Children who are having difficulties communicating often find visual cues beneficial to help them understand and deliver messages.

We use a variety of visual cues all the time including hand and body gestures, facial expressions, and logos.

While we only have a short amount of time to process a spoken message, things that we look at, such as photographs, pictures, objects, line drawings, and printed words last for a long time and can help children understand and remember the message.

Many children have communication challenges and breakdowns with spoken language. Visual supports improve language abilities because they do the following:

• Allow people to "say” things with items, such as pictures, when some or all of their spoken words may be misunderstood.
• Provide a back up system when there is a communication breakdown, especially when the child is speaking with someone he or she does not know well.
• Reduce the number of communication breakdowns by providing extra visual information about the message to the listener. If the child is understood, it is likely that frustration will decrease.

When Are Visual Cues Used?

Visual cues can be used by the child and family to help with:

• Organizing daily routines
• Knowing what is coming up or going to happen
• Understanding information
• Making choices
• Reminding a child what to say and do
• Increasing spontaneous speech
• Letting someone know he or she is understood

Examples of Visual Cues that Improve Communication

The following examples are some of the visual cues used at Duke. More than one item or strategy are often used together and each cue is customized to the child’s likes and needs.  

First/Then Board

A first/then board is a concrete way of showing children what you would like them to do and what will come next. It provides children a routine and structure, as well as helps them to anticipate a change in schedule. For example, a child may be asked to “first eat your food, then you can play with your toys.” This strategy can also be used to show a sequence, such as, “First put on your shoes, then get in the van.” 

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Visual Schedule

A visual schedule is a step-by-step description of what activities or steps of a routine the child is expected to do. For example, children may benefit from following visual instructions to brush teeth or having morning routines outlined to help with the transition to school. A visual schedule helps children understand the whole activity so there are no surprises and reminds children of all the steps or actions needed to finish.

In this example, the visual schedule represents the activities the child will accomplish with his speech therapist. As each activity is completed,  the child moves the picture to the right side of the chart.

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Visual Timer

A visual timer is a way to help children understand time by “seeing” it. It allows a chosen amount of time to be shaded so children can view the time and see how much is left until the end of a session or activity. By “seeing” time and knowing there is an end, children may be more likely to work hard toward finishing the activity.

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Countdown Board

A countdown board allows children to see how many times they need to do something before the activity is done. For example, you may show your child “you must eat five green beans and then you can color."  The visual and physical aspects of a countdown board can be rewarding for a child as the number gets folded over and velcroed every time he eats a green bean.

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Appointments for Autism-Related Speech Difficulties

Appointment types can vary and your speech pathologist and referring doctor can help you find the right intervention for your situation.

Services range from a full evaluation with the goal of starting a therapy plan to a one-time consultation visit that provides additional information to the services your child already receives. 

All appointments at Duke include the following:

• Services are individualized and activities or items are changed to fit each child’s individual needs and interests.
• The speech-language pathologist provides hands-on coaching for the family to help their child use techniques modeled during each session at home and school
• The child and family may participate in both the assessment and therapy sessions while learning through structured activities, tasks, or play.
• A variety of visual supports are provided. Many different visual supports will be used to find the best style and combination for the child and family.

Why is this appointment important?

Communication is a vital part of life. Finding a successful way for a child to be understood and express themselves can improve family and social interactions, facilitate learning in school, reduce frustration with miscommunications, and provide an overall enhanced quality of life.

To schedule an evaluation, contact Duke Speech Pathology and Audiology at 919-684-3859, Monday through Friday, 8 a.m. to 5 p.m.