The first AAC board should be small enough to learn and useful enough to say something real. Aim for words the person will need in the next week, in the places they already are: home, school, the car, and mealtime.

Start with people. Names of family, teachers, and friends belong on the first screen, because most messages are about someone. Add the words I and you so a sentence can begin without hunting.

Then add actions they can do or ask for: go, stop, help, open, eat, drink, play, and finished. These words work across the day. A noun like apple is only useful at snack time. More and all done work at snack time, play time, and bedtime.

Leave room for comments, not only requests. Words such as like, don't, good, silly, and uh-oh let someone react to what is happening. A board that only asks for things teaches a child that AAC is a vending machine. A board with comments teaches them it is a conversation.

Keep the layout stable. Put people in one place, actions in another, and describing words in a third. When a word moves, the motor plan has to be learned again. Add new words at the edge of a group instead of rearranging the words they already know.

Model before you test. For a few days, you tap the board while you talk: I want help, you go, that is silly. The goal of the first week is not a perfect sentence from the child. The goal is that they see the board used for real talk, many times a day.

When a word is missing and they reach for it, add that word. Skip the long list of objects until those words have come up more than once. Fifty words they practice will outperform five hundred words they never see.

Review the board after one week. Keep every word that was used or modeled. Remove a word only if nobody reached for it and it is crowding a word they need. Then add the next handful the same way: people, actions, and comments first.