “That was rich information but how do I organise it?” you’re not alone. 

Rachel describes this challenge: “You often get lots of lovely information, but then you’re trying to categorise it all afterwards, and that can be tricky.” 

The Pragmatics Profile for People who use AAC helps by guiding what to ask, shaping how to ask it, and supporting you to make sense of what you hear, while still leaving room for flexibility. Conversations can move, revisit ideas and evolve, just like communication itself. 

Keeping the “why” at the centre 

In AAC, it’s easy to get drawn into the complexity of access methods, sensory needs, system design and team training. These all matter, but they can sometimes overshadow the bigger picture. 

As Sam notes, “We can lose sight of what the person actually wants to do with their AAC.” 

The Pragmatics Profile for People who use AAC brings the focus back to what the person is already communicating, what matters to them, where the gaps are, and ultimately why AAC is needed at all. This shift is crucial for meaningful, person-centred goal setting. 

Supporting better goal setting 

Goal setting in AAC can be challenging, particularly for individuals with complex and highly individual profiles. The Pragmatics Profile for People who use AAC helps by grounding decisions in real evidence. 

For example, it can move us beyond a narrow focus on requesting and highlight the need to support other functions, such as expressing refusal, where there is clear evidence of need. 

It allows practitioners to clearly articulate: 

This is what we’ve observed. This is why it matters. This is why we’re starting here. 

This clarity can be especially valuable when different stakeholders bring different priorities. 

Making the invisible visible 

One of the most powerful outcomes of using the Pragmatics Profile for People who use AAC is how it highlights communication that might otherwise be overlooked. 

Rachel shares an example of a child whose communication was viewed as “limited” due to a lack of consistent speech, difficulty with formal AAC systems and perceived limited progress. Through structured conversation, a different picture emerged. 

By exploring questions such as “How do you know when she’s happy?” and “How do you know when she doesn’t want something?” it became clear that she was communicating effectively through facial expressions, body posture, gesture and subtle behaviours. 

“She was communicating successfully, but not everyone was recognising it,” Rachel explains. The Pragmatics Profile for People who use AAC helped reframe the narrative from “communication isn’t working” to “communication is happening and we can build on it.” 

Creating a shared understanding 

Another key strength of the tool is how it supports a shared language across teams. Families, education staff and professionals don’t always describe communication in the same way, and this can lead to misunderstanding. 

The Pragmatics Profile for People who use AAC helps align perspectives, build shared understanding, document communication clearly, and support consistency across environments. Sam reflects that this often leads to powerful “lightbulb” moments of shared learning between communication partners. 

When complexity increases, so does the value 

The tool is particularly valuable in complex situations, such as fluctuating presentations, disagreement across teams, subtle or highly individual communication, early or pre-intentional communication, or complex access methods like switches or auditory scanning. 

In one example, a family felt strongly that a young man was communicating but struggled to explain how. Using the Pragmatics Profile for People who use AAC, they were able to provide clear examples and describe behaviours meaningfully, strengthening their voice in discussions with professionals. As Rachel reflected, “It gave the family confidence in what they were trying to explain.” 

Small steps, big impact 

Sometimes the outcomes are simple but transformative. In one case, a team identified patterns in how a woman communicated using vocalisations to show enjoyment and looking away to indicate refusal. Recognising these patterns led to the introduction of simple yes/no supports. 

A small change, but one that opened up entirely new communication opportunities. As Sam explains, this was one step within a dynamic assessment but “opened up an entire new realm of conversation and communication” for the individual. 

Final thoughts 

The Pragmatics Profile for People who use AAC doesn’t replace other assessments; it helps us listen differently by slowing down, noticing more, valuing all communication, and centring the person. 

Because ultimately, AAC isn’t just about giving someone a voice, it’s about understanding what they want to say and why.