Communication Strategies

Communication requires 2 people: a listener and a talker. The 'listener' holds a lot of power in that they determine whether or not they will accept how one has talked. When they tell the 'talker' that they won't accept the way they communicated, then the 'talker' has a choice of either tantrumming and convincing the 'listener' to accept or go back to the old way they used to communicate OR change. This is the ONLY way to get a 'talker' to matter what age. That is why is it so important that the speech pathologist work with the significant other(s) so that they control the amount of change of the 'patient'. Once I can get parents of toddlers to see this....we are on our way to creating more instances of the child practicing to communicate the way they would like them to communicate!

When a person can't come up with the word..... First of all, of this is going to be an ongoing challenge, discuss with the person if they wish to show a 'hi sign' with his hand that he still wants the floor to speak OR if he wants you to help with saying the word and get on with the rest of the conversation. Respect their wishes and tell friends and family of 'the rule' so it can be respected.
When you are asking a person 'What do you want?'...... You might want to give choices instead of an open ended question. Example: "Do you want your green or red shirt?", "Do you want juice or water?". This also has you staying away from yes/no questions all the time.
Refrain from yes/no questions These get boring and limit the opportunity for the person to communicate 'they want something else' or what else is there to consider before giving a final answer.
When you can't understand or hear what a person said..... Instead of saying 'what?' and the person feels they have to state the whole thing again, you state what you think you heard and the other person then only has to repeat the part they feel you didn't hear correctly or understand.
To change a yes/no question quickly into verbal response of yes/no or a choice question.... If you catch yourself always asking yes/no questions that you might say "Do you want more? SAY yes or no?" or "Do you want milk? or water"
Use gestures, drawing, spelling, or a list to refer to common information A picture says a thousand words, sometimes. I'm not big on 'sign language' because it limits your communication partner to those that know your signs. It also requires ALL communication partners to know at least 500 signs and I haven't known anyone that ambitious. Letter/word or picture communication systems have their place.
How do you create a Picture Request System?
and a video
You need a 3-ringed binder (1/2 inch or 1 inch), 3 or 4 colored felt squares that are 8x12, 2 inch clear packing tape, sticky back velcro strips, and a scissor to ruin cutting the velcro. Line up the felt squares to the rings of the binder and make scissor cuts to you can place the felt squares into the binder. On the front of the binder you want 2 stripes of the fuzzy (not the scratchy) velcro. The top row will be the "I want" line and the second row will be where you put the icons representing the choices. The felt squares is where you house the various icons you create. Create pictures to represent what you want to reference and "laminate" them on the front only (scratchy velcro sticks better if the back isn't laminated) with the 2" clear packing tape. Pull the backing off the scratchy velcro strip and cut small 3/8 inch pieces with the scissor you don't mind ruining & place it along the top center of the icon/picture. I have probably confused you by now and you should call me to get it figured out. I also put together a
Spelling Board pdf

I like this style of a spelling board (the vowels are all on the left side for quick reference). Sometimes the erase-end of a pencil is easier to use as a pointer than a finger:

A b c d
E f g h
I j k l m n
O p q r s t
U v w x y z
Start Over

Ideas of tasks to do with your 0-3 year old child:

Puzzle Activity:  hold up 2 pieces of the puzzle and ask which one she would like; if she doesn’t state the name of object in the puzzle, state do you want the ‘____ or the ____?”; if she doesn’t state one of the names, tell her you will wait until she tries to tell you.  The final presentation style is to have her repeat the name of the object to receive the piece.  Praise her for using her words instead of grabbing for the pieces.

Book Activity: instead of reading to her, have her read and praise her throughout for ‘reading’.  Another venue is to point at objects in the pictures and have her state the names or have her point and you state the names (her stating the names if preferred). Asking who, what, where, when, questions in regards to the pictures also increases her vocabulary and comprehension.  If she doesn’t know what type of response to give, present it as “Is the ____ or _____?” with one of the choice obviously not even close to being an answer.

Craft Activity: hold up 2 choices of colors or names of pieces uses and state “do you want the ____ or the ____?”.  This includes color to choose for playdough, handing her cookie cutters by field of 2 choice instead of just grabbing for them. 

Free Play Choice:  ask where (which center) does she want to start her play.  If she doesn’t know the name of the centers (kitchen, book, paint center), give her a choice of 2.

Choice of toys also is a way to incorporate communication goals. Instead of saying a yes/no question ie "Do you want your blocks?", ask "Do you want your blocks or a book?".  Consider stating, "I'll wait until you tell me." and use pictures of the choices (even if they are rough hand drawings on paper) for the child to point to a choice and state the word.

 Use gestures along with the words for “I want” to encourage later for her to state from just watching you do the gesture.

 Have her imitate “my turn”, “move”, and “I want” phrases along with gestures in various interactions with peers. 

 Choice of drink:  “Do you want _____ or water?” . If no response state “I’ll wait until you tell me.” 

Utilize the picture request system, melodic intonation, and gesture-phonemes all references on

What would we do in therapy? We'd see what type of augmentative communication is appropriate and then practice with your communication partners how to utilize the system.


Communication isn't.....
just talking. It's first having the ability to comprehension (visually and auditorily) as well as attend to the conversation and have cognition (intelligence for vocabulary to know what is being said by the listener) and then finally speech intelligbility to be understood. That's why I say that Speech Pathologist work with brains and Occupational Therapists work with hands and Physical Therapists work with the feet.

Below is how to communicate with a person that has limited verbal or processing (word finding or comprehension) abilities:

Decide what you want for a response:

 1. word for food/object

 2. word from a choice of two “____ or ____”

 3. “more” or “all done”

 4. “yes” or “no”

If want Word reponse say: “Do you want ______?  Say ________”

                  Use gesture/phonemes

            Use sing-song voice, hold out sounds or duplicate the sounds (b^b^)

                       If he doesn’t imitate decide if you want to:

                        “I’ll wait until you try”

                        “Do you want _____? Yes of no?”

            If he doesn’t state yes/no, then use hand over hand assist to move his head and state “You are getting _____ because you told me ‘yes’ with your head”.                       

If want Word from Choice response say: “Do you want ____ or ____?  Use gesture/phonemes, pictures with pointing/taking.  Use sing-song voice, hold out sounds or duplicate the sounds (ex: /b^b^/)                                           

If he doesn’t imitate decide if you want to choose one for him and use Word protocol or go to yes/no protocol.

If you want a “More” or “All done" response say: “Do you want “more” or are you “all done”?”           

Show pictures of the choices along with gestures. Use the gesture/phonemes while you say these words. Praise him for pointing/taking and then request him to repeat the word with the gesture/phoneme.                    

Use hand over hand assist with the gestures and then praise him for telling you instead of crying. 

“You just told me ‘more’ with your hands; that is why you are getting _____ and not because you are crying”.                          

If you want a Yes/No response say: “Do you want more; Yes or no?”

                                    OR “Do you want ______; yes or no?”

Use gesture/phonemes while you say these words. gesture.pdf

Use hand over hand assist with the gestures and then praise him for telling you yes/no instead of crying. “You just told me ‘yes’ with your head; that is why you are getting _____”