Gestures, Signs, Pictures, and Words: How Does It All Work? Part 3

Pictures, also called visual supports, play a great role in the life of a child, for they represent objects and activities that the child may not yet be able to talk about. Children with developmental speech and language delays typically demonstrate relative strengths in processing visual information; auditory processing may be highly challenging to the child with Specific Language Impairment. Visual supports are pictures, photographs, logos, icons, or picture symbols which present information to enhance a child’s understanding or active participation.

Visual supports reduce the need for oral language processing in order to understand an activity and allow the child to more actively participate in the activity. They reduce confusion by providing a road map for the child, who then can make decisions about how she wants to participate. The child, for example, can pick up a picture of a cookie and hand it to the clinician during snack time; for transitions to new activities, the child can take the “activity” picture to the appropriate part of the room where a Velcro poster has a matching picture which confirms the child’s expectations that the activity will occur in that part of the room. Transition cards and choice boards are the primary types of visual supports used in the Early Intervention program because of the young age of the children. Older children benefit from visual schedules which prepare the child for what is expected during the day, and visual sequencing boards which define the steps within a task.

Nonspeaking, or minimally verbal, children can be supported by parents at home by using pictures in simple ways. We recommend making a picture icon of a highly desirable food item, putting it on the refrigerator with a magnet, and showing the child that if she pulls the picture off of the refrigerator and hands it to the 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 use only one picture at first. When the child “gets” the picture exchange, the parent can expand to two pictures, then two pairs of pictures, etc.

Digital cameras and smart phones have revolutionized the 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 these systems.

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