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Samuel learns to use his knowledge of symbols with both low tech and high tech communication aids.
A photo of Samuel

Samuel has a diagnosis of cerebral palsy which affects his fine and gross motor skills and his ability to speak. This means he is unable to walk and finds it difficult to control his hands to do basic tasks. He wears glasses to correct his vision. Samuel attended a conductive education early years setting part time and now attends a local special school.


Samuel uses a combination of different ways to communicate including facial gestures, some sign language and vocalisations. These are all effective strategies but were not always easily understood by others, so it was important to find ways that he could make himself understood to others more easily.

Samuel was introduced to the idea of using photographs and symbols for communication from a very young age. These were used to help him understand actions and events. He developed his knowledge of photographs and symbols and learned that these can represent meaning. To begin with Samuel watched his mother pointing to the symbols and images, but over time he began to use these for himself.

In finding ways to help Samuel communicate, it was important to think about the type of activities that he enjoys and identify some opportunities to encourage him to communicate in lots of ways. Samuel has always enjoyed sharing books, but frequently became frustrated when unable to turn pages of a book by himself. Some simple ideas were introduced to help Samuel to do this.

Small piece of sponge attached to the corner of the pages created a gap big enough for Samuel to place his fingers. Velcro dots, foam squares and tabs were also used

. A book with sponge pieces for easy page turning

With a gap between each page, Samuel can turn the pages by himself.

Samuel turning pages in a book

Samuel’s enjoyment of books provided an ideal communication opportunity. He was introduced to a Voice Output Communication Aid (VOCA) with some messages that enabled him to join in with his favourite story. Samuel soon learned that pressing the different buttons would make the device speak the messages and enable him to have some fun.

Samuel soon learned that pressing the different buttons would make the device speak the messages and enable him to have some fun.

Samuel using a Voice Output Communication Aid

Samuel was introduced to voice output communication. He could join in with the story by adding some sound effects.

VOCA image

Some messages were then added that allowed him to communicate about the story.

VOCA images 2

To begin with Samuel found it difficult to activate the messages on his TechTalk. He was able to reach all the buttons, but found it difficult to apply enough pressure to make the device speak. To help with this Samuel was given a ‘touch enabling device’. Commercial Touch Enabling Devices are available, but for Samuel a simple chunky pen was sufficient to apply enough pressure.

Samuel’s overlays for his TechTalk were stored in a book. This meant that Samuel was able to point to these as well as use his TechTalk depending on what was easiest for him to do at the time.

Samuel is using a low tech book to choose the colours, and his TechTalk to talk about the playdoh activity.

Samuel using a low-tech book to chooce colours

This is Samuel’s overlay for his playdoh activity. He can give instructions and make comments.

Playdoh Overlay diagram

Samuel quickly expanded his recognition of symbols and soon needed access to a wider range of messages. His collection of overlays and symbols were reproduced as a Communication Book. Samuel has a better range of movement left to right, so his pages were set up in a landscape format. A fold out flap provides space for extra vocabulary and contains the messages that Samuel uses most frequently, his ‘core’ vocabulary.

Samuel has developed his fine motor skills sufficiently for him to be able to turn pages by grabbing tabs, which are attached to the edge of every page.

Samuel enjoys using his low tech communication book. He is building sentences using his core vocabulary on his fold-out page on the left, and the topic vocabulary on the right.

Samuel using a low tech communication book

Samuel has had lots of opportunities to use his Communication Book and his TechTalk voice output communication aid. This has allowed him to learn new symbols and understand new words. In order to keep up with his expanding vocabulary he was given a chance to use a more complex communication aid called a MightyMo.

This communication aid is a dynamic screen device, which means that the pages can change. Initially Samuel did not explore the dynamic pages; instead his communication partner would find the right page for him. However, just as Samuel remembered where to find vocabulary within his low tech communication book, he has also learned to move around the pages on his high tech device to find the vocabulary that he needs.

High tech communication aids have features that are similar to a computer. Many can also be programmed to send infra red signals. This feature was used to enable Samuel to operate some of his remote control toys.

Samuel is using his communication aid as a remote control for his train. He has the infra red signals programmed in to his device. Samuel can chat and play with others.

Having been given plenty of time to practise using a high tech device, Samuel now has one of his own. He is learning to build up sentences and is also adding in ‘please’ and ‘thank you’ to his requests. He continues to use his Communication Book as well as his Voice Output Communication Aid.

Samuel’s pages are organised around the different activities that he does.

Samuel's remote selection page 1

This is an example of one of Samuel’s pages. He is beginning to build sentences himself.

Samuel's remote selection page 2

Samuel’s communication aid has required lots of programming to make it personal and appropriate to him. This will continue as his communication skills develop.

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