We’ve talked about visual, verbal, gestural and tactile cues. These are all cues that we provide as therapists. We also use visual supports or can change the environment to help our students meet their goals. I’m thinking about how I might use environmental cues to train the following common speech goals:
- Articulation: Saying an initial /b/ sound
- Syntax: Using regular past tense -ed
- AAC: Have a student tell you to “turn on” radio to listen to music.
- Pragmatic language: Greet another student
- Receptive language: Identify objects by function
- Vocabulary: Define a vocabulary word by category and function.
Visual support prompts are used when a visual support is required in order for the task to be completed. Examples include: picture symbols, sign language, photographs, or showing the actual object. If you are going to fade support, remember to pair visual support with verbal. (example to teach first/then, use visual support card with verbal: first we do train, then we do swing. Eventually you can fade to just first/then directions.) Linda Hodgdon has amazing books on visual supports-she is an engaging speaker. If you haven’t seen her, I highly recommend it.
- Articulation: I might use pictures of the articulation postures to teach a sound. I use a visual support when teaching /s/ blends frequently that shows how the air flow is turned on and then stops. I also use a lot of pacing boards when working on intelligibility or multisyllabic words.
- Syntax: I use a visual that has a box where I put the verb card on and than has a +t or +d depending on how the word is presented. A colleague of mine made it-it is really helpful.
- AAC: I might try using a picture of the symbol I want my client to activate. You could write out a variety of scripts for them to use. We use this a lot with adapted books with the picture communication symbols on the book as a guide.
- Pragmatic language: Again, I’d probably use a picture sequence to show how the conversation progresses. These sentence strips from Speaking of Speech are pretty good for that!
- Receptive language: Any time you add pictures for choices, you are using some visual supports to aid your students. I might change from providing 2 pictures to 10 pictures within an activity-or have them find the correct answer within a visual scene.
- Vocabulary: EET is a great visual (and tactile) support for defining words. I use the stickers included or the steppers to get the correct responses too.
Fading Visual Support Prompts: Before fading visual supports, remember that we ALL use visual supports to organize our day (things to do list, recipes etc.) If you feel fading visual supports is appropriate try decreasing the size of the supports, also can fade the ink on a support, or make your signs smaller.
Positional prompts and Dimensional prompts are ways that we can cue for language as well. I probably use these cues with my students who have more cognitive impairments or who have diagnoses such as Autism or ADHD where I want to make sure they are attending to the task.
Positional Prompts: using placement of materials to prompt the child‘s correct response. This is basically just positioning the item you want them to pick closer to the child. It can also refer to our physical proximity to the child when completing a task. (example with PECS, first train with materials and instructor in front of the child then move instructor farther away until child is able to request info from adult across the room, then move materials away until child is able to request from any part of the room by going to get the picture and then get instructor.) I also use this with some receptive language tasks, if the student hasn’t responded-I might move the card I want them to pick closer to them.
- Articulation: I can’t think of specific positional prompts related to visuals that would impact a student’s performance. There may be some benefits to changing your proximity-for instance, can they say the sound when we are right in front of them providing visual/verbal models? What about when we are next to them. Can they maintain productions when we are across the room? How about in the hallway? Potentially useful as we are thinking about carryover.
- Syntax: Positional prompts seem more effective when used in receptive tasks vs. expressive. You could try varying your position in the room and see if it makes a difference.
- AAC: When I first start teaching, I may be very close to my client. It makes sense, that you work on their ability to request the same information when you are farther away or not attending to them. This seems more like a carryover tool vs. a cue that you would use to get the correct response. You could change the position of the button you want them to activate-by putting the more “important” buttons in an area on the device where the child is most successful.
- Pragmatic language: You could try positioning the student you want the child to greet close to the door (I’m sure they will just stay there without moving, right?)
- Receptive language: If the student hasn’t responded-I might move the card I want them to pick closer to them.
- Vocabulary: I would probably use this in a more receptive language task as well. You could move the cards with the answers closer to the child.
Dimensional Prompts: Changing the size/characteristics of the object so that the child is more successful. Examples would include: increasing the size of the picture that you want the child to take. (when teaching letter identification, make the letter you want the child to choose larger than the other, gradually decrease size difference until the child is able to distinguish between the two letters.)
- Articulation: I don’t know that changing the size of a card would be effective in improving speech sound production. I think we can think of dimension in terms of some of our other prompts. We can make a gestural or facial cue smaller or larger.
- Syntax: Within a receptive identification task, you could make the pictures you want them to choose larger. This seems like a lot of work though-there are probably better methods of improving syntax.
- AAC: AAC is one area where dimensional cues seem to be really helpful. We use color coding on some communication boards to indicate the “part” of speech the child is using. Then we can use colored squares to teach sentence construction. You could temporarily increase the size of the button you want the child to choose and then fade it back to the regular size once they have learned the location.
- Pragmatic language: You could stand behind the student that you want them to initiate conversation with. You could start by having a really big (maybe full page length picture indicating “hello.” Eventually you could work down to a smaller cue card.
- Receptive language: Some clients may attend better to larger cards vs. a standard sized card. You might also have pictures where the object is outlined in one color and the function is outlined in a different color. Or maybe you have the same color outlined on cards that match. (example ball and throw are both outlined in blue. Other cards have different outlines.)
- Vocabulary: I might provide visual choices and color code them to match whatever cuing system I am using. If it is EET, I would have category choices outlined in blue and actions outlined in green.
We use a million visual strategies and modify our materials all the time to help our students learn. What are your favorites that you use in your classroom? I’d LOVE to hear about them below!
