Challenging Communication


The world of communication is a tricky place for any child to navigate but this can prove to be a challenging area for children with severe learning difficulties.  Our role as Speech and Language Therapists is to help find different way for children to communicate their wants and needs and to provide families and supporting adults with the tools to help them.  There are a range of varying strategies out there that can help support children with communication difficulties and it is important that you access a speech and language therapist to support you in deciding which method is right for you and your child.  Children with these difficulties can present as requiring alternatives to verbal communication – we call this area augmentative and alternative communication or AAC.  Systems range from:


  • Intensive Interaction: This system asks the supporting adult to copy the child’s actions in order to help them understanthat they can influence others.  This is the foundation to basic communication.
  • Communication Book: For those children who enjoy interaction but are frustrated because they cannot effectively get their message across, this is a book of pictures which allows the child to point to their request alongside verbal output (if in place).
  • Picture Exchange Communication System: This is a well-known visual system which helps the child to understand that they need to interact with others to request.
  • VOCA: Voice Output Communication Aids is an umbrella term for high tech devices that provide a verbal output.  A child must have developed a good understanding of navigation and categorisation to be able to use a device functionally.


                       page-4-comm-book.JPG              page-4-VOCA.jpg


Children with severe learning difficulties can be supported through environmental adaptations to support their communication.  Children with these difficulties often require support with:

  • Attention and listening
  • Expressive language
  • Understanding of language
  • Social communication

Speech and Language Therapists will often advise on a range of ideas to help support the home and additional learning and community environments.  It is for this reason that working as a multi-disciplinary team (with other professionals) is essential in supporting these children.  Ideas for supporting children’s communication can be as follows:

  • Make it visual: Children’s understanding is always better when you support key words with visuals, i.e. photographs/gesture/ objects
  • Break down your language: In moments of frustration or distress children’s ability to understand language reduces.  Try breaking instructions down into each part and providing pieces of information one at a time.
  • Waiting: Asking questions and commenting is great - give children the time to formulate a response
  • Opportunities: Make sure that children have the opportunity to communicate. Encourage them to request for things they can normally access independently, especially motivating activities. 


Communication has a key role to play in reducing children’s frustrations and providing a key into their world.  Take every opportunity to think about the role communication plays for your child and speak to your speech and language therapist if you want some more advice


Della Chubb

Highly Specialist Speech and Language Therapist

(Severe and Complex Special Needs)


This article is taken from the Winter 2014 edition of our newsletter, Challenge. You can read past editions of Challenge and sign up to receive it by email here.

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