Introduction

Many people with ASC have learning and communication difficulties. It is important to be aware of the difficulties with communication and adapt our communication and the environment to give individuals the greatest opportunity to understand and communicate. This entails looking at communication in its broadest sense and giving the person as many resources and opportunities as possible to understand and convey their message.

This holistic way of considering communication is called 'Total Communication'. The total communication approach is about using the right combination of communication methods for an individual to ensure the most successful forms of contact, information exchange and interaction. It is a way of optimising an individual's potential and reducing the extent of their communication difficulties.

Communication Model

Communication is a two-way process, it involves one person giving a message to another person, who is the receiver. When the receiver gets that message, they send back a response. The modes of communication used by a person with communication difficulties will not necessarily be the same as they need their communicative partners to use. For example, an individual might need to receive information via speech and signs while expressing themselves using signs and symbols.

Why Working Visually Helps

Many people with ASC are thought to be visual learners and so presenting information in a visual way:

• Provides a focus and adds reinforcement;
• Supports the ability to process and retain information accurately;
• Supports problem-solving ability;
• Provides structure and routine; Visual strategies can be used in a multitude of ways to enhance understanding, expression and problem-solving.

Different Modes of Communication

The Total Communication approach makes use of the following modes of communication:

• Written words and or drawings;
• Objects of reference;
• Photos/symbols of reference, for example with timelines, visual sequences, choice boards, cue cards, visual countdowns, Talking Mats and Social Stories;
• Affect, which is the use of non-verbal communication: gesture, body language and the voice. Affect accounts for over 90% of communication;
• Augmentative and alternative communication (AAC);
• Unaided forms of AAC - for example signing systems like Makaton;
• Aided AAC using assistive technology, both high and low tech. For example PECS books (Picture Exchange Communication System), switches and high tech communication devices with voice output;
• Eye-gaze and partner assisted scanning systems both high and low tech;

Person Centred

If the Total Communication is being used then it must be tailored specifically to the individual and take account of their communication strengths, difficulties and needs. Total Communication is the key to inclusion.

Important Considerations

There are important considerations when using the Total Communication approach these include:

Consistency

• Total communication has to be used consistently by all those supporting. Accessibility 

Accessibility

• Visual support tools and devices need to be easily accessible in all environments.

Language Level

• The language used must take account of an individual's keyword understanding and the amount of information they can retain and process at one time.

Processing Time

• Sufficient time needs to be given to allow the person to process the language and the other modes of communication used to support.

Encouraging Communication

• Total communication should be used to encourage and not force communication.

Context

• All modes of communication should only be used in context and in situations that have meaning to the person. Always make use of environmental cues and build on these, for example, objects, people, pictures, logos, colours, noise and texture.

Adaptability

• Be flexible and adapt to how a message is given if it was not understood in the first instance. Provide the individual with other ways of responding if they are struggling.

Back-up

• There should always be back-up sets of visual resources if an individual is dependent on them. This also applies to high tech AAC devices if in use.

Environment

• The environment needs to take account of an individual's sensory profile and must be conducive to encouraging communication.

Shared Attention

• Shared attention has to be achieved before initiating any interaction with an individual.

The Wellbeing and Autism Wheel

Useful Information

National Autistic Society - Communication tips (autism.org.uk)

ASHA - www.asha.org/public/speech/disorders/AAC/

Communication Matters - www.communicationmatters.org.uk

Makaton - www.makaton.org

Picture Exchange Communication System (PECS) - www.pecs-unitedkingdom.com

Inclusive Technology - www.inclusive.co.uk

Talking Mats - www.talkingmats.com

Carol Gray social stories - www.carolgraysocialstories.com

SCOPE - www.scope.org.uk/support/families/diagnosis/autism

I CAN communication charity - ICAN CHARITY