Getting Started with Eye Gaze AAC for Pediatric Users: A Practical Guide

By Courtney Smith, M.S., CCC-SLP

When a child has complex communication needs, Augmentative and Alternative Communication (AAC) can open up a whole new world. For some children, especially those with limited physical mobility, eye gaze AAC becomes the most accessible and empowering option. Getting started with eye gaze is not as simple as placing a device in front of a child. It requires thoughtful planning, support, and a child-centered approach.

Video: Amy McCaffrey using AAC with eye gaze in our Fort Washington, PA clinic.

Here are the key considerations when beginning eye gaze AAC with pediatric users:

1. Optimize Positioning for Success

Eye gaze systems rely on precise eye tracking, so proper positioning is essential. The child must be seated comfortably with head and trunk stability, and the eye gaze camera must be aligned with their natural eye line.

“A stable and upright posture allows for accurate calibration and consistent tracking, which are prerequisites for successful use of eye gaze technology.”
— Porter, G., & Kirkland, J. (2016). Learning to Use Eye Gaze AAC.

Use supportive seating, headrests, or adaptive chairs as needed. Even small shifts in posture can impact accuracy.

2. Start with Fun, Low-Demand Activities

In the early stages, the goal is not structured communication—it’s exploration and engagement. Begin with motivating activities like:

• Cause-and-effect games (e.g., “Look here to make the music play”)
• Choosing between favorite videos or characters
• Simple turn-taking games

These build the child’s understanding that their eyes control something meaningful—and that communication is fun.

“Engagement and motivation are crucial. Activities should be meaningful and immediately rewarding to the child.”
— Tobii Dynavox (2020). Eye Gaze Learning Curve.

3. Model with Aided Language Input

Children need to see AAC in action to understand how it works. Use aided language stimulation. This is where a communication partner models use of the device during natural interactions. This supports vocabulary development and device familiarity.

“Aided Language Input is essential for all AAC learners, and modeling on the eye gaze system helps children learn functional communication over time.”
— Goosens’, Crain, & Elder (1992). Engineering the Preschool Environment for Interactive Symbolic Communication.

4. Calibrate Often, Adjust as Needed

Children grow, shift positions, and get tired. Eye tracking systems need recalibration to keep up. Watch for signs of frustration or inaccuracy, and be ready to adjust sensitivity, dwell time, or calibration points.

5. Presume Competence and Be Patient

Many pediatric users are cognitively able to communicate much more than they can express physically. Presume competence and give time—time to look, process, and respond. Eye gaze communication often has a steeper learning curve, but the payoff is worth it.

“Presuming competence empowers the child and sets high expectations, which are critical to long-term AAC success.”
— Jorgensen, C. (2005). The Least Dangerous Assumption.

Final Thoughts

Starting a child on eye gaze AAC is a journey that requires a team approach—SLPs, OTs, families, and sometimes AT specialists all play a role. With the right supports and strategies in place, eye gaze can become a powerful tool for connection, expression, and learning.

Interested in learning more about eye gaze?

Parents, schedule an evaluation at Expansion Speech Therapy today!

Professionals, schedule a coaching call with one of our AAC experts today!

References

• Goosens’, C., Crain, S., & Elder, P. (1992). Engineering the Preschool Environment for Interactive Symbolic Communication.
• Jorgensen, C. M. (2005). The Least Dangerous Assumption: A Challenge to Create a New Paradigm.
• Porter, G., & Kirkland, J. (2016). Learning to Use Eye Gaze AAC: A Guide for Therapists and Educators.
• Tobii Dynavox (2020). The Eye Gaze Learning Curve. Retrieved from www.tobiidynavox.com