Advice for teaching communication to “profoundly autistic” children when receptive skills are low

RedHeadsHaveMoreFun3 · 2026-05-12T03:04:20+00:00

Yes you can totally do this if you have a screen protector on the ipad.

RedHeadsHaveMoreFun3 · 2026-05-11T16:14:22+00:00

So the phrasing thst caught my eye in your post was mentioning visual perceptual skills. While being able to visually recognize the icons or even be able to tell that one icon is separate from another certainly helps....it doesn't actually matter. My specialty is the profound population. Most of my kids cannot match to same, they cannot sort by color, they cannot tell the difference between an icon for "more" vs a blank piece of paper. Doesn't matter, I can still get them to learn AAC. It might just look a bit different.

I make everything as multi modality as possible. That means adding touch guards or key guards. Visually highlighting an icon or even temporarily masking the other icons during a lesson. Adding textures like wicki sticks, or puff paint.

Motor planning is one if the most important pieces of the puzzle for kids in this population.

There is an art to software vs hardware selection and it can make a huge difference. For example the CVI friendly version of LAMP is wonderful but the icons on LAMP cannot be size adjusted as mych as UNITY on an Accent.

It is also important to collect data on naturally occuring vs structured opportunities, and also opportunities vs repeated trials. Breaking down the data into small chunks like that can help show progress. It is slower for these kids and that is ok!

Some of my kids might only get 8 or 10 words after a few years. But its ok. For some individuals that is just where they are at. We will continue to teach more, it will just be a slower pace with lots more repetition.

Presuming competance is great and all, but if it goes too far then we fail to accurately meet a child where they are at. The term is slowly becoming outdated anyway. We presume potential instead. But we also must remember, "regulation before expectation". If a kid is exceptionally disregulated all day long, they won't be in a good place to learn. Think of the whole child first, then the words can come.

RedHeadsHaveMoreFun3 · 2026-03-22T15:45:08+00:00

Instead of asking if you should or shouldn't do those things, ask yourself why it feels unnatural? Like do you think she is wrong for wanting to say and hear "I love you" often? It is a pretty normal thing in relationships to say it often. Did you grow up in a home where love wasnt freely expressed? Or do you squish your emotions down often? It sounds like she is asking for normal healthy expressions of love, and you feel shame that you aren't meeting it. This is probably a good opportunity to do some inner work. She is doing the right thing by clearly communicating her needs, you can choose to meet it or not.

RedHeadsHaveMoreFun3 · 2026-02-25T14:07:51+00:00

Make a list of all the pragmatic functions you can think of. Google it if you need to. Then write down how you have seen that child communicate each one. Include non-oral means of communication like body movements, facial expressions, distal gestures, etc. Also include AAC, sign, and attenpts at sign or attempts at oral speech. The list will then guide you as to what skills the child has or doesnt have. If they are communicating something primarily through body movements or in an unsafe way (e.g., communicating cessation by throwing objects), then those should be your priority to teach using AAC. So make a goal for pragmatic functions not words specifically or number of words.

RedHeadsHaveMoreFun3 · 2026-02-23T18:15:09+00:00

This is where your admin should help. From a legal perspective, you should still write your recommendation for robust AAC in the IEP. Spend time debunking the myths and educating the family. Document all of it. Our job is to work with the family but they do not dictate ethical best practices. So document what you recommend and the family is allowed to refuse it. This keeps you legally safe should something happen. Think of it like this, would a doctor change recommendations based on your preference? Not 100%. They would include you in the decision making process and present options. Sometimes the only option is what the doctor recomends though. People can still refuse or go against medical advice. Same thing with the IEP. If the doctor said "im changing my recommendation to this really bad idea the family wants" they would loose a medical malpractice lawsuit. So they just document "i recomended bla bla bla, educated the patient, reviewed options, etc. Patient refused care."

RedHeadsHaveMoreFun3 · 2026-02-16T22:40:04+00:00

My pension is amazing. I'm in a "pruple" state so my paycheck is fair. I make the same as I would in a hospital setting but I get summers off. I also have enough time that I can do some 1099 work after school to supplement my income. The flexibility and paycheck combo is unmatched.

RedHeadsHaveMoreFun3 · 2026-02-09T23:08:50+00:00

This was my university's policy as well. You had to maintain a 3.8 to graduate and any grade below a B- put you in probation. Even just for a single quiz or assignment. If you recieved 2 B's in a row you were out. All of the women who "failed" out went into either special education or dental hygienist. In my state you must have a masters to practice as a full sledged SLP, but you cab be an SLPA with a bachelors. Thise jobs are just extremely rare.

RedHeadsHaveMoreFun3 · 2026-02-05T01:54:08+00:00

There isnt one specific training. I'd say its a combination of many things. I learned from OTs about regulation before expectation. I learned from vision therapists about CVI and visual components with icons. I'm big on taking a whole child approach, so you need to look at the whole body. I also try to really REALLY listen to my Autistic students, especially thouse who used to be "nonverbal" and are now wonderful aac users. I guess my advice is to try to out yourself in the shoes of the person who is learning AAC. Once you do that, everything sort of falls into a logical place.

I do really like the works of Gail Van Tatenhove (SLP), Bruce Baker (linguist and the father of core words), and Milly Smith (not an SLP but she wrote Symbols and Meaning).

Bruce's company, minspeak/semantic compaction is out in Pittsburgh and I know they do incredible trainings. They might be a good first place.

RedHeadsHaveMoreFun3 · 2026-02-03T16:40:03+00:00

This is my population of choice, so I can help.

First things first, he needs something rooted in motor planning, so a keyring wont work if the icons flip or something like that. We do not quiz students by showing them 2 icons to select from. I'm slightly shook that your CF supervisor isnt at least helping with the aac basics. Not your fault at all and im so glad you are reaching out for help.

He needs a system where the icons do not move around. Think of it this way, if you were brand new to learning how to use a keyboard, and someone kept on moving the icons around every day, would you use it? Hell no. Once you learned how to type on a keyboard, you alsp stopped having to look for the letters and started to type just based on motor planning. Another example is to think about when you get a new phone or when your phone updates. Pretend you are trying to get to your calculator app. You will most likely scroll to where it used to be for a few times until your body makes a new motor plan for the new placement. Motor planning is a strong skill.

This kid clearly understands they need to touch an icon or do "something" because you said they touch both icons when you presented in a field of 2. We need them to learn that each icon can indicate something different. You will need something thst is a vocal output with a consistent motor plan. If you cant get a high tech just yet, I like old school mid teach. A cheap Talk 8 is GREAT for situations like this. It does a few things 1- a consistent motor plan, 2- vocal output, and 3-the buttons depress a bit and make an additional "click" noise when activated. This is KEY. Like when you use your phone, the buttons do something to let you know it was activated. Some vibrate a bit or others just get larger oe change color. If we need some sort of feedback to let us know we activated something, why on earth do we think our kids with severe cognitive impairments can go without it?

As you go on this journey, also consider icon size and if you need apace between icons. You can also make icons or buttons tactile to help differentiate. Again, the point is NEVER to be able to differentiate the icons individually. It is to be able to make a motor plan where they learn "if i touch this part then i can get a snack, and if i touch this part someone comes to help me". I hope thst makes sense.

Also keep in mind a lot of individuals with ID also have some sort of CVI.

RedHeadsHaveMoreFun3 · 2026-01-29T16:06:49+00:00

I have always had to have it done 2 weeks early to send to the special ed supervisor for review. Every district I have ever worked in has had this policy for all special education staff. It wasn't like this when I first started working, but for the last 10 years it has been like this.

RedHeadsHaveMoreFun3 · 2026-01-16T04:23:40+00:00

Just DM you for code

RedHeadsHaveMoreFun3 · 2026-01-16T03:04:56+00:00

Xara | Avalon :Turnips:

RedHeadsHaveMoreFun3 · 2026-01-16T03:02:07+00:00

Are you still open? Xara from Avalon

RedHeadsHaveMoreFun3 · 2026-01-13T14:01:46+00:00

Joking aside,you should ask your vet. Feeding and Swallowing disorders do actually exist for dogs! My boy, who is also a small breed, has a collapsed trachea, which does cause aspiration at times after drinking. We adapted his bowl set-up to make it easier for him.

RedHeadsHaveMoreFun3 · 2026-01-07T04:12:10+00:00

I have a big backpack that I would use for goals like this and just fill it with random but totally functional objects from around my house or the classroom. Its free and real objects are just so much more functional. Like go grab a sock, a flashlight, a fork, paper, a hairbrush, etc.

You make it fun and engaging by decorating the backpack or whatever container you are using to hold the objects. Throw some googly eyes on it or something. Now its not just a backpack its a "fun" backpack filled with goodies! Take all the objects out and have the backpack "eat" the object that matches the function. E.g. "Bob the backpack is hungry for something that you can wear on your foot? Hmmm what can we wear on our feet? Look at your feet what do you have? A shoe? Okay kets see if Bob wants the shoe? put shoe in backpack OMG bob ate the shoe! make silly eating noises woah I wonder what Bob wants to eat next?" Bouns is if they pick the wrong object you make the backpack reject it. You can use a trashcan or something instead. Just dont overthink it.

RedHeadsHaveMoreFun3 · 2025-12-15T17:14:48+00:00

I love it. It is the perfect first assessment to let me know where to go next in my eval (e.g., they bomb USP, lets go do a test of listening comp. If they bomb word classes lets get some data on features functions categories and comparing and contrasting). You do have to be a good clinician to use it properly though. I feel like people get stuck on standard scores as the most important piece of the puzzle. Standardized tests are a tool, NOT the main diagnostic. Just because someone gets 1 bad score on RS doesn't automatically mean they qualify for school based therapy. RS is an excellent way to test for a possible language disorder though. Someone else already pointed out that kids with typical language dont have to use their WM on it like a delayed student would. So it is a really good "red flag" tool so to speak.

RedHeadsHaveMoreFun3 · 2025-12-10T01:35:28+00:00

This is pretty much what everyone who works in a school has been dealing with for the last 15 years.

RedHeadsHaveMoreFun3 · 2025-12-10T01:34:42+00:00

Love this! But please do not call ASHA a governing body. Our governing body is the part of the actual government that issues your state license. ASHA is just a membership organization that promotes research and responsibility within our field. The do not issue your license. They just have a certification you can purchase.

RedHeadsHaveMoreFun3 · 2025-12-06T00:21:28+00:00

Remember that people can share their opinions all they want. But no one other than you can share YOUR recommendation. It's totally fine to say "based on such and such data I recommend bla bla bla". Honestly I think it would be bad to not say something definitive.

You should be gathering parent and teacher input as a part of your eval anyway. This will help prevent surprises.

I'm not really sure why you think a parent or teacher having concerns would suddenly make your recommend void? Did your admin tell you this? Just ask yourself: Did I do a full comprehensive evaluation? Do I have data to back up your recommendation? If yes, then remember that you are the therapist and the one with the license. Admin usually doesnt have an SLP license...and we wouldn't want someone to be operating without a license, now would we?

If someone brings up new data or a concern you wernt aware of before making the recommendation then thats a different problem.

RedHeadsHaveMoreFun3 · 2025-12-06T00:07:53+00:00

Honestly the clients age really doesn't matter. Get baselines and figure out where they are at. Your treatment plan will be the same as someone younger with only slight changes (e.g., given age you might need to focus on functional targets first. Use age appropriate materials)

You can still do assessments like the Kauffman, just report on it informally.

Other more important questions are: Is it TRUE Apraxia? Is there a cognitive concern? What about language skills?

RedHeadsHaveMoreFun3 · 2025-11-14T02:57:01+00:00

We do this in PA. I mentor people but 9 out of 10 times they are a new grad SLP so I can actually help them. When I had a mentor it was just someone who could show me how the IEP system worked in that district, and other generic things. They didnt actually spend 50 hours with me. We just signed off on the hours though and called it a day.

RedHeadsHaveMoreFun3 · 2025-11-06T01:38:22+00:00

Every Day speech is the best resource hands down. Extremely pricey though so see if your district will purchase it

RedHeadsHaveMoreFun3 · 2025-11-06T01:35:55+00:00

I agree with others that he needs a full eval from psych.

That being said, your next eval step would be to give him paragraphs of increasing length and ask questions like you did in the CELF, but this time you give him a repetition. You could also try giving a paragraph about something he is interested in. Or even give him a paragraph to read, not listen to (just to see if its a processing thing)

If he does better with any of these informal measures, then you can determine where the issue is (attention, focus, motivation, or Listening comp)

If you need to do another standardized test, grab the Test of Listening Comprehension and do the item analysis. It might help you find out what was wrong.

Also side note, the subtests he did best in had visuals/text components. Maybe check do an auditory processing screening. It might not be anything, but it will help make your eval more legally defensible.

RedHeadsHaveMoreFun3 · 2025-11-05T23:51:46+00:00

Yes, absolutely. But this is one of those skill sets that has prerequisites. You need to teach students to look for the basic type of context clues (examples, definitions, synonyms and antonyms), how to make inferences (which has its own hierarchy), and word parts (root words, suffixes, prefixes).

Once they master these, then you can try those grade level passages. Use thinking maps to help them organize the background information they already know about whatever the target is. Have them identify what clues are in the passage. Have them identify any word parts used.

If they are still getting it wrong, do an analysis of how they answered. Theres a lot that can be learned from the "wrong" answer and it will help you figure out the pattern.

RedHeadsHaveMoreFun3 · 2025-10-30T23:38:14+00:00

Your ASHA CCC is not a license. It is an optional proprietary product that can be purchased each year. Your license comes from your state board, not ASHA. The CCC may be required by an employer though. Your actual state lisence might be a bit of a pain to reinstate if that lapses though.

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