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Communication Tools for Children with Autism Spectrum Disorder
Categories: ASD and DD, Child-focused

By Sarah Helm, M.A., BCBA, LABA
Children with autism spectrum disorder (ASD) or other developmental disabilities often have difficulty making themselves understood. Many are nonverbal; others can talk, but their speech is unclear. Sometimes an inability to communicate their needs, wants, and feelings can result in increased problem behaviors such as aggression and acting out.
Fortunately, there are a number of adaptive communication tools that children with special needs can use to express their preferences and make requests.
Determining which tool may be most effective for a particular child depends upon a number of factors. These include his or her fine motor skills, ability to make choices, and aptitude with image-to-item correspondence (understanding that a picture of an item may match or “resemble” that same item in its real form). A child’s past experience with various modes of communication may also affect which form of adaptive communication would work best.
What makes a communication tool effective? Most importantly, the tool must enable the child to communicate independently with people who may have little or no exposure to, or experience with, the method they are using. The following are examples of effective communication tools.
Picture Exchange Communication System
One common way for children with developmental disabilities to communicate with others is by using a Picture Exchange Communication System (PECS). Individuals who use this communication system carry around a hard cover book that contains a variety of icons. These icons are usually simple words and images, so someone who has never been exposed to PECS would be able to understand their meaning or what they represent. The child can hand icons to another person one at a time, or line up words and images on a plastic sentence strip to express a need or request.
Although PECS is very functional and can enable communication ranging from simple requests to more detailed communication, there are some down sides to this communication system. Icons may be lost or wear out and need to be replaced. This is not costly, but it requires time. In addition, PECS may be something many people have never seen before and so it may be slightly more stigmatizing than carrying around an iPad.
iPads and other Voice Output Devices
There are many benefits to iPads. They are cost-effective compared to other voice output devices, can be updated frequently, are relatively small and lightweight, and have the capability to be completely individualized.
However, using an iPad to communicate does require learning new skills, and the iPad itself may be a distraction. Using it to teach a functional communication system can be challenging because a child may think of an iPad as a toy. There are features (similar to settings) such as “Guided Access” that allow a caretaker to block certain areas (such as games) while the communication system is being used.
Although iPads are more affordable than many other options, they are still expensive, and they are breakable. If you plan to purchase an iPad for communication, it is often necessary to also purchase software, and a very sturdy case to protect the iPad.
There are other voice output devices similar to iPads that will work well when introduced and taught appropriately to children. They offer many of the same benefits as iPads, but tend to be more expensive and take longer to repair if they break. Another consideration is the fact that insurance companies will cover some of the cost of certain voice output devices, but usually not iPads.
Teaching a child who is nonverbal or cannot speak clearly to effectively communicate his or her needs and wants can be a challenging undertaking. If you are a parent or a caregiver taking on this challenge, it is important to select a communication system based on an assessment of that child’s abilities. Helping him or her learn a new method of communication may require teaching or improving upon pre-requisite skills before systematically introducing and teaching the system.
School personnel may be able to help parents or caregivers select the communication system that is right for a particular child. However, if you are planning to buy a system to use at home and you need assistance, it is a good idea to contact a behavior analyst or speech pathologist who can help introduce the system to your child.  
Sarah Helm, M.A., BCBA, LABA, is the Clinical Director at the May Center School for Autism and Developmental Disabilities in West Springfield, Mass. She can be contacted at

May Institute is an award-winning nonprofit organization with more than 60 years of experience in serving children and adults with autism spectrum disorder (ASD) and other developmental disabilities, brain injury and neurobehavioral disorders, and other special needs. For more information, call 800-778-7601.