Provide Adaptations to Support the Learner’s Participation (p8)

Since children with complex communication needs cannot rely on their speech to meet all their communication needs, we will need to provide adaptations to support their participation in storybook reading. They may use multiple modes to communicate. We can provide access to vocabulary by supporting the use of speech, signs, objects, communication boards with pictures, or AAC technology.  AAC systems should be selected based on the needs and the skills of the learner. The systems should be motivating and fun; they should be easy for the learner to use.

Some children benefit from using visual scene displays (VSDs) during storybook reading. These VSDs are scenes or pages from the book that are programmed into AAC devices and tablets using AAC software. The vocabulary for participation can then be programmed as hotspots. The child touches the hotspot to retrieve the spoken word or phrase.

But not the Hippo with hotspot addedVSDs are fun and are easy for beginning communicators to understand and use. For example, Gareth has severe cerebral palsy and uses AAC technology to support his communication. When he was 2 years old, he used VSDs of the pages of the book, But Not the Hippopotamus, to participate in book reading with his mom. He selected the hotspot of the hippo on each page whenever it was time to say the repeated line “But not the hippopotamus”. He also had other hotspots in each VSD so that he could comment on other parts of the story or ask questions.

Other children may use communication boards or AAC technology organized in grid displays. In this case, the display contains picture symbols, laid out in rows and columns on the display. Each picture symbol stands for a different vocabulary concept. For example, Maya was using a grid display on her AAC technology when she was reading the book about Maisie with her mom.

Here is an example of a grid display designed for reading the book, Goldilocks and the Three Bears. The display includes picture symbols to represent the characters in the story, the main actions, relevant descriptors, objects from the story, words to ask questions, and social comments (e.g., “oh no!”).  The child selects a picture or series of pictures to communicate a message and the words or sentence is spoken out.


*Research to practice

Recent research at the RERC on AAC has explored …Some children may benefit from AAC apps with features to support the transition to literacy (T2L). In these T2L apps, as the child selects a picture from the VSD or grid display, the word appears dynamically on the screen, originating from the picture and using smooth animation to attract the learner’s attention. The written word then stays on the screen for several seconds and the word is spoken out. The video below shows a demonstration of an AAC app with T2L features. Research shows that both children and adults with a wide range of disabilities increased their reading skills through the use of AAC technology with T2L features. Moreover, children with complex communication needs had fun using this app individually or with peers during small group storybook reading. The T2L features draw the learner’s attention to the written word and provide a clear link between the written word and the spoken word as well as the picture referent, thus supporting literacy learning.



Whatever the type of AAC – signs, gestures, communication boards, or AAC technology using VSDs or grids, with T2L features or without – what is most important is that the learner has quick and efficient access to appropriate vocabulary to participate in the interaction surrounding the storybook. It is important to include a wide range of concepts including the people, actions, locations, objects, and descriptors in the story as well as words to allow the learner to ask questions (e.g., What? Who? Why?) and make social comments (“That’s silly.”). Remember to also include vocabulary that will allow the learner to relate the story to his or her own experiences. Children may especially enjoy having access to sound effects that they can use during the story reading to add enjoyment (e.g., the sounds that the animals make in Brown Bear Brown Bear; or car and truck sounds for a vehicle book).

Provide adaptations to support participation

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