Picture icons are a great way of assisting with communication for children at all levels. The pictures represent objects and activities that a child might not yet be able to say.  They can be made from pictures you take at home and in the places you frequently visit. Using picture icons can decrease frustration for children who have limited verbal abilities as it can be a powerful way to indicate desired objects and actions. They can also increase communication and help establish expectations.

Non-speaking, or minimally verbal, children can be supported by parents at home by using pictures in simple ways. To introduce the concept, make a picture icon of a highly desirable food item, put it on the refrigerator with a magnet, and show the child that if she pulls the picture off of the refrigerator and hands it to you (or the other parent), the child can eat what she likes. Start with pictures from the wrapping the food is sold in, i.e., a cut out from the Cheerios box, and start with only one picture.  When the child understands the concept of the picture exchange, the parent can expand to two pictures.

Functions for Picture Icons

Picture icons may be used in numerous ways every day, including the following:

• To request desired foods/toys by handing over or pointing to a picture icon. Icons of your child’s favorite food can be placed on a fridge magnet. Then you can help her hand you the icon or point to the icon to request that food. Icons can also be placed on clear plastic boxes showing what toys are inside. Your child can request the item inside by using the icon. During a meal or a snack, children can choose between pictures to represent the food or drink items they want to request. There could be pictures of common food and drink items such as milk, juice, fruit, rice, bread, crackers, etc.
• To make a choice between two activities. For example, a child could choose between two DVDs, or between playing outside or reading a book.
• As a visual schedule showing the day’s events. For example, you can use picture icons to represent the following schedule of activities, so you child knows what to expect: Go to the store, Go home, Eat dinner, Go to bed.
• As a visual schedule showing steps within an activity. For example, the getting ready for bed routine may include icons that represent changing into pajamas, brushing teeth, reading a book, and getting into bed.

Combining Words with Picture Icons

Once your child has been taught to use picture icons to communicate her needs and wants at the single word level, she may be ready to move on to combine two or more words. In typical language development, children learn to combine words into short phrases once they have an adequate set of vocabulary words to use (at about age 18-24 months). Children typically begin by combining subjects plus verbs (e.g. “Car go,” “Mommy come”), verbs plus objects (e.g. “Go home,” “Drink juice”), and also modifiers plus objects (e.g. “More cookie,” “All done song”).

Picture icons combine very well with signs or verbalized words. Three words young children use frequently to request wanted objects and items are “more,” “open,” and “all done.” These words act as “pivot” words because they may take almost any noun following them and make a phrase. For example, in the phrase “more_______” the blank may be filled with words like “juice,” “song,” or “swinging.” A child using icons to express nouns and verbs can be taught to verbalize or sign the word “more” “all done” or “open” to be used in combination with handing of the icon to make a phrase (e.g. “more swinging” or “all done song” or “open juice”).

A phenomenon occurs in children’s language where they create novel utterances, ones they’ve never heard anyone say before, simply by using words they’ve learned in new ways. For example, you might hear a young child say something like, “More tie shoe” because you’ve tied one of her shoes, and she wants the other one tied as well.

By helping your child learn to combine her words into phrases (perhaps using icons), you’ll give her an infinite amount of ways to express her needs and ideas.

How to Make Picture Icons

Digital cameras and cameras on smart phones have revolutionized this process. Parents can take pictures of any item in the home, i.e., the tutu, the favorite stuffy, etc., and have them available for the child to exchange for the real thing. As children become familiar with the picture exchange system, the process can become more complex. Parents are encouraged to avail themselves of the expertise of the clinicians if they would like assistance in developing more complex levels of these systems.

Picture icons are easy to make using a digital camera or smart phone, a word processing program, a computer, and a printer. If you do not own these items, disposable digital cameras can be purchased at many drug stores. You can also gain access to a computer and a printer at your local library.

To create picture icons, you must first upload the pictures to your computer.  Save them in a specific file where you will be able to access them. The directions below are especially for Microsoft Word but any word processing program would work, although the exact steps may vary.

To put the picture in a Word document:

1. Open a blank document.
2. Click on “Insert”
3. Click on “Picture”
4. Select “From file”
5. Double click on the desired picture.
6. You will then see the picture in the Word document.

To re-size a picture in a Word document:

1. Right click on the picture.
2. Choose “Format Picture.”
3. Click on “Size”
4. Change either the height or the width.  If you change one, the other one will automatically change in the correct proportion.  You can either type in a number or use the up/down arrows.

To add a label to a picture in a Word document:

1. Highlight the picture.
2. Center the picture using the centering formatting icon.
3. Put your curser on the line above the picture.
4. Type the label.

An ideal size for picture icons is between 2” x 2” and 3” x 3”.  Several picture icons can be formatted onto one page. Once the icons are printed, cut them out and either mount them on heavy cardstock or laminate them to increase durability. Please let us know if you need assistance with any aspect of this process.