The communication partner needs to commit to pointing to symbols as they talk with the learner, and to embrace the strategies and aims outlined at each stage in the guide. Learning to communicate through a different medium can feel daunting at first. This is a normal reaction. Be brave, have a go, point to some symbols as you chat, make mistakes, and have fun. After all, that’s what learning is all about. On the plus side, it is easier than learning sign language or another spoken language, as you don’t need to remember the signs or words – all the symbols are labelled for you.
It’s a journey you will take together. As you become confident in symbol communication you will inspire others around the learner to have a go and find pleasure in communicating in this way.
It works well to introduce eye pointing to symbols within fun and motivating activities. Ideally these activities will be ‘no fail’. In other words, activities which don’t have correct and incorrect outcomes. Examples might be blowing bubbles, looking at photos on a smartphone together or playing with a doll. Whatever the learner really enjoys.
Once you have all gained confidence in using this way of communicating, you can expand beyond the fun activities to developing a full and rich communication book.
Communication partners can sometimes feel anxious about reading eye pointing. It can be hard to decipher, particularly when you are just getting started, and you may find yourself worrying about whether you have correctly understood. This anxiety can be very off-putting for both you and the learner, particularly if you start double checking every time whether you have got it ‘right’. An approach that can work better is to simply point to and speak aloud what you think the learner is looking at. If you have got it really wrong, they can let you know!
Introducing eye pointing within the no fail activities discussed above can also help alleviate any anxiety. If you do misinterpret what the learner is looking at, there are no adverse consequences. It is simply a learning opportunity. When playing with a doll for example, if the doll’s hair ends up being brushed rather than the doll being given a bottle, all can learn from this, but there is nothing to feel worried about and no sense of failure.
Each stage in the guide introduces and develops skills that you can use to support the learner to become a competent and confident communicator.
The first skills that you will need to master are watch and respond. This simply means that whilst engaged in a fun activity, watch what the learner is looking at and respond / react to this. It sounds so simple, but these powerful strategies can help the learner to understand that they can communicate using their eyes. They also underpin the rest of the skills you will learn. Using watch and respond is a very rewarding way to interact with the learner.
Modelling symbols is another essential skill that will be introduced. In other words, you will point to relevant symbols as you chat. There’s no need to match every word you say to a symbol when you are modelling – just the main ones are fine. As you become familiar with the symbols, you’ll find all sorts of things you can say. The learner will see you using the symbols when you are talking to them and begin to understand both what they mean and how they themselves could use them.
You will be encouraged to take your time when modelling. If you avoid rushing, you may find that the learner joins in too, and if they do, make sure you respond! This approach is enhanced by the strategy of waiting expectantly. This means that you signal with your body language and facial expression that you are anticipating a response, which may provide additional encouragement to select a symbol. But if they don’t, just carry on pointing to symbols as you chat.
As you move through the stages, the skill of modelling will be developed so that you are teaching the meaning of the symbols themselves, how to select them using the colour encoding system that is introduced during Stage One and how to find symbols within the book. Talk out loud as you do this so the learner understands what you are doing and why. For example, you might say “I’m hungry. I need the food & drink page” while pointing to the food & drink page symbol on the Menu page and then turning to the page.
From Stage Two, you will also be encouraged to support the learner’s developing use of symbols by adding to what they say. In other words, if they say something to you, you might repeat it back including an additional symbol. This is how we instinctively interact with young children learning to speak – we are all natural language teachers.
At Stage Three, you will be introduced to the idea of summing up an activity. In other words, you will recap what has just taken place by talking through it and pointing to symbols. This is another way of using modelling to support the use and development of language in a meaningful way. In time, the learner will be encouraged to share that information with others.
From Stage Four, you will also be encouraged to really develop the learner’s ideas, helping them to produce more complex messages using symbols.
There’s no right or wrong way to place the book. What matters is that the learner can see the symbols and you can see what the learner is looking at.
If the learner’s head is well supported, and they are comfortable, it will be easier for them to use their eyes to communicate. You may find the following strategies helpful:
Making use of a headrest.
Positioning the book at their eye level.
Adjusting the height of any table.
Having the book between you initially, and then moving it to the side as you gain skill in reading the learner’s eyes.
Young children with complex physical disabilities may find it hard to change position or even wriggle. Yet young children without disabilities are constantly on the move! The young learners in the project all concentrated and engaged best if their position was regularly changed. This principle may apply to an older learner too.
Like all children, young people with complex physical disabilities love to play. They may find holding items difficult, but if you can help them to physically hold, touch, knock down or interact with the play items in some way, their attention will be sustained for much longer. This will enable more opportunities for communication. Again, this principle may also apply to an older learner who might enjoy being helped to physically interact with cooking ingredients, for example.
Photos are great for representing very specific items and people, but when it comes to words like ‘help’, ‘friend’, ‘meal’ or ‘dog’ (rather than my pet dog called May), then you really need a symbol.
There are several different symbol sets used in the UK, and you will need to choose one that suits the learner. The symbols found on the accompanying demonstration pages are PCS™ (Picture Communication Symbols).
When choosing a symbol set, look at what symbols (if any) are used in the learner’s environment (school, day centre, existing communication system, etc.), and unless there is a good reason not to, try and use the same symbol set for consistency.
Please see Appendix One for more information about symbol sets .
In any language, some words will be used time and again across lots of different situations, topics of conversation and activities. Such words are known as core vocabulary. You will find a suggested core vocabulary for each stage of the book that is accessible whatever the topic page being used. A limited set of core vocabulary is introduced at Stage One. This is expanded at each stage through to Stage Five.
Core vocabulary is key to developing the language skills of the learner. The symbols may look hard to learn, but they represent concepts that are used by even very young children. You will demonstrate the meaning of these symbols by using them yourself as you talk to the learner (modelling). The fact that the core symbols are available in the same place no matter what the topic also helps with learning.
The core vocabulary used in this guide is drawn from a developmental model of spoken language acquisition but does not stick rigidly to it. You will find symbols at earlier stages that would not appear until later if the standard developmental model was applied. A visual language is different from spoken communication, and some words that appear later in a standard developmental model are actually quite important for people using symbols. This is particularly true for older children or adults communicating at a developmentally early level who bring life experiences to their communication that a typically developing young speaking child might not have had.
If an item of core vocabulary does not suit the learner then do change it. Nothing is set in stone.
The core vocabulary is so important that at Stages One and Two it is always visible on the left side no matter what the topic.
From Stage Three, twelve items of core vocabulary are always visible on the left. However, the learner needs more than twelve items of core vocabulary at this stage and the remaining items are hidden underneath the topic pages. The learner can access this hidden core vocabulary by requesting it using a cell that is in the top right corner of all topic pages.
Depending on where you are in the book, you can either turn to the page which displays all the core vocabulary at the back or bring in the duplicate loose page (which has a Menu page on one side and core page on the other). This loose page can be held in front of the topic page while the learner makes their selection. This latter option reduces the amount of page turning needed.
From Stage Four, all the core vocabulary is hidden by the topic pages. Like at Stage Three, it can either be accessed by turning to the page of core vocabulary at the back or bringing in the duplicate loose page.
To further reduce page turning, individual hidden core symbols can always be reproduced on topic pages if they are especially useful for that topic. For example, on Page 25c pictures the core vocabulary symbols different, I, me, my, mine, you, your(s), like, not, look and help sit alongside the topic vocabulary in the same place as they appear on the Core page.
As well as modelling the meaning and use of the core vocabulary, from Stage Three, you will need to model how the learner accesses it by selecting the Menu / Core symbol on a topic page.
You may have noticed that there are not any symbols for 'yes' and 'no' on the accompanying demonstration pages. This is because most learners will be able to communicate this already in some way, and it is good to always be able to communicate ‘yes’ and ‘no’ without having to rely on symbols in a book. However, if you feel that access to ‘yes’ and ‘no’ symbols would be helpful, you can always incorporate them into the learner’s book. Ensure they are available no matter what is being talked about by placing them on the edge of the binder itself or adding them to the Core Page.
This guide provides some ideas of the type of pages you might want to include in a communication book, and examples of the kind of vocabulary you might want to use on topic pages (sometimes referred to as fringe vocabulary). However, it is in no sense an example of a completed communication book. Everyone is different, and you will need to change, adapt and add to the ideas supplied. You will find worksheets to help with this in Appendices Four and Five.
The example Menu Pages suggest topics you may want to include, but some may be irrelevant to the learner and others will almost certainly be missing. The school / college topic might not be necessary, or the learner might have a love of music or soap operas. There might be so many pages about football, for example, that it becomes a topic in itself that is accessed from the menu rather than being placed within a more general sports topic. It really is all about making the Menu Page work for the learner. If the learner is using an electronic communication aid, you may also want to be informed by the menu structure of the vocabulary package being used.
When you come to design a topic page for the learner, the most important thing to remember is that there should be a variety of types of symbols on each page. Communication will not go very far if you only have a set of nouns. As prompted by the worksheet in Appendix Five, try and include action word symbols and symbols that can be used to comment and describe.
On Page 5a bubbles at Stage Three for example, you will see action word symbols like pop, blow and catch alongside describing word symbols like pretty, fast and slow. This enables much richer communication than would be possible if you only had the nouns bubbles, bubble mix and wand. On a personalised page of football players for example, you might want to include action word symbols ‘score’ and ‘miss’ alongside symbols for describing the players like ‘injured’ and ‘expensive’, depending upon the learner’s language level. These sorts of symbols enable you to communicate so much more than if you just had the names of the players available.
Personalised topic pages may well contain symbols that are also available on other pages – that’s ok. While movement through the book is to be encouraged, communication will be faster with less page changes. If there is a symbol that is particularly useful for a topic, don’t worry about duplicating it. For consistency, try and keep the symbol in the same place on a page whenever it is used. If that is not possible, try and at least maintain the same colour code if you can.
Remember that a communication book cannot contain every symbol in existence. There will always be compromises to be made, and symbols that are needed that are not present. It is worth keeping a piece of paper in the communication book so that you can quickly jot down obvious symbols that are missing ready for you to add in when you next update the pages. Some have also found it helpful to quickly draw a missing symbol in a blank cell as a temporary measure. This works particularly well if the pages are laminated as you can use a wipeable pen. Some additional strategies to generate new meaning from symbols that are present in the book are introduced at Stage Five.
One way of keeping the amount of vocabulary under control is to make use of lists. For example, if the term’s topic is the Ancient Egyptians, the learner may briefly need to talk about a ‘canopic jar’ but is unlikely to require that symbol again. Instead of producing a symbolised topic page for the communication book, such items can be written on a list that is kept in the book. During an activity, you could get out the list and read aloud each option, with the learner indicating when you get to the desired item. Before discarding the list at the end of term, you might want to go through it and check that the learner does not want to keep any of the vocabulary in their book more permanently.
Of course, if you find using eye pointing to symbols works better for the learner, you can always choose to present temporary topic vocabulary in this format. Just be selective about what stays in the book longer term.
With both core and topic vocabulary, the symbols will need to be learned. Modelling is a great way to demonstrate their meaning. However, another way symbols are learned is by becoming familiar with their position on the page. Consistency really helps with this.
If you repeat symbols across different pages, try to ensure that they are in the same place on the page where you can. Similarly, as you move up a stage, try and keep the position of the symbols and / or its colour code (if used), as consistent as possible to minimise re-learning.
Just think about how awkward it is when the controls are in a different location in a hire car, or when you come to use a keyboard that is in an alphabetical layout when you are used to QWERTY. It is the same with symbols!
It is also worth being consistent in your choice of symbols. Some sets offer a choice of symbols for a word – choose the same option each time to help with familiarity.
As speakers we are used to speaking quickly in grammatically correct sentences that the listener understands. However, with eye pointing, there is a need to take a different approach and focus more on the ideas than the detailed grammatical information.
When you are abroad and using an unfamiliar language, you’re likely to attempt just key words with lots of clues. For example, shrugging your shoulders and saying the word “station” to communicate “where is the station?” Communicating with eye pointing and symbols is a bit like this. Although there are symbols for little words, expecting the learner to eye point to a symbol for every little word in a spoken sentence would simply take too long and would lead to communication breaking down. Communicating key ideas is more motivating for both the learner and the listener. It also tends to be much more successful, particularly in the earlier stages. Speed helps to keep the relaxed rhythm of interaction flowing.
Here are some examples of ideas that the learners in the Look2Talk project spontaneously communicated using symbols:
The symbols above were used by one learner to communicate, “I don’t want any more porridge.”
Another learner used the following symbols to enquire about someone who was pregnant, “When is Katharine’s child coming?”
Some learners find creative writing or story telling a good way to explore expressing new ideas with symbols.
From Stage Two, there are example topic pages for chatting. As with all topic pages, you will want to personalise and adapt these. Remember to ensure that the learner can express negative views. You may want to add some additional insults or ways of expressing frustration that are appropriate for the learner. Of course, the learner may also be able to use their existing vocabulary creatively – one girl turned to her food page to call her brother a banana!
Sometimes people worry about whether to include swear word symbols. There is no right answer to this. However, it is worth thinking about the fact that swear words are accessible to individuals with speech, and it is all about learning to use them (or not!) appropriately. If someone is worried about such words being on show, one strategy is to place them on a separate page at the back of the chat topic. Alternatively, flaps could be used to cover such vocabulary or the labels could be printed using a paler font.
Even at early stages of communication ability, it is important to provide a spelling page. This may seem counter intuitive. Surely a spelling page is for spelling, and if someone can’t yet spell words, what is its purpose? It is all about learning and exposure. By having easy access to a spelling page, letters can be brought into multiple communication opportunities. The ability to spell is fundamental to developing truly creative communication – i.e. communication that is not dependent upon the provision of symbols by others.
People who require symbols to communicate may miss out on some of the activities in life that underpin the development of writing. For example, they may not be able to hold a pen or pencil and may miss out on all sorts of early mark making experiences (on paper or furniture!). We need to provide people with alternatives to pencils to give them plenty of opportunities to begin to explore letters and write. This is where a spelling page can come in.
If you say the letter sound as you or the learner (eye)points to it, you are reinforcing that letter knowledge. You could also write down the letter that has been chosen on a piece of paper as further reinforcement. A spelling page does not have to be used to spell perfectly. Indeed, it can’t be used to do this unless we put in the time and effort to support the development of these earlier skills.
There are many ways a spelling page can be used before someone is ready to spell for the purpose of communication. Writing could be used in an imaginative game such as pretending to write a shopping list, for example, with the communication partner writing down whatever letters are selected. Someone could be supported to find the letter at the start of their name when introducing themselves or when their name is being written on a form or piece of work. ‘I spy’ is a game that could be enjoyed together. The key is to regularly bring a spelling page into meaningful and motivating activities.
As literacy develops, someone might be able to use a spelling page to support their communication, perhaps indicating the first letter, or even more, of a word that is not available in their communication book.
Example Spelling Pages are provided within this guide. However, these can easily be adapted if the learner is already familiar with a different letter layout.
It is important to be able to access the vocabulary in the book easily. There is nothing more annoying than knowing there is a page about food ‘in there somewhere’ but not being able to find it at the crucial moment.
With that in mind, each stage has an example Menu Page, and each topic page has a corresponding numbered page tab along the bottom. These tabs are important, as they help everyone using the book to quickly locate pages.
If you have a lot of topic pages, you can divide these into sections with the help of tabs on the right-hand side. If you label the side tab with the numbers of the pages behind it, this will help you to move more quickly through the book. You can modify a standard set of dividers as shown in the diagram below:
Symbols that link to topic pages have a folder shaped border. The folder shape indicates that the symbol is directing you to a specific page.
In addition, symbols such as turn page or Menu are provided for navigating around the book. These symbols have a square border.
At Stage One and Two, there is no expectation that the learner would use such symbols themselves – they are there for you to model how to move around the book as you chat together. From Stage Three, it becomes an aim for the learner to begin to use these symbols themselves. However, your use of them will always be important to help the learner see how it is done.
All main topic pages can be accessed from the Menu Page(s). To speed up communication, from Stage Three it is recommended that you have a duplicate Menu Page that is kept with the folder (with a duplicate Core Page printed on the reverse). If the learner asks to use the Menu Page, you can just hold this loose page in front of the topic page they are currently on while they select from the page. This reduces the amount of page turning needed to change topics.
Velcro™ adheres to the looped surface of the communication easel from Ability World (see Ability World's website here). If you are using this file, it is probably easiest to stick some Velcro™ dots or tape onto the loose sheet so that it can be kept attached to the back of the book. This will also make it less likely to fall out and get lost. You will need to use male / hook Velcro™ rather than female / loop. Take care not to obscure any of the symbols or colour information. Using a light coloured Velcro™, like in the picture below, helps.
From Stage Three, you may also want to include an occasional quick link to a related page on a topic page which can speed up communication. For example, it is likely that on a clothes page you are going to want to discuss the colour of the clothing. You might therefore choose to put a link to a colours page directly on the clothes page to save having to access it via the Menu Page. You can see examples of this on Page 4a garden at Stage Three and Page 16c make up at Stage Four.
Although the guide is divided into stages, there is no assumption that everyone will start at the Introductory Stage and gradually progress through each stage in turn until they reach Stage Five. Some will start at a later stage; some may start at an early stage and not progress on to the later stages; others may gradually work their way through each stage and move beyond symbol-based communication altogether. The guide aims to provide you with an incremental structure to tailor and adapt for an individual.
Each stage has suggestions around readiness to help you identify which stage would be a good one to focus on for now. Those who are most familiar with the learner will be in the best position to decide where to start.
A team approach involving a wide range of people is invaluable when developing a communication system. Communication is not something that happens with just one person – all around the learner need to be trained, involved and engaged.
The most important members of this team are the learner and their families. As a learner moves through the school system and then beyond, families who have skills and knowledge about the communication system can be a constant figure who can show new team members how to communicate with the learner. This makes the system much less vulnerable to being lost or discarded as the environment and professionals around the learner change over time.
The Look2Talk project was set up to work with children with complex needs and their parents / guardians. In doing this we fell into the trap that so many practitioners often do of forgetting about the siblings! From day one, no matter what age the sibling was, they all wanted to be involved. More importantly, their involvement was highly motivating to the learner.
Like siblings, peers are also highly motivating and may be keen to become involved – they just need to be shown how. The peer group of one child who had been involved in the Look2Talk project understood and valued her communication skills so much that she was elected to be their class representative on the student council!
All of this will be true for older learners who are using the Look2Talk approach as well.
You can read more about our experiences of involving siblings in the Look2Talk project in Appendix Six.
While the demonstration pages can be viewed on a tablet or laptop, the learner's communication pages are designed to be printed and used within a A4 communication easel. The advantage of these files is that they enable ‘hands free’ eye pointing as you can place the file on a flat surface. However, in our experience, once you get beyond Stage One, the readily available files are often too flimsy to cope with the number of pages that are required for a communication book. We therefore suggest using the robust communication easel file produced by Ability World - see Ability World's website here.
Ability World also sell an A3 communication easel file - see Ability World's website here. You could print pages made using the templates at A3 size to use within this larger file if this was beneficial for the learner. However, it does result in a very large communication book so this approach is only recommended if the A4 size is found to be inaccessible. The advice of a QTVI (Qualified Teacher of the Visually Impaired) should be sought if possible.
If you are happy to hold the book, an alternative is to simply keep the pages together using four metal binder rings. Spiral binding is another option, but as books evolve and change, you may find that you are having to re-bind regularly.
Occasionally there may be a role for a small second binder. For example, one child who uses the Look2Talk approach kept her main communication book with her most of the time but, for a time, had a small extra one that went out with her to the playground. This contained just a few pages related to the games that were being played during breaktime and was easier for everyone to manage.
Communication books can contain more than just symbols. Try and have a section where you can keep mementoes like photographs, leaflets or ticket stubs to make it easier for the learner to share their stories about people and events. These might be kept in a punched plastic envelope wallet at the back of the book, for example.
You will need to purchase or have access to resource making software to make the pages of the communication book. This is essential, as the accompanying demonstration pages are examples only. You can find out more about software options available in Appendix Two. Templates for making pages within Boardmaker and InPrint 3 (coming soon!) software are available on Ace Centre's website here.
While templates are provided, don’t be afraid to change them, so long as you implement the changes consistently. The colours used for encoding may need to be modified if the learner has a form of colour blindness, for example, or the size of symbols used may need to be adjusted to accommodate other visual issues. The experience of the team around the learner will be invaluable when accommodating visual issues. Some trial and error may also be needed to learn what suits the learner best.
In the original Look2Talk project many of the pages were made using black and dark background colours and you will see such pages in some of the videos. The dark background made the symbols and colours used for encoding really stand out. However, the problem was the amount of printer ink required was prohibitive for many. When you come to make your own pages you can decide whether to use a background colour on the pages. Do bear in mind that for some, a certain background colour may assist the visual accessibility of the pages. You might also experiment with the thickness of the borders and the amount of space between the symbols to support visual access.
Once you have identified a layout that suits the learner, try and keep the structure consistent.
The pages will need to be printed, laminated (optional) and hole punched. See Assembly Instructions for more detailed information about constructing a Look2Talk book. Appendix 7: Assembling an A3 communication book outlines some additional considerations if printing at A3 size.
There is no such thing as a finished communication book. It will always need to be tweaked, adjusted and modified along the way.
Do remember that there is no need to present an individual with a ‘perfect’ book. You can always leave blanks on pages that can be filled in gradually, and not every category has to be in use from day one.
Having said that, it is worth taking some time at the beginning to map out how you think the book might look so that you have a structure in place that can be added to. Moving symbols around and changing their location and colour code (if used) on pages can hinder learning.
Time to develop the book, time to adjust it, time to learn it, time to use it, time to support its use… Developing and supporting a communication book is not a quick process, but it is really worthwhile.
