Facilitating early communication

The first Disabilities Expo has come and gone and, although tiring, it was very exciting to be a part of the event. It was interesting to see that our market is still primarily at low tech level. We had wonderful alternative and augmentative dedicated devices, head mouses, joysticks and rollerballs on display but they received relatively little reaction compared to the low-tech side. It is for this reason that I have decided to dedicate this article to Low Technology and AAC.

To develop good communication skills one must start as early as possible, beginning with the individual’s strengths and needs. The start-up costs are minimal. Displays and books are portable, and very easily made, customised, reorganised and updated. Often a combination of low technology strategies can be used at the same time e.g. wallets, communication boards and books, necklaces and AAC devices. The disadvantages of low technology are that vocabulary storage may be limited and communicating abstract ideas beyond the here and now may be difficult.

There may be heavy reliance on communication partners due to the lack of voice/print output which may result in AAC users becoming passive communicators. The use of low technology sometimes leads communication partners to underestimate an AAC user’s abilities.

Where does one start?

We will follow the progress of Savannah, a seven-year-old girl who has no functional speech. She had never used any symbols or communication aids other than a few self-initiated gestures. We started where she was at. We made symbols for eating, basic needs and socialisation. At first, her family used the symbols to talk to her until she got the idea of what the symbols were and what we were trying to do. Each person is unique and while guidelines can be used for implementation it is important to be led by the user.

We thought that, due to her lack of concentration, she would not cope with more than 30 symbols. However, learning to use these symbols to communicate increased her concentration and grew her social skills. We then introduced symbols to discuss her favourite activities.

Savannah copied her mother and started initiating conversation with the symbols by pointing to Monday and Swimming or Tuesday and tuckshop. Savannah progressed from a few symbols on a necklace to a Flip and Talk, then communication books and displays, to her current technique of alternating their use or using them all together, to ensure effective communication across all her communication needs and with her various communication partners. She also started to recognise the words written above the symbols so we are now leaving out the pictures in some of her symbols.

Savannah found the power of communication liberating and after seven months she now suggests what she wants for supper, when she is tired, what she did in her day, who she saw and best of all, when she wants some words added. In fact, right now we are struggling to keep up with her demands for added communication displays. Savannah has progressed to using a voice output communication device with her picture board displays. This too is a breakthrough as Savannah had sensory challenges and did not like devices. She recently spoke to her Grandmother in Durban using this output device over the phone and we were all truly amazed.

All activities can be represented in communication boards. Circle time activities are a great way to introduce communication boards as circle time is done daily in pre-school and these boards can be used over and over again. Parents can then use these same boards as a conversation starter with their child about their day at school. School worksheets and class activities can also be printed with Board Maker, which will benefit all children in the class.

What is perhaps not apparent is that if symbols are being taught as a means of communication, then these symbols must be put everywhere and used constantly and everyone must get on board and use the same method of communication.

Lastly, communication boards can be used at every level through school and in the workplace. For the individual using even the most sophisticated communication device, sometimes an alphabet board or communication board is the most accessible and effective means of communication.

Communication boards can be made very easily, rapidly and efficiently with Board Maker (even for inexperienced computer users!). Boards can be produced quite effectively with Clicker or Writing with Symbols if you already have these programmes. However, for these programmes, you would do well to purchase PCS Symbols to increase the store of graphics to choose from.

Here are some low technology ideas:

  • (Picture 1) A necklace with a few words or phrases worn all the time.
  • (Picture 2) A Grocery Shopping Board used by adults or children to simulate play or for a shopping request. These boards are pre-made.
  • (Picture 3) A play activity for filling the fruit bowl. Made with Board Maker, Laminated and Velcro Coins used at the back (hook side) and on the picture (loop side) for easy placement. These can be used over and over again by therapists and teachers.
  • (Picture 4) A play, language development exercise. All pictures are laminated and cut to size. Magnets are placed and the back of each picture and used together with a Magnetic Board white board. Notice a Yes, I do not know, and No symbol at the top of board. This is a very useful tool for nonverbal individuals. This was a dressing activity but it can also be used for stimulated discussion about seasons, hot versus cold and appropriate clothes for different occasions etc.
  • (Picture 5) Using Activity Sheet, Cards and Boards to stimulate and communicate.

If an individual cannot pick up a card, perhaps you can place a Velcro coin (hook side) on the top of the card next to the picture. The person will then put a mitten on their hand and pick up the card with the mitten. In this way you are sure that the person knows what you are asking and he/she is able to perform the task on their own. (Tip from: Enid Moolman, Speech Therapist, Nuwe Hoop School.) All these activities, boards. Velcro coins, magnets and programmes can be ordered through Inclusive Solutions (011 678 5685).

Please let us know if this article was of any value to you. Would you like us to investigate anything in particular, please send an email to inclusive@telkomsa.net with the subject Rolling Inspiration. In the next article we will be discussing the implementation of AAC Devices in the classroom and workplace.

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