Total communication is a highly effective approach for supporting children with autism (and other communication challenges) in learning to communicate, including developing spoken language. The concept of total communication emphasises using all available communication methods to ensure that the child can express their needs, thoughts, and feelings in the most effective way for them.
Total Communication Approach
The goal of total communication is to combine speech with other forms of communication to support language development and help the child succeed in social interactions. This might involve using multiple modes of communication, including:
- Speech: Encouraging verbal communication, even if it starts with simple sounds, words, or phrases.
- Sign Language or Sign Systems: Many children with autism benefit from learning and using sign language (e.g., American Sign Language or simplified sign systems). This can support expressive communication and help bridge gaps while verbal speech is developing.
- Picture Exchange Communication System (PECS): PECS is a picture-based system that helps children communicate by choosing pictures or symbols that represent objects, actions, or ideas. It can be particularly useful for nonverbal children or those with limited speech.
- Gestures: Gestures and body language (e.g., pointing, waving) can help children convey meaning and understand the communication of others when verbal speech is not yet developed.
- Written Words or Symbols: For some children, learning to read and write (or use a communication device with written words or symbols) may be a helpful form of communication, even before they are able to speak fluently.
- Augmentative and Alternative Communication (AAC) Devices: These are tools or technologies (like tablets or communication boards) that help children with limited speech produce messages through pictures, symbols, or text-to-speech functions. Examples include apps like Proloquo2Go, which allow children to build sentences with symbols or words on a screen.
Why Total Communication is Important
- Access to Communication: Not all children with autism will develop spoken language in the same way or at the same rate. By using a variety of communication methods, the child can still express themselves, participate in learning, and build relationships even if speech is not the primary or most immediate mode of communication.
- Supporting Speech Development: While some children may struggle to speak initially, using other forms of communication like signs, gestures, or picture symbols can help them understand the structure and function of language. This can provide a solid foundation for later speech development. For instance, when children use PECS or sign language, they are still learning the concepts of communication (such as making requests, expressing desires, or labelling objects), which can pave the way for verbal language.
- Reducing Frustration: When children can’t express themselves, they often experience frustration, which may lead to challenging behaviours. Providing multiple ways for them to communicate can help reduce this frustration and improve their overall emotional well-being.
- Increased Social Engagement: Children who use various communication tools may be more motivated to engage with others because they have access to a functional means of communication. Whether it’s a picture board, a communication device, or sign language, these tools can help the child feel more connected to their peers and caregivers.
Examples of Total Communication in Action
- A child might use sign language to ask for help, pointing to a desired object, and then use a speech-generating device (SGD) to say “I want juice” when they are thirsty.
- A child might first use PECS to request an item, and then gradually combine PECS with spoken words or signs as they begin to develop their verbal language skills.
- A teacher or therapist might use gestures and visual supports alongside speech to help the child understand and learn new words, concepts, and social cues.
How to Implement Total Communication
- Assess the Child’s Needs: Every child is different, so it’s important to assess their strengths, preferences, and abilities to determine which communication methods will work best for them. Some children may prefer visual supports (e.g., PECS or picture cards), while others may benefit more from sign language or a speech-generating device.
- Consistency Across Environments: It’s crucial that communication methods are used consistently across all environments—at home, in school, and in social settings—so that the child can generalise the skills they are learning.
- Collaborate with Specialists: A speech-language pathologist (SLP), occupational therapist (OT), or other trained professionals can help guide the development of a personalised total communication plan for the child.
- Encourage All Forms of Communication: Children should be encouraged to use any and all forms of communication—whether it’s spoken words, sign language, gestures, or technology—based on what works best for them. It’s important not to limit the child’s communication options.
- Gradual Transition to Speech: As the child’s communication skills improve, spoken language may become more prominent, but the goal is not to eliminate other methods. The child should always have access to the communication strategies that work best for them, whether or not they eventually use spoken language exclusively.
Benefits of Total Communication for Children with Autism
- Empowerment: The child gains more control over their environment by being able to communicate their needs, thoughts, and desires in a way that is accessible to them.
- Reduced Behavioural Challenges: Communication difficulties are often a trigger for frustration and challenging behaviours. When children can express themselves, they may experience less anxiety and frustration, leading to a reduction in such behaviours.
- Improved Social Connections: Using total communication strategies can foster better social interactions with peers, caregivers, and teachers. This can help the child feel more understood and connected.
- Better Learning Outcomes: When children have effective communication tools, they are better able to engage in educational activities and interact meaningfully with the world around them.
In summary, total communication is a comprehensive approach that includes speech, gestures, sign language, symbols, and/or assistive technology to give children with autism a full range of communication options. By using these multiple forms of communication, we can help them build the skills they need to eventually develop spoken language or, if necessary, use other forms of communication to thrive.