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TeachNet NYC: Lesson Plans
Moving from Talking with Pictures to Speaking with Words and Sound

Background Information:
It often becomes obvious that a nonverbal student becomes frustrated when he/she wants to convey a message and the appropriate vocabulary is not available on his/her manual communication board(s). Also, the board(s) become limited in the amount of information they can convey when they are filled with pictures. Pictures are often used to convey only a single message. Words, on the other hand, can be strung together to form more complete sentences and complex thoughts, as well as enhance literacy skills. I find it absolutely necessary to move the student from pictures to words (or a combination of both) on manual communication boards to eventually an electronic voice output device. When the student is ready for a device that has voice output - a whole new world has opened up for them - they can now "speak" so others can hear them. While using manual communication boards, they have to make sure that they have the attention of a communicative partner focused on their board. This is not always easy to do, especially in a classroom. (Some electronic voice output devices have the ability to change the voice in order to match that of a speaking child the user's age as well as change to more mature voices as the student ages.)

Goals and Objectives:
a) To determine the necessary, frequently used vocabulary on a student's manual communication board(s) and develop an assessment tool in order:
b) To replace Mayer-Johnson picture symbols with words on student's manual
communication boards.
c) To move the student from manual communication boards to an electronic voice
output device.

Estimated Time:
The assessment process should be on-going as the needs (vocabulary) of the student changes with time. Speech services are provided during 30 - 45 minute intervals from 2 - 3 times per week. It is suggested that this assessment should be done at least once during the week.

Prerequisite Knowledge and Skills:
The student has demonstrated ease, frequent and appropriate use and a comfort level in using his/her manual communication boards.

Speech therapy room or classroom.

Interdisciplinary Areas: Reading, Communication, ESL


  1. Teacher created assessment: Data sheet created in ClarisWorks assessing the students ability to match words and pictures and identify words without the pictures. See attachment #1.
  2. Strips of Mayer-Johnson picture symbols (without the words), laminated and cut. [These pictures and words should be taken from the student's preexisting manual communication board(s) so they are familiar to the student - logs have been kept to determine the most frequently used vocabulary. Log created in ClarisWorks. See attachment #2]. The size should be 1 - 2 inches depending on the visual abilities of the student. Strips of the corresponding words, laminated and cut.
  3. A thin strip of (hard) velcro should be placed behind each picture at the top. A thin strip of (soft) velcro should be placed above each word at the top.


  1. Ask the student to give a requested word by lifting it off the picture. (The student is initially allowed to look under the words at the pictures if necessary).
  2. Ask the student to match the word to the picture by velcroing (putting) the word back on the picture.
  3. Ask the student to give the requested word. This time the words should not be near the pictures but arranged on the table randomly.

** The therapist or teacher is recording the data throughout this activity. See attachment #1

Homework: A ditto will be sent home in which the student has to draw a line from the word to the picture using that day's assessed vocabulary. Homework created in ClarisWorks using Mayer-Johnson picture symbols from Boardmaker. See attachment #3

Follow-Up Activities:

  1. At the beginning of the next speech session the student will be asked to give requested words as part of a review.
  2. The speech therapist will convert the "old" communication board to one filled of words as the student masters them.
  3. Once the student has developed ease with his/her new communication board - a referral will be made for an electronic voice output device. Most schools have programmatic devices in which students share them in the classroom and throughout daily activities. These devices should be used as part of the initial assessment. [An initial assessment must be done in order to determine what type of device is appropriate. Different states and schools have different procedures regarding referral and assessment of devices. For helpful hints to get started you can contact me.]

Helpful Hints:
It is important to have all staff members working with the student (classroom teacher, paraprofessionals, OT, PT, coverage teachers, and administration) as well as the student's parents and close family members as involved as much as possible. Input from different professionals and family members can only enhance the student's achievement and success.

When your student finally gets an electronic voice output device don't be surprised if you find yourself telling the student "Shh, it's time for quiet." The excitement is overwhelming once the student learns he/she finally has a voice and he/she wants you to hear it!

Success in learning and using these devices is also determined when the student turns from having mostly adults as their primary communicative partners to seeking out other students in their classes as well as peers in the general education settings. The logs from home also help the therapist and teacher see how their language blossoms from the usual requests for food or toys to more socially appropriate and needed expressions. For example, a child who has never been able to verbally tell her mother that she loves her is now able to do so by activating one "button" or "cell" on her device: "Mommy, I love you!" Many parents have reported that such phrases as these bring tears to their eyes because they have longed for their child to "speak" for so many years. That alone makes it worth all of the time and effort that everyone involved has contributed!

Related Links:
http:// assistivetech.com

A communication board is a means of communication used by individuals who are nonverbal, unintelligible, recovering from strokes, or those who cannot verbally convey their wants, needs, etc. The boards usually consist of one or more of the following: picture symbols combined with words, words alone, the alphabet, and numbers. The individual using a communication board points to the message they want to convey and for those physically impaired, a switch, light/head pointer, etc. is designed to meet their needs.


Michelle Flammia
Michelle Flammia is a teacher of the speech and hearing handicapped. She works with elementary autistic students in Bayside, New York.

Subject Area: AAC (Alternative Augmentative Communication)

Grade Level: Elementary Autistic - can be used with all nonverbal students

E-mail: MISHL5150@AOL.COM

School: P.S. 224 @ P.S. 710


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