Augmentative Communication

Augmentative Communication

I use some type of picture request system all the time with all types of challenges.

Where does a person start when it comes to this?

Augmentative Communication page has information for those of you who want more information on amplifying what you hear (like a hearing aid). switches to activate toys or communication systems (picture, computer, or eye gaze). is a company that has voice amplifiers and I've been very pleased with their customer service.  There is the Speak Easy (around $99) and it attached to your belt or can sit on a table.  It is very small, but carries your voice so that you can be whispering and others can hear you just fine through the Speak Easy device.  They suggest the pencil-shaped microphone or the throat microphone. is a company that sells switch activated toys and some augmentative communication systems ranging from the pictures on paper style to the computerized type.

Mayer-Johnson has the PECS (Picture Exchange Communication System) that is generally used by all.  Type this in the search box and you'll find them.

Remember you first need to determine what level of communication you are wanting: picture, picture/word, spelling, phrase from a picture or word, sentence from a picture or word, switch activated, scanning activated, typing keyboard style (QWERTY or alphabet sequence), and a whole host of other decisions need to be made before ordering.

Loan a device: Illinois Assistive Technology has a 'device loan' page and you can put down on their form to loan devices for 5 weeks and then send them back.
Learn about devices: is a place to obtain information on a whole bunch of devices.
pdf of a letter board:

You can make a "qwerty" style board by turning a word document page setting to 'landscape' and type across the letters like they are represented on a typewriter. If you'd rather have the "abcdefg" style of board, I suggest making one with all the vowels on the left:


I also suggest for certain types of communication challenges that you write 'somewhere' on the letter board: Tell me what you think I said and I'll spell out the part you didn't understand."

What would we do in therapy:

We would see what type of device suits your needs. The augmentative communication devices are 'pricey' and insurance may or may not help with the purchase. The homemade and handy ones are 'cheap' but not always the most efficient. The main thing is to make sure "EVERYONE" uses it in a conversation and makes changes to the system as needed.

How to use a Picture Request System with toddlers:

I divide the "communication intent" into 2 parts:
1. decide from the choices given in picture form and place the picture/icon
2. now that the decision part is done, now all they have to focus on is trying to say the icon choice (with varying amounts of assistance ie imitation, gesture-phoneme, and/or melodic intonation (discussed on the gesture-phoneme page)

Why do I use this with toddlers? Well, you are probably being dragged around the house to the place the child wants to communicate his needs/wants. The picture request system/notebook allows the discussion to be made at the couch; the way you did when you asked your mother for a glass of juice or something to eat. You didn't drag you mother to the refrigerator and stand with the refrigerator door open forever and hearing "What do you want?" and when you picked out something (nonverbally) and heard "No, you can't have that" and then tantrummed with the refrigerator door still we do all the negotiating 'on the couch'. I do not recommend leaving icons on the refrigerator door and in other rooms. Then the kid has to go out to the kitchen and bring it into the parent and that is too much work. This way, the entire notebook can go 'anywhere' ie grandma's house, daycare, restaurant.

I have a video of how to make the picture request system and how to use the picture request system. click here


More about Augmentative Communication:
The key to any system is to make sure everyone involved as a communication partner understands how to incorporate the system into all types of conversations. One cannot place on the responsibility on the person with the communication challenges to initiate its use.