Assistive and instructional strategies for communication

Accessing Communication Boards and Devices

Students need proper positioning to access communication aids effectively. Devices like slant boards, lap trays, or adjustable desks may be used. Pointing tools such as head pointers, mouth sticks, or light beams support symbol selection. Access depends on students’ physical, sensory, and cognitive skills, with occupational therapists assisting setup.

Direct Select

Direct select involves students pointing or touching symbols directly. It’s the fastest and simplest method, preferred for those with fine and gross motor abilities. This system avoids intermediate steps, making it efficient for communication.

Scanning

Scanning is an indirect access method where students use switches to choose symbols. Types include automatic, inverse, step, and direct scanning, tailored to cognitive and physical abilities. Choices may be highlighted visually or auditorily, with patterns like linear or circular arrangements.

Encoding

Encoding uses codes to represent messages by combining letters, numbers, symbols, or colors. Systems like Morse code or abbreviation expansion (e.g., “EMD” = “I want McDonald’s”) allow faster communication. This requires consistent motor or cognitive control and is suited for students with reliable skillsets.

Vocabulary Selection

Vocabulary for physical and health needs depends on the student’s cognitive and physical abilities. Selection should be individualized rather than from standard lists, making communication more efficient. Words should help students express needs or instruct others in procedures, using a structured step-by-step process.

Vocabulary to Express Health and Physical Needs

This includes both general words (“hurt,” “sick”) and more specific terms (“headache,” “nausea”). Tools like pain gauges or body charts help students indicate severity and location of pain. Additional vocabulary supports problem-solving actions such as requesting medication or calling a parent.

Vocabulary for Performing Health Care Procedures

Students with physical disabilities may not perform tasks themselves but can direct others. Vocabulary should include names of supplies, steps of procedures, and instructions. This gives students independence and control, even when relying on trained or less-trained personnel for assistance.

Instructional Strategies for AAC (Augmentative and Alternative Communication)

Students requiring AAC must be systematically taught to use it in daily routines. Communication opportunities should be frequent and embedded in activities like snack time or requesting mobility. Consistent responses to all attempts are essential, ensuring students learn to use devices effectively across varied settings.

Instructional strategies handout

Antecedent Prompts

Antecedents are cues or instructions used to initiate behavior. When natural cues aren’t enough, teachers use prompts to guide correct responses. Prompts should highlight natural cues, be as minimal as possible, and be faded quickly to avoid dependence. Overuse or strong prompts can hinder independence.

Expanded and Relevant Feature Prompts

Expanded prompts add extra details to natural cues (e.g., tracing dots to write a name), while relevant feature prompts highlight essential task features, often with color coding. These support correct responses but must gradually fade so the natural cues eventually stand alone.

Proximity Prompts

Proximity prompts involve altering the placement of materials to guide student responses. For example, placing the correct utensil closer during trials helps highlight it for selection. Over time, the distance between materials is reduced until they are presented equally, promoting independent, accurate choices.

Associative Prompts & Modeling

Associative prompts pair abstract concepts with concrete examples, like flashcards showing the word fork with a picture of a fork. Over time, prompts are faded to encourage independence. Modeling involves a teacher demonstrating a behavior for students to imitate (e.g., brushing teeth). For effectiveness, teachers must gain attention, provide clear demonstrations, and use simple cues.

Match-to-Sample & Self-Operated Prompts

Match-to-sample prompts provide an example item for students to follow, similar to modeling but object-based (e.g., showing a sample completed task). Self-operated picture or auditory prompts guide students through tasks, offering ongoing support, particularly for multistep activities or students with cognitive challenges.

Learning Strategies

Learning strategies focus on how students learn rather than specific content. They are especially useful for students with mild or no impairments. These strategies include describing, modeling, rehearsal, and practice. They often use mnemonics (e.g., ESP—Equipment, Steps, Problems) or rhythmic structures (songs, raps) to support memory, note-taking, health, and physical education.

Response Prompts

Prompts help students perform behaviors that are absent or incomplete. They guide motor responses, prevent errors, and reinforce correct performance. Five types include:

• Full physical prompt: teacher fully assists.

• Partial physical prompt: minimal assistance or direction.

• Model prompt: teacher demonstrates for imitation.

• Gesture prompt: teacher signals nonverbally.

• Verbal prompt: teacher gives spoken instructions.

Systematic Use of Response Prompts

Prompts should be used systematically, either as a single strategy (time delay) or multiple strategies (maximum prompts, least prompts, graduated guidance).

• Time delay: teacher gives an instruction, waits for student response, then prompts if needed.

• Maximum prompts: start with full assistance and fade gradually.

• Least prompts: begin with minimal help and increase if necessary.

System of Maximum Prompts

This method begins with the most assistance (e.g., full physical support), then systematically reduces help as the student gains independence. The teacher provides errorless practice, testing reduced levels of prompts until the student can perform independently. The goal is to fade teacher involvement while increasing student mastery.

Demonstration-guided practice-independent practice model

This model is often used with students with mild to no cognitive impairments. It involves three stages:

1. Demonstration – the teacher explains and models the skill.

2. Guided Practice – students practice with teacher support, prompts, and feedback.

3. Independent Practice – students perform skills independently, with minimal guidance but continued feedback when needed.


It gradually shifts responsibility from teacher to student, allowing skills to be learned, generalized, and practiced until mastery.

Three step process

Ecological inventory

An ecological inventory is a process teachers use to identify functional or specialized skills students need to participate in school, home, or community activities. It focuses on real-life tasks rather than isolated developmental milestones, taking a top-down approach to curriculum.

It involves a five-step sequence:

1. Listing current and future student environments.

2. Identifying relevant sub-environments.

3. Listing priority activities in each sub-environment.

4. Identifying skills needed for those activities.

5. Prioritizing activities/skills for the student’s Individualized Education Program (IEP).

Listing Current and Future Environments

Teachers identify a student’s present and future school, home, and community environments through interviews. These include classrooms, cafeterias, gyms, and community places like grocery stores, malls, and medical services.

Identifying Relevant Sub Environments

Sub environments are specific areas where different activities occur, such as kitchens, bathrooms, or grocery store sections. Recognizing these allows teachers to plan functional skills relevant to each unique setting.

Listing Priority Activities

Teachers identify functional activities in sub environments, like ordering food in restaurants or navigating grocery stores. Activities are broken down into steps, ensuring students learn essential participation skills within environments.

Identifying Priority Skills

For each activity, teachers identify necessary motor, communication, social, and academic skills. For example, tube feeding requires equipment preparation, giving formula, and cleaning tools—focusing on practical life skills development.

Discrepancy Analysis

Discrepancy analysis identifies gaps between what a student can currently do and what is required. It involves observing performance, noting errors, and determining skills needing direct teaching, adaptation, or alternative strategies. This structured process highlights exact instructional needs for skill mastery.

Performing a Task Analysis

Task analysis breaks activities into small, measurable steps to support learning. Teachers or peers may model each step while recording functional or motor actions. This method allows clear observation of 

student ability, highlighting specific skills to target for teaching or adaptation.

Observing and score performance

Teachers observe whether students can perform task steps independently, with verbal guidance, or with physical assistance. The goal is to assess understanding, motor ability, and independence. Teachers record results, noting full independence, partial assistance, or guided performance, ensuring accurate tracking of student capabilities for instructional planning.

Recording Student Errors and Doing a Performance Discrepancy

When errors occur, teachers record them, analyzing causes such as cognitive, physical, sensory, motivational, or communication issues. This process helps identify why a step wasn’t completed, guiding whether further instruction, adaptations, or alternate strategies are necessary for student success in performing required skills.

Providing Instruction, Adaptations, or Alternate Performance Strategies

Teams decide whether to reteach as modeled, adapt tasks, or develop alternative strategies. Adaptations should only be used if essential, and instruction should promote independence. When adaptations are ineffective, alternative strategies (e.g., technology or communication devices) may be introduced, ensuring students achieve the same functional outcomes despite impairments.

Strategies, Problems and Management

Instructional strategies

Students using positioning equipment are taught communication signals, schedules and movement preparation to reduce resistance. They may practice independent mobility, assist with adjustments and signal discomfort. Instruction encourages participation, relaxation, and safety checks. On leaving equipment, functional movements and skin inspections are emphasized to support independence and prevent complications.

Handling and positioning problems and emergencies

This section emphasizes safe handling and positioning of students. It highlights that positioning should never cause pain or be forced. Adults must watch for signs of distress, such as crying or grimacing and students should be taught to indicate discomfort. If pain arises, repositioning or removal from equipment is necessary. Regular checks for redness or injury should be performed, with reports and appropriate actions taken. Therapists should guide responses even if no visible injury is present.

Management issues for handling and positioning

IHPs (individualised health plan) and IEPs outline handling methods, equipment use and emergency precautions. They include therapy needs, risks, and objectives to support student safety, independence, and achievement of educational goals.

Tracking implementation

A student schedule organizes handling and positioning alongside academic activities, ensuring consistency. For example, during reading, a student might spend 20 minutes prone over a wedge to improve engagement. Data sheets track type, duration and goals of positioning to monitor progress, safety, and effectiveness. Documentation also helps evaluate how positioning aligns with educational goals, such as comprehension or motor skills, and ensures planned use of equipment. Regular data collection ensures students benefit functionally and educationally from positioning strategies, while maintaining accountability for both staff and student progress.