We all know people who can speak volumes without ever opening their mouths. They use their hands, their body language, their facial expressions. Experts tell us that when we talk with each other, only 7% of our message is communicated by the actual words we speak. Now that we know that communication is not really about words -- it may be a little easier to look beyond words when we communicate with our kids who don't use words to "talk". Our tips today are divided into 2 groups -- #1) communicating their basic needs & the stuff in their environment & #2) sharing their ideas, feelings, & comments on life. So where do we start. Our words of wisdom:

#1 - Needs & Stuff

1. Start with yes & no - By starting with yes & no you give your child the ability to answer two very important questions: „X Are you (tired, hungry, thirsty, etc)? „X Do you want (a snack, your red shirt, to go to the park)? Another advantage of starting with yes/no is that it can be done in a variety of ways from the standard head nod to virtually any combination of motor responses. For example, twitching the left hand can mean yes & a head jerk can mean no. The key is to find something your child has good control of & to use the system consistently.

2. Choice making - The next logical step from yes/no is usually a point response. This allows you to offer your child a wider range of options. Instead of doing the time consuming one at a time choice you can offer your child a 2-3 choices at a time. If a point response doesn't work this can also be managed using head movements to the right, left, & center. Just be sure your child understands the choices & which item he/she is picking!

3. Word Labels - If your child is mobile & has a fairly large vocabulary (or if you want to encourage more vocabulary) word labels may be a good choice for your family. Labeling involves typing the names of frequently used objects in a large type size, laminating the sign & attaching it with velcro to the actual item. When your child wants the item they simply pull off the label & bring it to you. This works really well if you start with your child's favorite items. In addition to exposing your child regularly to written words this also encourages your child to initiate requests rather than wait on someone else to offer them something.

4. Touch Screens - Touch screens are a wonderful invention! They allow your child to experience the awesome sensation of being in control -- making things happen! In addition to this experience with cause & effect they encourage kids to get comfortable with the computer. Down the road that comfort & familiarity will go a long way towards helping them adjust to more complicated assistive technology devices.

5. Request/schedule boards - Request boards are simply photographs or black & white drawings of objects & activities that your child enjoys or needs often. They can be easilly updated as your child's favorites change & work well velcroed to wheelchair trays for kids who spend lots of time seated in a wheelchair. Even the pictures can be velcroed on if you have a really "changeable" child. This allows the child to select which pictures they want on their board at the beginning of the day. Picture boards also work well for school or family schedules & can help kids who stress about change know what's coming up next.

6. Show me - Perhaps the simpliest communication strategy is the simple "Show me what you need" response. This can be a real frustration reliever when your child just can't get the words out or make their body cooperate. The only drawback to this strategy is that kids rapidly become "sleeve tuggers" if you use this method regularly. A good way to prevent this is to build in step 2 right from the beginning. Once your child shows you the desired item, respond with "Oh you wanted your teddy bear! Great! Now, let's add a picture of teddy to your board so that you can show me the picture next time!"

#2 - Ideas & Feelings

7. Augmentative Communication Boards - These devices come in an amazing array of shapes & sizes (& prices) and can really allow your child to communicate an awesome variety of messages both practical & more abstract. If you feel like your child is ready for this level of device (a good clue is when they frequently seem to have things to say that they just can't communicate effectively) then there are several things you need to do: „X Find a good speech language pathologist to assist you. „X Have your SLP do a full assessment to determine what type of messages your child needs or wants to send & what types of devices they can operate or learn to operate independently. „X Work with your SLP to narrow down the number of possible devices to just 2 or 3. If possible try to borrow the devices for an in home trial period from a state technology lending library or the actual company that sells the device. „X Try to anticipate all of your technology needs up front. Who will train your child to use the device? Who will program the device, both now & as your child's needs change? Who will train your family & other support people in how to use the device? Who will repair the device if it breaks down? Will you need help to fund the device? If so, what do you need to do now to obtain the funding ? This sounds like a lot of effort & it can be. But if your child truly can utilize a communication device to "find their voice" everything you do will be worth it.

8. Teach typing - This may seem like an old fashioned suggestion, but give it some thought. Whether you use an actual typewriter or teach them to type on a computer keyboard you give them 1 tremendous advantage -- free thought. Your child will be able to say virtually anything (& they probably will!). This approach does not rely on anyone else to select pictures or program phrases. It's all their own creation. One advantage of going with the computer keyboard -- there is software available that can anticipate frequently used phrases. This saves valuable keystrokes for slow typists that may have lots to say!

9. Comment Cards - A decided more low key approach is comment cards. These are simply index cards with different comments typed on them in a large size. The cards can be color coded to help kids select the one they one quickly & easily. So, the red card says "I need a break" & the blue card says "I want a turn", etc. Comment cards work well for kids who see a lot of different people in the course of their day. Even folks they don't know too well will understand a printed message. Communication isn't so secure if they are relying on subtle body movements.

10. Switch activated signals - These signals can be operated a variety of switches that can be geared to virtually any controlled body movement. Signals usually consist of lights, sounds, or vibrations & work well if your child attends group activities where they need to communicate with the group leader. Common messages might be, "I'm done" or "I need help with this". Although these tips may seem simple we feel that most communication systems will actually use a combination of approaches. What works at school, may not always be right for home & vice versa. The most important things to shoot for when developing a communication system: „X Does your child understand the system & can they use it independently. „X Is your family & other people your child sees regularly comfortable enough with the system to use it every day. „X Is the system reliable & useful enough that it is working & in use more than it is broken or stuffed in a closet.

Hopefully some of these ideas will allow you to open the wonderful world of communication to your child! Happy chatting!

Copyright 2001, Lisa Simmons