Key Considerations for Selecting a Communication System

When determining the most appropriate system, assess the following factors:
  • Ocular Motor Skills: Consider the student's ability to fixate, hold fixation, and move their eyes purposefully. This influences their ability to visually access and interact with communication materials.
  • Field Losses:  Assess how field losses affect the student's visual access and placement of communication items. Ensure that communication materials are positioned within the student's visual field for optimal access.
  • Visual Acuity: Determine the student's level of detail vision, keeping in mind that it may be challenging to assess in nonverbal students. Choose communication materials that are appropriate for the student's visual acuity level.
  • Specific Characteristics of Visual Impairment: Consider any specific characteristics of the student's visual impairment, such as sensitivity to light, contrast sensitivity, or color vision deficiencies.
  • Visual Energy: Consider how much information the student can gather through vision and how this influences their ability to use visual communication methods effectively.
  • Communication Choices: Determine how many communication choices the student can handle or attend to if vision is used as a communication modality. Adapt the communication system to match the student's abilities and preferences.

Assessing Picture Use Readiness: The Noe Method

​Before transitioning from object schedules to pictures or symbols, it is important to determine if the student can visually recognize and interpret pictorial representations. This systematic approach, developed by Tricia Noe, a Teacher of Students with Visual Impairments with over 35 years of experience, helps assess visual processing and discrimination skills.
Steps in the Noe Method:
  1. Select Picture Format:
    • Choose between Boardmaker PCS symbols, real photos, clipart, or other visuals based on the student’s needs and experience.
  2. Picture-to-Object Matching:
    • Present a picture of a favorite toy or object.
    • Upon fixation or selection, immediately offer the actual object.
  3. Preferred Object vs. Blank Foil:
    • Show a preferred object’s picture next to a blank card.
    • Reinforce the selected item, whether blank or correct, to determine discrimination.
  4. Preferred vs. Non-Preferred Object:
    • Present pictures of one highly preferred and one non-preferred item.
    • Deliver the item the student selects and track consistency.
  5. Gradually Increase Visual Similarity:
    • Start with clearly different shapes/colors, then:
      • Similar shape, different color
      • Similar color, different shape
      • Similar shape and color
  6. Record Data:
    • Note patterns in recognition, accuracy, and preference.
    • Use this to inform whether the student is ready for symbolic representation.
Downloadable Resource:
You can print the "Evaluation of Picture Use" for Students who are Visually Impaired and Nonverbal" form, also known as the Noe Method, to support documentation and team collaboration.

​Using Schedules and Communication Cards

​For students who benefit from object schedules, tactile symbols, or low-vision adaptations, consider the following setup:
Recommended Materials:
  • Tactile Connections Kit: Symbols for Communication from APH
  • 18pt font labels printed on Avery address labels
  • Clear adhesive braille sheets (consider using contracted or uncontracted Braille as appropriate)
  • Tactile objects paired with symbols (e.g., a spoon for lunch, a small car for transportation)
Be sure to adapt these materials based on what is meaningful, familiar, and accessible to the individual student.

​Additional Tips for Implementation

  • Use consistency in presentation and placement to build a routine.
  • Consider multi-sensory supports, auditory output (voice output devices), tactile cues, and auditory schedules may enhance comprehension.
  • Collaborate with SLPs, OTs, and Orientation & Mobility Specialists to ensure alignment and generalization of the communication system across environments.

​Related Resources

  • Tactile Connections Kit: Symbols for Communication. This kit, available from APH, helps teachers create a tactile card system that is individualized for students who are blind or visually impaired who have additional disabilities and/or lack a formal means of communication or literacy. Objects that can also be paired with words are mounted on hand-sized cards representing core vocabulary categories.
"If a child can't learn the way we teach, maybe we should teach the way they learn." ~ Ignacio 'Nacho' Estrada

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