Using Words, Photos and Symbols A Practical Guide March 2006 to Communicatio This booklet was developed and designed by Mike Leat of The Clear Communication People Ltd as part of a Communication Project funded by the Surrey Children’s Fund n TOTAL COMMUNICATION Total Communication A philosophy using the mixture of communication methods that work best for you We are all different!!! There is a wide variety of communication systems around today. Some are alternative systems, that is they are used instead of speech. Others are augmentative, that is they are used to support speech. Alternative and Augmentative Communication (AAC). Some people, both children and adults, find communication difficult because they have little or no clear speech. There are many reasons why this might be the case: for example, as a result of cerebral palsy, stroke, head injury, or learning disability. The idea behind AAC is to use the person’s abilities, whatever they are, to compensate for their difficulties and to make communication as quick, simple and effective as possible when speech alone does not work. Although we all use aspects of AAC from time to time (e.g. waving goodbye instead of saying it, pointing to a picture or gesturing to make yourself understood in a foreign country) some people rely on AAC all the time. Helping people to communicate improves their quality of life. It improves their opportunities, education, social life, friendships and independence. Total Communication is a philosophy that sees the value of all communication systems, and accepts that people may benefit from using aspects of different systems. Gone are the days where we rigidly stick to one system. We are guided more these days by trying things out and using what the person finds works best for them. In This Booklet we will cover mainly speech, signing, photos, symbols, and communication passports. These are known as low tech methods. We will explain how they work, and also give you practical ideas about how to make them for yourself. A Limited Number of Booklets come with a free CD. The CD is full of useful tools to print and use, and training handbooks to give you more information. Many of the tools we will show you in this booklet will be on the CD. If you haven’t got a copy of the booklet with a CD don’t worry. All the files on the CD are also freely available to download from our website. www.communicationpeople.co.uk. There is more information about using the CD and website on page 15 We have used a variety of images to illustrate this booklet. Many are of adults which may seem odd in a booklet aimed at those supporting children and young people! It’s just that there’s not a similar imagebank with photos of younger people. The information in the booklet is just as relevant to adults as children. Using Words, Photos and Symbols - Developed & Designed by The Clear Communication People Ltd CONTENTS Section 1 - Using words, signing, photos and Symbols • Page 4 - Being careful about the words we use • Page 5 - Speaking so you are understood • Page 6 - Gestures and signing Objects of reference • Page 7 - Photos, symbols and clipart • Page 8 - Using photos, photos from the internet • Page 9 - Using symbols • Page 10 - Using ‘Writing with Symbols’ • Page 11 - Choosing the right symbols to use • Page 12 - Starting to develop your communication tools Section 2 - Developing Visual Aids • Page 14 - Developing visual schedules • Page 15 - Daily & weekly diaries, symbols for labelling Using the templates on the CD and website • Page 16 - Weekly chart, weekly timetable, and flipbook • Page 17 - Monthly calendar, fortnight calendar, and family rota • Page 18 - Individual Routines and schedules, menu planning • Page 19 - Making choices • Page 20 - TEACCH, a popular system using visual schedules Section 3 - Communication Tools • Page 22 - Alternative and Augmentative Communication Systems (AAC) • Page 23 - Developing an AAC communication tool Communication Matters • Page 24 - Low-tech and High-tech tools you can buy The Hospital Communication Book • Page 25-26 - Makaton, Talking Mats, PECS Section 4 - Communication Passports • Page 28 - Communication Passports • Page 29 - Developing a Communication Passport • Page 30 - Making pages for a Passport There are some Practical Tips on page 31 WATCH YOUR LANGUAGE !! Being careful about the words we use....., Using Literal Language The words we use do not always make literal sense. For example look at these phrases: ‘Can you lend me a hand’ ‘Come on, let’s call it a day’ ‘She drove me up the wall’ We know what we mean by these phrases because we’ve learnt that those words, said in that order, in that tone of voice, take on a different meaning than when used literally. It can be hard for children and young people learning language to tell whether we are being literal or not. Some young people may take everything we say literally. Using Familiar Words It’s important that we help young people learn new words and extend their vocabulary. We also need to be aware of the words they know and understand and use them consistently. When things go wrong it can be funny! John was very excited when his mum told him she had booked a tennis coach for his birthday party. In his mind was a big bus with a tennis court inside. He was a bit disappointed when Julie the tennis coach turned up. It can be more serious though! Developing Our Language & Vocabulary We all have a vocabulary, like a dictionary, in our head. Nobody knows all the words in the dictionary, though some people with communication difficulties have quite a small vocabulary. When you hear a word you recognise it’s as if you get a picture in your head. All research shows that using signing, photos, symbols and objects help people to develop their speech and vocabulary. A wide variety of people use Alternative and Augmentative Communication (AAC), & the less speaking ability a person has the more they may need AAC Sara loved going to the park and playing on the swings. She doesn’t use speech to communicate but understands many words. Sara stays at a respite home for weekend breaks sometimes. One weekend they said we’re going to the ‘park’. Sara was very excited but after they’d walked around the fields and got back to car without seeing any swings she got very upset and wouldn’t get in the car - after all as far as she was concerned they hadn’t been to the park yet ! Page 4 Using Words, Photos and Symbols - Developed & Designed by The Clear Communication People Ltd WATCH YOUR LANGUAGE !!! Speaking so you are understood......, Key Words Many of our misunderstandings and arguments in life start when we only hear part of what someone says to us and we ‘take it the wrong way.’ Some children and young people with a learning disability may only pick up key words in a sentence. For example you might say: ‘I’m sorry we are running late so we can’t go to the shop today’. The child may only pick up on the key words - shop today. This is even more likely as they are the last words you said, so likely to be retained. A Speech and Language Therapist will be able to accurately assess a child’s processing and understanding of language and give advice on how best to communicate together. Here are a few tips to help you be understood: • Speak slowly - it gives people more time to process what you say. • Keep your sentence short - only have one idea in a sentence. • Use everyday words • Use gestures - do a sign for steering wheel if you mean ‘car’. Choice is a Complicated Thing Do you want tea or coffee? A simple choice you would think. When making that choice your mind has to bring up a memory of both drinks, consider them, then select one based on how you feel there and then and communicate that to the other person. It is in fact an incredibly complex process. Perhaps that’s why we often say ‘whatever you’re making !!’ When offered a choice of two things verbally some children will repeat the one that was said last. This shows they are having difficulty processing the choice. Keeping It Real If someone has difficulty making a choice or understanding language there are several ways we can make things more real for them. Less Real Words - written or spoken. Gestures and Sign Language - backing up the words. Symbols - simple line drawings. Photos - a more real picture. Objects - a solid 3D representation More Real There’s more information about objects, photos and symbols on the next few pages. Again, it is valuable to have the advice of a Speech and Language Therapist about what approaches are best for your child Using Words, Photos and Symbols - Developed & Designed by The Clear Communication People Ltd Page 5 OBJECTS AND SIGNING Gestures and Signing Gestures are a natural way of communicating We all use gestures and body language to communicate. Using a gesture to support the words you are using gives the person some visual clues about what you are saying. For example it’s easy to explain that you’re hot or cold, hungry or thirsty. Some activities like swimming and bowling are also easy to communicate through gesture. You naturally do the gesture as you say the word. British Sign language has now been recognised as an official language in the UK. For information and support on deaf issues contact Royal Association for Deaf People (RAD) in Surrey. Phone: 01306 881958. Signalong and Makaton have been developed to support the communication of adults and children with communication difficulties. These communication systems combine words, signs and pictures, and only use signs for key words. So they are systems that support speech rather than an alternative to speech. Signalong is based on British Sign Language, using BSL signs wherever possible. The Signalong Group has researched and published the widest range of signs in Britain. For more information go to www.signalong.org.uk or phone 0870 7743752 Makaton was developed from a research project which identified the words that we all use most frequently and need in everyday conversation. Signs from British Sign Language were matched to these words, so that as you speak you sign at the same time. Makaton is an integrated language system and also has symbols for their signs. For more information about Makaton see page 25 Objects of Reference Using Objects When offering a choice of drinks we can show the bottle of squash and coke. Activities can be represented by objects e.g. trunks for swimming, a hairdryer for hairwash, a utensil for cooking. A key could represent home. The object backs up what we say, and gives the child something to hold to remember what’s happening. Objects of Reference have been one of the communication systems used by people who are deafblind. They can be useful for people who don’t easily understand language & find photos or symbols complex. Objects have to be chosen carefully and used consistently. Shown here are the objects used to represent one school’s activities. We found the ACE Centre Oxford’s website has good information about objects www.ace-centre.org.uk Page 6 Using Words, Photos and Symbols - Developed & Designed by The Clear Communication People Ltd DIFFERENT KINDS OF PICTURES Photos, Symbols, & Clipart Learning Through Seeing Many people with communication difficulties find using pictures helps them to communicate, make choices, and understand what’s happening. • A picture is a permanent reminder - a picture stays while words and signing float away. • Pictures help people understand information - Pictures make things like school timetables easier for people who have difficulty reading to understand. • Pictures help people make choices - looking at two pictures is much easier for people than weighing up a choice in your mind. • Pictures help people get their message across - if a child doesn’t use speech yet, or their speech is unclear they can use pictures to say what they want & need. Photos, Symbols and Clipart We are all familiar with photos. Digital photography is now making it easier to use photos quickly to make communication tools. Photos are more ‘real’ so are easier for people to understand than symbols or clipart. They also look appealing to people. • Photos are very good for showing people and specific places like ‘my school’ You have to be careful when using photos. E.g. you may use a photo of a supermarket to say that’s where you’re going. Problems can happen if you go to a different supermarket. In this case a photo being very specific is a drawback not a benefit. Not all children will find this difficult, but many will. Make sure a photo represents what you want it to. A car in front of a photo of a shop could be distracting. A symbol is a simple line drawing that represents an object, place or idea. Symbols are less ‘real’ than photos so can be harder to learn. There are benefits to symbols: • They can be used to show a general idea - this symbol for supermarket doesn’t show Tesco or ASDA, but the idea of a supermarket • Symbols are widely used and available • They can easily be photocopied and many handdrawn Some clipart is installed on most computers and available on the internet through programs like Microsoft Word. They are cartoon images that show a range of people, places & activities. Some people use these as they are the only pictures they have. Some are quite good, but many are complex and open to people thinking they mean lots of different things Many good communication materials use a mixture of photos and symbols. Photos are fun and attractive, and symbols clear and simple. Using Words, Photos and Symbols - Developed & Designed by The Clear Communication People Ltd Page 7 USING PHOTOS Photos are personal We all want to communicate about personal things Photos are great for showing my cat, my dog, my nan, my brother, favourite toys, foods, and places. Photos are fun to look at, grab attention, & are easier to understand than symbols and words. Using Digital Photos Digital photography is making it quicker and easier to get the photos you need for communication. You can see the photo straight away and either get prints made or put them on a computer to print off. Technical info Digital cameras can take photos at a variety of resolutions. You usually will not need to use the highest resolution. For example: • A photo taken at 3million pixels is 72 cm wide & uses 1.25 megabytes memory. This is a very large photo - It can be printed up to 72cm x 54cm. I doubt we’d ever need to print this large!! This photo will take up a lot of memory space on your camera and computer. When you’ve got a few photos this size on a page they may even start to slow your computer down. • A photo taken at the lowest setting is 22cm wide & uses 0.15 megabytes memory This is a much better setting to use. Many more photos will fit on the camera, and they’ll be easier to use on the computer. They will still print well up to 22cm x 17cm. Please note - these photo size settings may vary with different cameras, though photos taken on the lowest settings on most cameras will be large enough to use. Using Ordinary Photos It’s a good idea to get 2 copies of your photos when you get them developed so you’ve got a back-up. You can use either scan them into your computer, or use them as they are by laminating them. See page 31 for more info on practicalities like laminating. Photos from the internet You can search for, and download photos from the internet. Go to www.google.co.uk. Type in the search box what you want a photo of, for example - thomas the tank engine. Then click images Google will then search for images rather than websites. Double click on the image you want with the mouse. Click see the full size image if that’s an option. Then hover your mouse on the image - icons should appear letting you print or save the image. Otherwise click the right hand mouse button and click ‘save picture as’ or ‘print picture’ Page 8 Using Words, Photos and Symbols - Developed & Designed by The Clear Communication People Ltd USING SYMBOLS Using Symbols Different Symbol Sets There are three main symbol sets that are used by people in the UK • Widgit Rebus • Makaton • Picture Communication System (PCS) In the yellow box the 1st symbol is the Widgit Rebus symbol for‘teacher, the 2nd is Makaton and the 3rd is PCS The Widgit Rebus symbols seem to be the most commonly used these days. Most people use the ‘Writing With Symbols’ software to get their symbols, and the Widgit Rebus symbols are the first ones that appear when you use the program. Not all symbols are easy to understand. Looking at the 4 symbols below they get more abstract from left to right, therefore harder to understand straight away. The more abstract a symbol is the more careful you need to be to make sure your child understands it. If you can’t see what it is straight away it’s unlikely your child will. Cricket Music Therapy Swings Car Boot Sale To help your child learn symbols, for example swings - you could take the symbol with you to the swings and look at the symbol together pointing to the swings. Using ‘Writing with Symbols’ On the CD that comes with this book is a handbook about how to use ‘Writing with Symbols’. This file is called ‘Widgit Handbook’ & is in a folder called ‘Training Handbooks’. See page 15 for more info about using files from the CD & website. You may well be able to use this program on computers at the school your son or daughter goes to. Perhaps someone at the school will help you print out the symbols you need. ‘Writing with Symbols’ is now installed on a computer in five of the main libraries in Surrey. It’s on a computer in Epsom, Staines, Guildford, Woking, and Redhill libraries. If you are a member of a Surrey library you will be able to use the computer free of charge. The software is on the adapted computer for disabled people each library has. All three symbol sets are installed on the library computers. If you have any computer experience ‘Writing with Symbols’ is a fairly straightforward program to use. You just type the word for the symbol you want and the symbol appears above the word on the page. There is a starter guide on the next page. Using Words, Photos and Symbols - Developed & Designed by The Clear Communication People Ltd Page 9 WRITING WITH SYMBOLS Using ‘Writing with Symbols’ to get the symbols you need Click the red car icon on the desktop of the computer to start up the program. There will be 4 options on the main window - choose the symbol processor. www.widgit.com The program is very similar to a standard word Is where you can find out processor like Microsoft Word. Try typing a few more information about ‘Writing with Symbols’. words. When you press the space bar after each word the symbol will appear above the word. Here are a few useful features F11 lets you rename a symbol F12 lets you choose an alternative symbol for the word, or choose not to have any symbol for that word Lets you make the symbol larger or smaller. Many schools have the software and they may well let you use it. It is also in the 5 libraries mentioned on the previous page. You can buy the program for your own computer. Prices start from £160. Changes the colour of the symbol Lets you change the text - font, font size and font colour. F12 is a useful feature of ‘Writing with Symbols’ If you type a word - for example ‘park’ a symbol will appear. There may be more than one symbol for ‘park’ • The first symbol that appears is likely to be the Widgit Rebus symbol. There may also be a PCS or Makaton symbol for ‘park’ if those symbol sets are installed. • There will be a symbol for ‘park - you walk in’ and ‘park - as in park the car’ After you’ve typed the word ‘park’ and the first symbol has appeared click with the mouse so the cursor blinks inside the word ‘park’. Now press the F12 button and alternative ‘park’ symbols will appear. Keep clicking F12 to see all the alternatives. After the last symbol a blank space will appear - you can choose to have the word without a symbol. After the blank the first symbol will appear again. F11 lets you change the word under the symbol rover Page 10 Type the word ‘dog’ to get the symbol. Then click on the word ‘dog’ press F11 and the word disappears. Now type ‘rover’ and then press the right arrow key on the keyboard (this completes the renaming) Using Words, Photos and Symbols - Developed & Designed by The Clear Communication People Ltd CHOOSING YOUR IMAGES Choosing the Right Images to Use Choosing Your Symbols Carefully If you are starting to use symbols at home it’s important to try to use symbols that your son or daughter may already be using at school. Sometimes you may find that the symbol for a place or object is a bit confusing, or doesn’t really look like what it’s supposed to represent. For example the symbol for supermarket is very complex. There is a really good symbol for the word ‘trolley’ which you could use to represent supermarket. You can even rename the supermarket symbol to have the word ‘supermarket’ - this is explained on the trolley previous page. Keep Your Photos Simple A symbol is a simple drawing showing one object or activity clearly. When taking photos to use for communication think of them in the same way as symbols. If you are taking a picture of a building try to include the key feature e.g. the bright red door. If you are taking a photo of a person try to fill the photo with their head and shoulders so there is less in the background to distract attention from them. You should always have the word underneath the photo or symbol as this helps people learn to recognise the words. A Speech and Language Therapist is trained to assess people’s ability to understand symbols and photos. It’s wise to ask the Speech and Language Therapist at your school for advice if you want to start using photos and symbols. A Simple Home Exercise - Try laying out 2 or 3 photos or symbols of familiar things, say a dog, cat, and horse - then ask ‘Where’s the cat?’. If they point or look at the cat picture you know they are taking meaning from pictures. Photos are easier than symbols, but many children learn symbols quite easily - Try this out with several images. You know your child - it’s best to start introducing new pictures slowly making sure they’re understood. Though children do get the meaning pretty quickly if the motivation’s right. ( Most children recognise the McDonald’s symbol from a very young age !!!!) It’s also good to use everyday images like logos as these are used by everyone in their daily life. You could use logos for places like Burger King, Pizza Hut, or even your local club. When you’re on holiday you can pick up leaflets of local attractions and use the photos to help make choices and explain where you are going. Using Words, Photos and Symbols - Developed & Designed by The Clear Communication People Ltd Page 11 DEVELOPING YOUR MATERIALS Where Do We Start? Work out what’s most needed The aim of all communication materials are quite simply to make life easier and more enjoyable for you and your child. If your child doesn’t understand something they probably won’t calmly say ‘please give me a visual aid’!!!! There is basic information we all need to know to survive the day, such as: • What am I doing • Where am I going • Who am I seeing • What am I eating There are people we meet during a day who we want to share stuff with, such as: • My likes and dislikes • My favourite activities • My family and pets • What music I like There is also important information people need to know about me if they are looking after me, such as: • What I can and can’t eat • How I make choices • What medicines I may need • How to help me if I’m unwell There are many ways of using photos and symbols to help communication and daily living. We’ve sorted them out into 3 main catagories. Visual aids to make information and routines easier to understand No-one can remember everything. To help us get through life we use calendars, diaries, lists, post it notes, and to do lists. These are visual aids. We will show you how to produce pictorial versions of these that children and young people, who have difficulty reading, can use to understand what’s happening, make choices, and organise themselves. Materials to help people communicate their views and needs Symbols and photos can be used to help your child to communicate with others. We will show a few examples of these kinds of materials. There are also several well used communication systems like Makaton and PECS which we will explain about. When setting up a communication system it’s important to get the advice of a Speech and Language Therapist, and link closely with the school. Materials to help others get to know and understand you We will tell you about communication passports. These help people get to know and understand the needs of your child. We can make them pictorial as many children then find them fun and interesting. Page 12 Using Words, Photos and Symbols - Developed & Designed by The Clear Communication People Ltd Developing Visual Aids VISUAL AIDS Making Information & Routines Easier for people to Understand swim lunch cooking What’s happening next ? Some children are quite happy to go along with the flow. Others, particularly children with Autism and Aspergers Syndrome, get anxious if they don’t understand what’s happening. Routines are very important to many children as they give a sense of security. Using a photo or a symbol to back-up routines, and what you’re saying, gives the young person a permanent reminder of what is happening. This also gives you a useful tool to use when a routine has to change. Developing Visual Schedules Horseriding Minibus Home Depending on your child’s needs you can begin by simply using one symbol or photo to show what’s happening next. Or develop a more complicated weekly diary showing a range of activities on different days. There is no set design for a visual schedule. They can vary from: • Large symbols or photos that are blu-tacked to the wall each day to show the main events of the day. • A wooden or cardboard strip with room for 5 or 6 smaller symbols • A laminated diary page with room for a few symbols • A school timetable showing lessons with symbols Use whatever seems most appropriate for your child There are examples on the next few pages Important Tips For Developing a Schedule • Don’t make it too complicated - Unless you’re sure your child understands the idea of tomorrow or the days of the week stick to today’s events. Show the key activities rather than every detail of the day. Keep the pictures to 3 or 4 maximum. Always show events in order - from left to right or top to bottom. • Make it interactive - Many children like to be able to take pictures off when an activity is finished. If you involve them in putting the pictures on they are more likey to take an interest in the schedule. • Have a good supply of materials - Blu-tack or Velcro are good for sticking pictures on with. Laminated pictures last a lot longer! Try to make sure you’ve got extra copies of your pictures for when they mysteriously go missing!! Page 14 Using Words, Photos and Symbols - Developed & Designed by The Clear Communication People Ltd VISUAL AIDS Daily and Weekly Diaries Using Templates From The CD or Website On the CD that comes with this booklet there are some templates. Friday Optician Chips You may not have a CD - only a limited number were printed. The templates are also freely available on our website www.communicationpeople.co.uk We’ve developed sets of diary pages in 3 sizes. • A4 size - standard paper size • A5 size - half A4 size • Filofax size Each set has a page for each day of the week, and also a page for today and for tomorrow. You can laminate and hole punch the days of the week pages and use them in a binder. If you use the filofax pages they will fit into a standard filofax. You will need to get a special 6 hole puncher from the stationers. If having all seven days will be too much for your child just use the today, or the today and tomorrow pages. If you laminate your photos and symbols they can be stuck on and taken off using blu-tack or velcro which a shop like WH Smith’s sells. You will find these templates in the folder called Diary Pages Most of the templates are .pdf files. They can be viewed and printed by using Adobe Acrobat Reader. If your computer doesn’t have Acrobat Reader you can get it for free by going to www.adobe.co.uk and clicking on the ‘Get Adobe Reader’ Icon. You can only view and print .pdf files, you can’t change or edit them. A few of the templates are files that can be opened and used in ‘Writing with Symbols’. There are also pdfs of these for printing. In the Training Handbooks folder are handbooks on how to use Microsoft Word & Powerpoint, and Writing with Symbols. These are quite basic and aim to give you the confidence to get started. Labelling with Symbols Labelling a room with symbols can help some children to become more independent. • One family have labelled the drawers and cupboards in the kitchen with symbols for things plates, spoons, cereal, and milk. Their son now finds what he needs for breakfast on his own and even helps put the washing up away sometimes! They have also labelled the drawers in his bedroom with symbols for socks, T-shirts, trousers, jumpers etc so he can easily find and put away his clothes. Using Words, Photos and Symbols - Developed & Designed by The Clear Communication People Ltd Page 15 VISUAL AIDS Weekly Chart This can be used to show a week at a glance. It’s useful for showing basic information like what days are school days, or counting down to an event. The chart can be printed off and laminated and we’ve also put together 2 sheets of symbols you may find useful to use with it. You will find these templates in the folder called Weekly Charts Timetable Monday Tuesday Wednesday Thursday Friday This is ideal to use as a school timetable. It’s quite complex having 5 spaces for each day, so would not be suitable for some children. This is saved on the CD as a pdf file that you can print off and stick symbols on, or as a Writing with Symbols file which you can open in Writing with Symbols and type the symbols on. You will find these templates in the folder called Timetables Flipbook This uses security badge holders bound together by metal rings. Each security badge can display 2 symbols or photos. The symbols and photos are laminated and cut out, then can be put in and taken out of the flip book as needed. It’s small and portable for taking out with you to explain what’s happening, or to find out what your child needs. It can be used as a visual aid and a communication tool Office Services is a small work skills project for adults with a learning disability in Surrey. They will make and send you a flip book for £6.50. They will send you some free laminated symbols to get you started. You can then add your own pictures and symbols as you need them. Contact Office Services on 01372 832426 Page 16 Using Words, Photos and Symbols - Developed & Designed by The Clear Communication People Ltd VISUAL AIDS Monthly Calendar For some children showing plans over lots of days can really help with anxiety. We have produced a 35 day calendar that can be used with symbols. It will fit any month. You can just buy an ordinary wall calendar that has a large enough space on each day to put symbols on. Sometimes adapting something we all use for use with symbols is the best way forward. You can use a calendar in several ways: • As a countdown calendar to a special event like a birthday or holiday • To show school days, holidays, and especially bank holidays and those teacher training days when school is closed unexpectedly. • One family use this to show when mum or dad are away. On those days they use an aeroplane symbol. They use a home symbol for when they are coming home in the evening. Fortnight Calendar This clever calendar shows up to 14 days at a glance. It comes in 3 pages that can be laminated, cut out, and blu-taked onto the wall or fridge. There is room for 2 key symbols next to each day. You can cut out an arrow to point to ‘today’, and move this down each day. When you finish the top page take the page off the wall, move the other 2 pages up and fit the empty page below to add new symbols onto. You will find this template in the folder called Calendars You will find this template in the folder called Calendars Family Rota This is good for children who get anxious about where people are This aims to show where everyone in the family is. There’s room for 4 photos on the left hand side - you’ll need to print 2 copies if you’ve more than 4 family members. You can use symbols to show where everyone is in the morning, afternoon evening and night. There is also a simpler version on the CD with just 1 space to show where each person is ‘today’. You will find these template in the folder called Calendars Using Words, Photos and Symbols - Developed & Designed by The Clear Communication People Ltd Page 17 VISUAL AIDS Individual Routines and Schedules There may be specific events or routines that you need to explain to your child using pictures. Schedules can also help children to do tasks for themselves giving them the independence and you a break from having to nag! You can produce routines like these using ‘Writing With Symbols’. See the Widgit Handbook on the CD for tips. Visual reminders are helpful. • Signs for important things, like washing your hands. • Lists for packing for an overnight stay, or a shopping trip. • Routines for the morning and the evening. Lists and routines are individual so we haven’t produced templates. A pdf of the ‘wash your hands’ sign in a folder called ‘routines’ on the CD Menu Planning Photos of food are great for planning a menu together and making choices about what to eat. The templates on the CD have many food photos, though there will be things missing. You can add to the photos. We suggest you print them off and laminate them so they last longer. Surrey & Borders NHS Trust has developed a full food planning pack. This comes already laminated. You can buy one for £25. Contact them on 01483 782835. In the folder named ‘food and drink’ there is a pdf template for the ‘today’s dinner’ page, and several pages of photos of foods also as pdf files. Page 18 Using Words, Photos and Symbols - Developed & Designed by The Clear Communication People Ltd VISUAL AIDS Making Choices Making a choice is complicated. We have to imagine the choices we have, weigh them up in our mind, put them in order and communicate them. No wonder we say ‘I don’t mind’ when offered tea or coffee! Many children find using pictures help them make choices. It’s easier to weigh up your options when you can see them in front of you rather than having to think about them inside your head. Here are a few examples of using pictures to help choicemaking: I don’t know what to do! Most children have times where they don’t know what to do with themselves. Or they may get so involved with one activity constantly that we worry they are not having enough variety. James has a folder at home with photos of activities he can do to fill his free time. Photos include colouring books, riding his go cart, playing lego, using his climbing frame, and playing his keyboard. Mum finds this helpful to give him when trying to get him to choose something other than playing computer games. I don’t like vegetables! We’re not suggesting that using pictures will magically get children to eat their greens! Some families have found that children who help to choose their food seem keener to eat it. Lauren is very fussy about what she eats and couldn’t say what she wanted to eat. By using the food photos supplied, and adding to them by taking their own photos, Lauren could point to the foods she wanted to eat. The family discovered that she was a lover of red vegetables like peppers, and of course baked beans. We have developed a symbol menu for typical fast foods and drinks to help children choose. You can print this off and try it out. A pdf of the ‘fast food and drinks menu’ is in the folder called ‘food and drink’ on the CD Choosing to say no! Harry used his visual diary regularly and would check it each day to see what was happening each day. He quickly got used to the idea that if a picture of an event was on the diary it was going to happen. He also worked out that pictures could also be taken off. Harry loved his thursday swimming and would look forward to it each week. One thursday morning Harry went to his diary and took the swimming symbol off. His family thought this strange and wondered if he was well. Sure enough it turned out he had a temperature. Harry would also take off symbols if he didn’t want to go somewhere even when he was well. The doctors symbol reqularly came off. Harry learnt that sometimes you have to do things you don’t like. This was helped by mum letting him choose from some treat symbols to put on the diary after the doctors. Harry often chose ice cream Using Words, Photos and Symbols - Developed & Designed by The Clear Communication People Ltd Page 19 VISUAL AIDS TEACCH - Treatment and Education of Autistic and related Communication handicapped CHildren TEACCH is commonly used in schools supporting children with autism. We wanted to mention it here as it uses visual schedules to help give children structure & create a learning environment. TEACCH was developed in North Carolina USA in 1972. The TEACCH approach organises the physical space that a child works in. There are clear visual boundaries that seperate space in the classroom. This helps the child to understand what they are expected to do in each area. A child may have their own workspace which has few distractions. TEACCH uses visual schedules which are used to structure each part of the child’s day. The schedule is personal to the child. Often they start the day by putting their photo on the schedule. The schedule covers a period of time, say a few hours. Every activity is shown so the child is never uncertain about what is happening. Amy Register + Maths Drink Play Story A child will often take a symbol from the schedule with them to the activity it represents. There is usually a finished box. After an activity is finished the child takes the symbol off the schedule and puts it in the finished box. New pictures are added for further activities. Changes may happen to a schedule. For example an activity may have to be cancelled due to bad weather. There are rules for explaining changes. A coloured sticker may be put on a symbol that is going to change before it is taken off and replaced. TEACCH is very much a system for helping children cope with what is happening, what they need to do, when it’s finished, and what’s happening next. It helps them to predict events. The schedule can use just words if the child is able to read well. Children with autism often find the world a confusing and unpredictable place. They generally cope with visual information better than spoken information. www.teacch.com Is the website of TEACCH in the USA. There is a lot of information on the website - much of it very complicated. Many special schools in the UK use TEACCH for some of their pupils and it is worth asking at your school. TEACCH will not be appropriate for all young people. Page 20 Using Words, Photos and Symbols - Developed & Designed by The Clear Communication People Ltd Communication Systems and Tools COMMUNICATION TOOLS Alternative and Augmentative Communication Systems (AAC) These are communication systems that replace speech (alternative), or support speech (augmentative). An AAC communication system is more involved than a visual aid, more personal. People who may benefit from using a AAC Communication system include: • People who have limited or no speech • People whose speech is hard to understand • People who physically find it hard to use other systems like sign language. There are two main types of AAC Communication Systems High Tech systems including computers, keyboards, and voice simulators. These range from quite cheap gadgets to very expensive systems. Low Tech systems using materials like words, pictures, paper, boards, and velcro. We can make Low Tech tools fairly cheaply ourselves. Below is a good example of a low tech communication tool using photos and symbols. Shamir’s Communication Board Shamir doesn’t communicate by using speech. He has a good understanding of photos and symbols. He also has difficulties using his hands to turn pages, but with a bit of support he can point to pictures on a board on his lap. People Activities Drink Food There are 4 symbols on the board to start with. They are the main catagories. When Shamir points to one of the them, say drink, these symbols are taken off. 4 drinks symbols, like tea, coffee, water and squash are put on for Shamir to choose from. Shamir has a stock on symbols for each catagory. After he’s finished choosing the 4 catagory symbols are put back on. Shamir found that by pointing to people, then physiotherapist, he could tell people that his feet were hurting in his boots. Page 22 Using Words, Photos and Symbols - Developed & Designed by The Clear Communication People Ltd COMMUNICATION TOOLS Developing an AAC Communication Tool The advice and support of a Speech and Language Therapist is important when developing communication tools. Shamir’s system was designed with the support of his keyworker and speech and language therapist. His system wouldn’t be right for many people. Some people have loose leaf pages of symbols arranged in catagories. Each person’s communication tool will be different, based on their needs. Your school is likely to have a Speech and Language Therapist. They are able to accurately assess a child’s level of understanding and their ability to take meaning from pictures. They can also advise on whether a high tech or low tech system would be most appropriate. Some Tips on Developing A Communication System • What will we need pictures for? - activities, feelings, people, food & drink. • What will it look like? - a board to use at the table, maybe a small book? • How big will the pictures need to be? • How can we organise the pictures so the young person finds it easy to use? • Is a high tech or low tech system most approprite? • Where will we keep it? - it’s no good if they can’t access it • Where will we keep the pictures so they don’t all get lost? • How will we decide when to add new pictures? • How will we make sure key people know about it, and how to use it with the person? • Will we need extra copies? - to use at school and at home www.communicationmatters.co.uk Communication Matters is a national charity that focuses on the needs of people with complex communication needs who may benefit from AAC systems. You can join Communication Matters and receive regular newsletters. In 2006 Communication Matters launched their DVD called The Power Of Communication. This is available for £15 and gives a good insight into the use of ACC systems and the basic human right to communicate. CASC is the UK Trade Association of communication aid suppliers of AAC products and services. They are a subgroup of Communication Matters and run regular roadshows across the UK where you can see a range of electronic communication aids in action. For more information look at their website or phone Communication Matters on 0845 456 8211 or email [email protected] Using Words, Photos and Symbols - Developed & Designed by The Clear Communication People Ltd Page 23 COMMUNICATION TOOLS Liberator Ltd - www.liberator.co.uk Is a company that sells a range of communication products. They have some Low-Tech tools For example the ‘Portable Waist Communicator’ that can be used with pages of symbols. Bear in mind the symbols are not usually supplied. It costs £14+VAT. See page 10 for tips on how to access ‘Writing with Symbols’ There are some relatively cheap High Tech tools The Talking Photo Album is an easy-to-use device that has many potential uses. You can record four minutes of speech, 10 seconds for each picture or photo. You can use photos, symbols, or drawings, on each of its 24 pages. You can use it for instructions, to tell stories, to record important information, help daily conversation, help order in restaurants, to help memory and for scores of other purposes. It costs £25 + VAT There is information on more complex & expensive High Tech Systems The Mercury is a fully-integrated AAC device and Windows XP computer, and weighs only 6lbs. It is totally self contained and prices for this start from £5429 + VAT. You would need a full professional assessment to work out suitability before buying a tool like this. For more information and ideas contact Liberator for a catalogue or look on their website Write to: Liberator Ltd, Whitegates, Swinstead, NG33 4PA Phone: 01476 550391 The Hospital Communication Book This is a communication book developed by us for the Learning Disability Partnership Board in Surrey. The idea came from a project that found that some people with a learning disability often received a Symbols of Drinks poor service in acute hospitals. The Hospital Communication Book (ELPINGTOMAKESUREPEOPLEWHOHAVEDIFlCULTIESUNDERSTANDING ANDORCOMMUNICATINGGETANEQUALSERVICEINHOSPITAL 4ALKINGCLEARLY 6ISUAL )MPAIRMENT 5SING3IGNING 4EA #OFFEE 5SING0ICTURES AND3YMBOLS 3UGAR -ILK ,EMON (EARINGLOSS Symbols of Procedures $EVELOPEDONBEHALFOF4HE,EARNING$ISABILITY0ARTNERSHIP"OARDIN3URREY /RANGE (OT#HOCOLATE &IZZY$RINK 3QUASH "LACKCURRANT 2ED&RUITS 7EIGHT $RESSING "ANDAGES 0LASTERCAST 7ATER -ILKSHAKE 4HE(OSPITAL#OMMUNICATION"OOK 4ABLETS 4EMPERATURE .AILCARE 4HE(OSPITAL#OMMUNICATION"OOK Page 24 ,IME *UICE $EVELOPEDONBEHALFOF4HE,EARNING$ISABILITY0ARTNERSHIP"OARDIN3URREY 0AGE 3LING -EDICINE -OUTHCARE Communication was found to be an important issue. The books have been printed and given to hospitals in Surrey. It has pages of symbols for foods, drinks, hospital tests, and other pictures to use at the hospital. 0ULSE $EVELOPEDONBEHALFOF4HE,EARNING$ISABILITY0ARTNERSHIP"OARDIN3URREY "LOOD0RESSURE 0AGE A pdf of the ‘Hospital Communication Book’ is in a folder called ‘Hospital Book’ on the CD You can print the booklet and use it if you need to visit an acute hospital Using Words, Photos and Symbols - Developed & Designed by The Clear Communication People Ltd COMMUNICATION TOOLS There are some well used Communication & Language systems in the UK PECS Some schools use a specific Communication and Language System to help pupils communicate. We thought it would be useful to give you some basic information about these systems as you may come across them. Can you imagine what it would be like if you couldn’t understand speech? How would you cope? It’s a situation which is similar to the one you might experience if you were in a foreign country and couldn’t speak or understand the language. What would you do? You would probably begin to gesture to explain what you wanted, and hope that others would understand your gestures and would gesture back. You might also start to draw pictures and diagrams to help get your messages across. Makaton combines all these elements in a highly successful teaching approach Makaton users are first encouraged to communicate using signs, then gradually, as a link is made between the word and the sign, the signs are dropped and speech takes over. Makaton symbols support the written word, in the same way that signs support speech. Makaton Symbols have been specially designed. Most of them are black and white pictures illustrating the important meaning of the words we use. For some children and adults, combining symbols, signs and speech together is proving to be an effective way of developing literacy skills. Contact Makaton for more information. Address: Makaton, 31 Firwood Drive, Camberley, Surrey GU15 3QD. Phone: 01276 61390 Fax: 01276 681368 email: [email protected] Website: www.makaton.org Talking Mats is a low tech communication framework involving sets of symbols. It was originally developed by The AAC (Alternative and Augmetative Communication) Research Unit to support people with communication impairment. Talking Mats are an established communication tool, which uses a mat with picture symbols attached as the basis for communication. It is designed to help people with communication difficulties to think about issues discussed with them, and provide them with a way to effectively express their opinions. Continued on page 26 Using Words, Photos and Symbols - Developed & Designed by The Clear Communication People Ltd Page 25 COMMUNICATION TOOLS Below is an example of how Talking Mats are used. They were having a chat about school and wanted to find out what a young man felt about the lessons he had. The mat was laid out with a large symbol for school and 4 options at the top. The young man then decided under which of of these four headings each lesson should go. Having things laid out in a clear visual way made this discussion much easier. There are Talking Mats packages you can buy and they also run training. For more information about Talking Mats visit their website or phone them: Website: www.talkingmats.com Phone: 01786 467645 The Picture Exchange Communication System (PECS) PECS is a communication system that began in USA. It began as a way of teaching children with autism to communicate their wants, and learn to make conversation. Many children with autism develop speech late, and find it hard to communicate directly with another person. PECS helps children to learn to communicate by exchanging a picture of something they want, such as a toy, for the toy. A lot of focus is put on the children having pictures for things they really like and want as this is what will motivate them to communicate. There is a lot of emphasis on encouraging the child to spontaneously ask for things by offering a picture. A childs vocabulary of pictures quickly grows and they begin to make sentences and use their pictures to comment on things as well as just asking for things. They have their own PECS diaries full of their pictures which they carry around with them. It has been reported that both pre-school and older students have begun to develop speech when using PECS. PECS is a very structured system to learn - this is just a very brief overview. You would need to find out more and attend PECS training before starting a PECS programme with someone. For more information contact PECS Website: www.pecs.org.uk Phone: 01273 609555 All children are individuals. No communication system suits every child. It’s good to find out about all the different approaches and which may suit your child best. It’s important that both home and school have the same approach to communication. Page 26 Using Words, Photos and Symbols - Developed & Designed by The Clear Communication People Ltd amily F Friends and s are and friend My family e. I rtant to m really impo lk n people ta love it whe . e m h wit about them Things I like I’m a sociable pe rson and enjoy being with other people I antedningDrtoinmkyutCD’s - and having a do solis Fodiosclove metimtes o b!e c d Jake. eds ers, Leo an th y food ne ro b MI’ 2 t o mall . e m I’ve g n m a in greeattoswsim older th ora m f th p o b u re a s. mer. I wear They armba le spie toce abnd ke w ep me afloat e h c d n a and love splash ootball in Leo loves f llynd. g ar ciaou s purs. les, e pe S b a s t rt e o g p p e u v s s guitar.I don’t like manIy enjoy being out in th e fresh sic and play u m s e . v lo e Jak g about me green ones ! air and also ren n jo o y s th t I love e a , n re g etecoca ritde weth He wrote a s, sin o r r to r ge a sw t c t th imming lo e er a k . e e ers I do li oks after m red pepp d n a s e My mum lo r o e ’m w tomat ke sure I egetable too ! I can get rks in a flo try to ma and also wo av e cold as I s e a r a le P s . s me e. Chip s e h t d shop someti h can’t move e it r w e f y f ll o ia d ec on an izza, esp rks in Lond food is p y a e eetcorn around My dad wo d it w r s ry u e , o v e v e chees My fa e train , o th t s a e h m o tc t a c of a topping . m a sure and h ase make le p o s r e t e my a slow ea e you tak r o f e b I’m quite d e ave finish I really h y! plate awa Developing Communication Passports COMMUNICATION PASSPORTS Communication Passports Communication Passports were developed in 1991 by Sally Millar, specialist speech and language therapist at the Communication Aids for Language and Learning (CALL) Centre at the University of Edinburgh. Communication Passports are a practical way of supporting people who cannot easily speak for themselves. They show the unique personality of the young person in a fun and informative way. A communication passport is not used instead of a communication tool. An important section in a communication passport can be explaining how the young person communicates, and how to use their communication tools with them. A Communication Passport aims to: Describe the young person positively, as a whole person, capturing their personality and humour. It’s not just about focusing on their disabilities and what they need help with. Give people important information about how to communicate with and support the young person. Things I like I’m a sociable pe rson and enjoy being with other people I love listening to my CD’s - an d having a disco sometimes ! I’m a great swim mer. I wear armbands to ke ep me afloat and love splash ing around. I enjoy being ou t in the fresh air and also enjo y the ride in the car to get there rink Food and D to be cut needs My food all e into sm up for m pieces. chewable cially les, espe b a t e g e v ke many I don’t li es ! green on corn, ts, sweet o r r a c e k I do li eppers. and red p tomatoes e sure I’m getable too ! y to mak e a ve Please tr . Chips ar e s e h t d y with offere especiall , a z iz p is n rite food cheese, sweetcor My favou , o t a m o of t a topping . m and ha My family and frien ds are really imp ortant to m e. I love it wh en people talk about the m with me . I’ve got 2 brothers, Leo and J They are ake. both olde r than me . Leo loves football a nd supports Spurs. Jake love s music an dp He wrote a great so lays guitar. ng about me. My mum lo oks after me a lot and also w orks in a flower shop some times. My dad w orks in Lo ndon and catches t he train e very day Friends and F amily A Communication Passport is most likely to be a book that the child or young person carries with them in a bag or on their wheelchair. Occasionally they are on a CD. Page 28 Using Words, Photos and Symbols - Developed & Designed by The Clear Communication People Ltd COMMUNICATION PASSPORTS My Developing a Communication Passport ion Communicat ough me words, th I do use so to ls o my symb I mostly use ith w communicate say to of what you h uc m nd ta I unders me time to owly to give me. Speak sl listen. can answer ions that I st e qu e m Ask and no very can say yes I . to no or yes To begin with you need to make a few decisions. 1. What size will it be - A4 is probably easiest as this is standard size paper we use in computer printers. A5 (which is half the size of A4) is more portable clearly. ds I can say: e of the wor m so e ar re He mum dad pizza I need help to get around as I Leo haven’t yet had an e ngine fitte d to my Jakewheelchair ! You w ait and see w hen I do ! Car I get cross if you just wh somewhere eel me without te lling me wh we are goin ere g. Supporting M e Please mak e sure you don’t leave the sun as me in I burn eas il y and can’t get myself into the sh ade mum will be cross if I’v e melted whe n she come s to get me ! I get really bored, and a bit uncom able if I sit fortin my chair all day. I li get out and ke to have a goo d roll aroun floor for a d the t least an h our during the day. 2. What folder will you use - Below are 2 examples of folders that would be ideal for a Communication Passport. Snopake Ringbinders These come in great electric colours and have a pocket on the spine where you can insert your own name. They come in both A4 and A5 size. You need to hole-punch pages to insert them. You can laminate the pages to protect them. Rexel Display Books These also come in A4 and A5 size. They have plastic sleeves that pages can be slid into. In the sleeve the page is protected so doesn’t need laminating. It’s very easy to take pages in and out to update them. You can also insert a page at the front to really make it personal. Both of these types of folders should be easy to find in local stationers. We ordered them from Viking Direct - see page 31 Once you’ve chosen the folder, or ideally the young person has chosen their folder, you can begin working out what to put in the passport. What to put in the passport? Each young person is different, so it’s hard to give a simple list of what to include. Hopefully the sample passport shown on this and the previous page will give a few ideas. Here are a few ideas for page titles: My Communication Important People Supporting Me Food and Drink My Likes Keeping Me Safe My Dislikes My Health A passport is not a behaviour programme, or guide to intimate personal care. These are more private and should only be seen by those directly caring for the person. A passport helps the young person to build friendships. Words are always written in the first person. For example I like..., as if the young person is saying it in their words. Using Words, Photos and Symbols - Developed & Designed by The Clear Communication People Ltd Page 29 COMMUNICATION PASSPORTS Making the pages Only start designing the pages once you’ve gathered all the information. It’s good to involve a range of people in writing the information. Teachers, brothers, sisters, aunties, friends may all have bits to add that we don’t think of. Don’t forget to involve the young person themselves. Also gather other bits like photos, drawings, bits cut out of magazines. Anything to make the page look fun. The more fun a page looks the more likely people will read it. With a passport it’s important not to have too much text on a page. You should be able to read it quickly and easily. How to make the pages Not everyone will be a great designer on the computer. That’s Ok. You don’t even have to design your passport on computer. It’s fine to handwrite your pages and stick pictures and photos on them. Do photocopy them, ideally in colour in case they get lost though. Designing a passport on computer has several benefits • It’s easy to print extra copies • It’s easy to make changes and update - it is important that you do update a passport and as children grow they change - Spiderman may not be cool anymore ! • You can make it look good by using different fonts, cartoons, and colours. Using Microsoft Word This is the program most people are comfortable using. It’s used for writing letters and reports. You can use photos and pictures in ms word. In summer 2005 we had Sinead on work experience with us in the office. Sinead designed a booklet for us to teach people how to use photos and pictures in ms word for designing communication passports. A pdf of the Microsoft Word handbook is on the CD in a folder called ‘Training Handbooks’ Using Microsoft Powerpoint This is a great program for designing passports in. We used this for designing the photo books and passports we did for families during the Children’s Fund Project. It’s a bit more complicated than word. We have developed a basic ‘Powerpoint Handbook’ which is on the CD in a folder called ‘Training Handbooks’. More Information The Call Centre in Scotland is the best place to go for more information. They have written an excellent book called ‘Personal Communication Passports - Guidelines For Good Practice’. This book is available from their website for £14. Go to - http://callcentre.education.ed.ac.uk/ There is also lots of other useful information including passport templates as powerpoint files and pdf files you can print off and use. Page 30 Using Words, Photos and Symbols - Developed & Designed by The Clear Communication People Ltd PRACTICALITIES Laminating Laminating makes sure the pages and symbols you print last a good while. Laminating covers the paper in a plastic wallet which is then heat sealed through a laminating machine. Prices for laminaters start at about £100. Most schools have a laminater and always seem happy for parents to use them for communication materials. You will need to buy your own laminating sheets. These usually come in packs of 100 sheets and cost between £20 - £25. You can get both A5 and A4 size sheets. To make A5 pages (half standard A4 size) pages it’s best to get A5 laminating sheets as this gives you a seal around all 4 sides. When producing a page of symbols try to fill an A4 page with symbols you need, then print them off, laminate the page, then cut the symbols out. They may come apart or get lost eventually, so make sure you have spares ready laminated. Fixing symbols to your pages We use velcro to fix symbols onto pages. You can buy this in strips or small coins. You need both the hook and the loop vecro. These two stick together. Make sure you are consistent about using either the hook or loop on the page or symbols. Blu-tack is another good way of fixing symbols on pages We wouldn’t normally recommend one stationer over another, though Viking Direct do have a wide range of binders, velcro, and laminating supplies. Web: www.viking-direct.co.uk Phone: 0800 1971 747 Extra copies of this booklet You may be asked by friends or colleagues where they can get a copy of this booklet. Only a limited number of these booklets have been printed. We are not selling this booklet, we are giving it away. We can’t send extra Due to the cost of producing CD’s only copies of the booklet but it is freely a limited number of these booklets come available as a pdf on with a CD attached. the CD and on our website If this booklet does not have a CD you can www.communication download all the templates and training people.co.uk handbooks from our website: The Surrey Children’s Fund paid us to run www.communicationpeople.co.uk a 2 year project Click on the image of this booklet. that supported over 85 families in Surrey The folders are then clearly displayed. Just click on to develop photo and the folder to see the contents inside symbol communication to download. We hope you find the booklet materials for their and website helpful. children. Most of the templates on the CD and website are pdf files. If We hope this booklet you can’t open these on your computer you need to downwill be a lasting load Adobe Acrobat Reader. See page 15 for details. legacy of the project. Using Words, Photos and Symbols - Developed & Designed by The Clear Communication People Ltd Page 31 Credits and Acknowledgments Many thanks to The Surrey Children’s Fund for the grant that made this project possible. Thanks also to Jacqui Mulvagh and Michaela Banks who ran the project. Thanks also to all the families and children, without whom there would not have been a project ! We hope this booklet will help families and staff to be inspired to produce useful tools for children to use to have their say in the world they live. Though this booklet is aimed at the needs of children, many adults also benefit from alternative and augmentative communication tools. A lot of the information in this booklet will be useful for adults Widgit Rebus symbols used with permission from Widgit Software Tel: 01223 425558 Photo symbols used to illustrate pages within this booklet. For more information phone: 0117 959 4424 or visit their website: www.photosymbols.com
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