Thursday, December 12, 2013

How to encourage a non-verbal child to communicate

"My son is 20 months old and though he lacks a diagnosis, has many symptoms of cerebral plasy—he lacks a suck/swallow reflex, has significant motor delays and will likely be non-verbal. There are questions about his hearing, but it's clear to us that he understands what we say and can follow direction (when he wants to). We are told his cognition is very good, which is really the only good news we've gotten. We're seeing a speech therapist who specializes in AAC but as I've learned, we have to do our own research to educate ourselves and make sure we're asking the right questions. So, that's why I'm emailing you. Can the Proloquo2Go work for kids who can't yet read? Have you used any other apps that you've found useful? I recognize that Max didn't have access to an iPad when he was a little one since they didn't exist, so I'm really curious what worked for you and how you helped Max express himself."—Shanna

When Max was two, we wanted to make sure he had a means of sharing his wants and needs. So we did the most basic thing: We snapped a bunch of photos of stuff in his life, then taped them onto pages and labeled them by section: People/Toys/Clothes/Breakfast/Lunch/Dinner/Places To Go. We assembled them all in a looseleaf binder. When we opened the page for him, he could basically gesture at what he wanted (he hadn't yet started to point or shake his head). It did the job.

Eventually, we moved onto the PECS (Picture Exchange Communication System). It's an alternative communication option involving illustrations and is more advanced, in that a child has to understand the concept of drawings representing reality. They feature words.

Pictures about feelings, for example, look like this:

We also put labels on different items around the house and we'd name them throughout the day, to help Max make connections between words and objects. 

Max had a Dynavox device for a couple of years, which he mostly used at school. We found it overly complicated to program, but the latest version looks easier to use and now there's an app that can be downloaded. And then, iPads came around along with The Proloquo2Go ($219.99), also based on illustrations with words. That was a big game-changer for Max, who took to the technology right away (he loves computer anything). A couple of years ago, Max appeared in a demonstration video made by the company: 

A child doesn't have to read to use the P2Go. You can create a super-simple page layout (say, just three images) and it can grow with a child (Max is now putting words together to form sentences). And you can upload photos, too. A child just needs the manual dexterity to tap the images; the P2Go actually encouraged Max to isolate his pointer finger. 

Of course, there's the X factor—whether or not your child takes to an app. Other options I've heard about: My First AAC app, which as you'd expect is very basic—but is also just $24.99.

There's also a great app called Speak for Yourself ($199.99). Dana Nieder of Uncommon Sense has written about the success her daughter Maya's had with it; there's a free version on iTunes, Speak For Yourself Lite, to try. Here's Dana's video review (read more about their communication journey here):

Parents, speech pathologists and AAC specialists: What tips do you have for encouraging communication in tots who aren't verbal? What are your experiences using speech apps with young children? Please, share.

PECS images: amp'ed


  1. My recommendation is that to start using something now. Be it PECS or something like Proloquo2Go. All the research that I know about indicates that using other ways of communication will not hinder actual speech if your child is able. By starting now you are teaching your child that they can (and must) communicate. Since he is so young, this also gives you time to learn how to use a communication device with him (sounds easier than the reality) My son has autism and is non-verbal, so my big issue has been trying to teach him the advantage of communication. You don't have to be a reader to use P2G. And you can put sentences and phrases under the buttons. (This is how my son gives a presentation at school.) This allows you to modify what the icons say in a manner similar to how a child learns to talk (e.g. single words, 2 word phrases, to sentences). It is super easy to add words to. P2G has a ton of icon pictures, but it is also very easy to add your own.

  2. Kyle is 7 years old and nonverbal. Like Max, he pretty much went the same route over the years. We also began by snapping photographs of the common things in our house he would want/need. I put Velcro on the back and stuck them to a posterboard on the side of our kitchen counter. He would take the picture off himself and give it to us. His speech therapist next moved to the traditional PECS, and for the last several years he has had the Proloquo2go App. The only thing I would have done differently was to get assistance in how to incorporate the App in our everyday life and more training on how to customize it. It was a new program, not many therapists knew how to use it, and so I felt I was figuring it all out on my own. It's working for him, though, and now all of his therapists and teachers are on board with using it with Kyle.

  3. Definitely look at Dana's blog. Her daughter is non-verbal with physical issues but is very bright. She has had good success with SFY.

  4. My son is 6, ASD, minimally verbal. We also started with PECS. I agree it's good to start low-tech. We found that when we started with P2G at around age 3, it wasn't very effective. (This was also before Apple created Guided Access, which allows you to disable the home button, so it was hard to keep him on the app.) Buy yourself a laminator (there are probably some good deals on Amazon right now) and take pictures of everything your child could possibly want and laminate them. I labeled dresser drawer with pictures. I created pictures for TV shows my son liked. I created pictures for members of the family, and favorite foods. Instead of a PECS book, i started by just hanging them on a teacher-style "pocket chart" within reach. That way, he could just toddle over to the chart and hand me what he needed.

  5. No matter what App you use - it's about working out what they like and then teaching them to communicate appropriately to get it. This is what BF Skinner called "Verbal Behaviour" where the speaker understands they have to engage a listener. This can be with sign, pecs, an App or words, but it is only if they are using it to get your attention. I wrote a manual on how to identify reinforcers, to take control of them and then teach a user how to get access using a prompted means like pecs or Grace App. Remember, it's about what they want, not what you think they want. Once you have that fluent you reduce frustration and enable more communication based on their interests and needs. Follow the child into their world and they in turn might wanna take a step into yours. "Guide to Grace App" is where you can download the manual for free.

  6. Ellen:

    I work for Bethesda Lutheran Communities and we have a resource called "Connecting with People Who Are Non-Verbal." If you or Shannon would like to take a look, I'd be happy to send a copy over to Shannon if she thinks it will help.

    You can check it out here to see if it seems like something she'd find useful.

    Just drop me an email at with Shannon's address and I can get it out to her.


  7. Does anyone have experience with switching devices? My son (now 17) has been using a Dynavox at school with modest success. He will not use it at home. I am considering trying a visual scenes based AAC like Autismate or GoTalkNow for communicating at home/daily living and SLPs are talking me out of it. They say switching systems could be a major set back. We agreed to try visual scenes on the Dynavox and see how that works. Help!!!

    1. Hi Randi,

      My name is Jeff Stillman. I'm a Marketing Strategist at SpecialNeedsWare, creators of AutisMate. I'm happy to answer any questions you may have about AutisMate and how it can help your son. Feel free to contact me at I hope this helps,

      Jeff Stillman

  8. Love. We're using the ipad, too. Just love the commercial.

  9. I am an early intervention teacher. There is a growing body of research supporting the use of visual scene displays versus traditional grids with young children. The thought is that a visual scene is more concrete for our young learners and that traditional grids are too abstract and compartmentalized. I am still researching this as the concept is very new to me. We have had great success with PECS and this is often the first step with a child if the child has the motor ability to exchange a picture. PECS does a great job of teaching the critical step of initiation. We also use many voice output devices from a single button to a 6 picture grid. As far as apps go, we use Talkn' Photos, Clickn' Talk, My First AAC, Tapspeak Button, and have recently added the visual scene display app, Scene Speak to our toolbox.


Thanks for sharing!

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