Some children are unable to rely on spoken language to communicate all their needs and thoughts. They will need to use additional strategies or communication aids to help them communicate with the world around them. This is known as Augmentative and Alternative Communication (AAC).
Many children use a combination of methods in different situations depending on what suits them best.
For some children this will be a short-term solution to support them while their speech is developing. For others, AAC will be an important part of their communication throughout their life.
A Total Communication Approach supports children to communicate their wants and needs using whatever form of communication they can. This could include facial expression and body language, signing and natural gestures, symbols and pictures or spoken language.
Signing can be used to help children to understand spoken language, as the signs provide extra clues to what is being said. Signing can also give a means of communication to those that need it.
Research shows that signing can help your child develop their language. It will not stop them from learning to talk.
Core boards are colour-coded, grid-based symbol sentences focusing on core vocabulary. Core vocabulary is the words we use the most throughout the day. It makes up 75 to 85% of the words we use every day. This includes words we can use at different times of the day and with different people, like:
Core boards can support children to communicate for lots of different reasons including requesting, commenting, instructing, questioning and sharing opinions. They support language development by giving your child a visual support for the words they hear. This will help them learn what the words mean.
Point to symbols as you talk: This will show your child how to use the core board and help them understand the words you say. Don’t worry if there isn’t a symbol for the exact word you want to say. You can model phrases pointing to the functional words or symbols and adding in other words, for example “I want cheese”. You could also use the same symbols in different contexts, for example ‘not’ could be used for “not working – broken” or “I do not like it!”.
Extend your child’s language: Model language one step ahead of where your child is currently. For example, if your child is just starting to learn how to use their core board, model single words in context (more, help, stop, again). If your child can already communicate single words using their core board then model putting two words together (“I want help”, “not go”).
Comment: Use the core board to comment on the things your child is doing throughout the day.
Pause and listen: After you have used the core board to communicate something, pause to let your child learn and respond if they would like to. If they respond, listen to their message and respond to it so they know what they have communicated is important.
Make it fun: Use fast and easy messages during your child’s interests to motivate them, for example “go” in a car race or “more” to request more of something your child likes.
A communication book is a book or folder that helps people to communicate using symbols or pictures. They are used to help people who can understand more than they can say, or to support their speech if it is not always clear. They also support children with their language development.
Model: Point to the symbols in the book as you talk. This will show your child how to use the book and the types of things they can say. Show them how to find words on different topic pages.
Extend your child’s language: Model language one step ahead of where your child is currently. For example, if your child is communicating two-word phrases, like “more juice” or “want ball” then show them how to make three-word phrases, such as “want more juice” or “want big ball”.
Make it fun: The communication book is for chatting and commenting. Use the book during fun activities. Avoid using the book to test, by saying things like: “Can you find the symbol for book?”
Use the book throughout the day: Keep it with your child whenever possible or somewhere they can easily find it.
Pause and listen: After you have used the communication book to communicate something, pause to let your child learn and respond if they would like to. If they respond, listen to their message and respond to it so they know what they have communicated is important.
You may have heard of different communication apps and devices that are available to give people a ‘voice’. For some children, this may be their main form of communication. For others it may be to help when their other ways of communicating, such as using their spoken language, are not enough.
Your speech and language therapist will help you to know if your child would benefit from a communication device and which communication app would be the best for your child.
Children should always have a non-powered form of communication alongside their powered device, such as core boards and communication books.
Show your child how to use it: Everyone who is communicating with your child should use the communication device as well; this helps your child learn how to use it to communicate by watching and motivates them to communicate in the same way.
Pause and listen: After you have used the communication device to communicate something, pause to let your child learn and respond if they would like to. If they respond, listen to their message and respond to it so they know what they have communicated is important.
Extend your child’s language: Aim to model language one step ahead of where your child is currently. For example; if your child is just starting to learn how to use their communication device then model single words in context, for example “biscuit”. If your child can already communicate single words using their communication device then model putting two words together, for example “more biscuit”.
Make it fun: Use your child’s interests to motivate them to communicate using the communication device. For example, practise using it for things like snack time, chatting about favourite characters or people, or playing games. It should not be a test – show them how to find the words they can use instead of asking them things like: “Can you find apple?”.
Use the communication device throughout the day: Make sure the communication device is always available to your child to allow communication to take place. Model the use of the communication device to your child consistently throughout their daily routine. Repetition is the key to helping your child learn.
Picture Exchange Communication System (PECS) is a communication system that allows children to use symbols to requests objects and activities and to comment on the world around them. PECS skills are taught in a specific order of 6 phases. Phases progress from exchanging a symbol for an item a child wants, to using symbols to describe and comment on the world around them.
In the later phases of PECS children are given the opportunity to use spoken language alongside their symbols. If a child does not use their spoken language, they are still able to progress through the phases.
As your child progresses through the phases they will store their symbols in a folder (the PECS book). This folder can be fitted with a strap that will enable your child to carry their book with them. This means PECS can travel with your child most places - at home, in school, on the bus, at the local park etc.
Some parents may feel that their child can already go and get what he or she wants, so PECS isn’t necessary. This is fine until something goes wrong, such as their juice bottle is empty, or they meet somebody new that doesn’t understand them. It’s then that your child needs a means of communication to ask for what they need. Plus communication is for much more than getting things that you need. Think of all the reasons you might communicate: greetings and socialising, asking and answering questions, commenting on things around you, sharing your feelings, telling stories about what has happened and your hopes for what will happen.
The speech and language therapist supporting your child will decide if this is the right approach for your child.
Your speech and language therapist or assistant practitioner will work with you and your child’s setting to ensure everyone working with your child has the correct skills to support them.
Switches are buttons that play a short, recorded sound when pressed. A BIGmack is a type of switch. It is easy to record a new message on the switch and they can be updated throughout the day. They can also be connected to a device or toy that can be activated when the switch is pressed, supporting children’s cause-and-effect skills.
Switches are useful for children who:
Model: When introducing the switch, show your child how to use it during new activities. During the activity, give them time to press the switch themselves. If they do not, model it for them.
Visual support: Include a picture or symbol on the switch to help your child know what the purpose of the switch is.
Respond: Reward your child’s communication when they use the switch immediately. For example, if they use the switch to say “hello”, smile and say “hello” back. If they use the switch to ask for a snack, give them a piece of their snack.
Some children are not able to use their hands to point or sign. For these children, communicating by using their eyes to look at objects, pictures or symbols may be a consistent and powerful AAC method.
Children naturally look at objects and pictures around them. We can support them to understand that by looking at a picture or object, something will happen. For example, if they look at a toy, switch it on. If they look at a snack, offer it to them. This can be done with objects, pictures, or symbols.
Your child may have been provided with an E-Tran Frame. An E-Tran frame is a sheet of transparent plastic with a hole in the middle (like an empty picture frame) on which objects, symbols or letters/words are placed. The E-Tran Frame is placed in front of the child, either held by the communication partner or mounted on a stand. The child looks towards the option they want to communicate and the communication partner looks through the hole to see where the child is looking. As children become more skilled with their E-Tran frame, more items can be added and colour or number-coding systems can be used.
Only 2 or 3 options initially: To start with have 2 or 3 objects/symbols/words on the frame, making sure the top left and right positions are used first. Always include a ‘finish’ indicator in the bottom right position of the frame. The number of options available can increase as your child becomes more experienced using the frame.
Use objects or pictures/symbols: Use blu tack or Velcro to attach objects or symbols to the frame. Write the words on the back of the attached symbols so you know which your child is looking at.
Give your child time: They may look between the options before settling their gaze on one option specifically.
Some children may use their eye gaze to access powered communication aids instead of a mouse.
Your speech and language therapist can support with funding and setting up eye gaze technology if it is right for your child.
A communication passport is the important information about your child – their likes, dislikes, how they communicate and how best to communicate with them. For children with communication difficulties a communication passport allows people who are new to them to quickly learn about your child, what matters to them and how to interact with them. This will help to support your child during times of transition, in new places, or with new people.
Easy to read: Information should be concise and clear using simple language. Include photos and symbols where appropriate.
Highly personal: A communication passport should have the child at the focus. The key people around the child should work together to create the passport, including your child’s own views as far as possible. The communication passport should be written in the first person, for example “I am…”, “I like…”. The information inside should be positive about the child. The communication passport should be kept up-to-date so it is always relevant to your child.
Keep it near: The passport should be with your child at all times and easily accessible to those around, so in a hospital, keep the communication passport out on their bedside for hospital staff to refer to. Consider laminating to make it durable. You can have both digital and physical copies.
You can access Speech and Language support by calling Just One Number on 0300 300 0123. Our opening hours are 8am-6pm Monday-Friday (excluding bank holidays).
