Total Communication: A flexible approach to communicating
So what IS total communication, and who is it important for? Read on to learn more about the many ways that we ALL communicate, and how we can harness different modalities to enable everyone to share their wants, needs, emotions, and thoughts!
You may have heard over the years, “Oh, she’s a visual learner”, or “Me? I learn best by doing”. Well, just like we all learn in different ways, we all communicate in different ways too! Similarly, some people may communicate better in one way than another, and just as we need to teach the way individual children learn, we need to communicate with others flexibly to enable success. The concept of a “total communication approach” is that there are many ways to communicate, and each of them is powerful in its own right and should be accepted as communication.
Often, a child or adult with a communication challenge may not use just one of these modalities below… they might use more than one! And that is just fine and should be encouraged - however someone communicates, if their communication partners understand them, we should accept and encourage that communication act.
Different Communication Modalities
There are many different ways to communicate. Here are just a few:
Handwriting - a simple whiteboard or notebook can go a long way for many people with communication difficulties. The brain is an incredibly complex organ, and sometimes people are able to communicate in writing but not verbally.
Typing - for many people with communication disorders, having a keyboard on a computer, phone, or tablet can be a great way to communicate. There are even small keyboards with screens at the top that generate a message that can be read or spoken aloud to a communication partner.
Gestures - simple waves, nods, and body positioning can contain a great deal of meaning. By being attentive to these
Facial expressions - much like gestures, facial expressions contain a great deal of meaning and insight into another person’s thoughts and emotions. Remaining attuned to these facial cues can be difficult for some people with communication disorders, so it’s important not to assume that one facial expression might mean something in particular.
Verbal expression - this would be the most “traditional” method of communication in today’s world, using your voice and your mouth to produce sounds that are combined to form spoken words. Sometimes people with communication challenges may use “verbal approximations”, or productions of sounds or words that aren’t exactly correct, but are still understood by their communication partners.
Sign language - with the increasing popularity of using sign language to help small children communicate before they are able to speak, more and more people are becoming familiar with sign language as a communication modality. However, it’s important to remember that “sign language” has different connotations for different people. For members of the Deaf community, American Sign Language (ASL) is a complex, rich language with its own grammar, syntax, and geographical nuances and differences. It’s important to remain respectful of the rich community that uses ASL when we also join in using our hands to communicate.
Low-tech AAC Systems - some children and adults may use paper-based, often laminated communication boards that have picture support. A person in a hospital who cannot speak due to intubation might use a communication board to talk with their medical team to tell them what hurts and where, and to advocate for themselves. An Autistic child might use a Picture Exchange Communication System (PECS) to tell their family and education team what they want, need, or are thinking.
Mid-tech AAC Systems - these systems have some technology to them, but aren’t quite as complex as a hi-tech system. A GoTalk device, for example, allows you to record multiple messages that the user can then select by pressing a button. There are also switches, like a Big Mac, which is a large button that can be pushed to activate a toy, speak aloud a recorded message, and control a wheelchair.
Hi-tech AAC Systems - some children and adults may use more technologically complex systems that have voice-output and are usually controlled by a touch screen device. You can also connect switches (buttons) to these devices to help someone who might not have the fine-motor capacity to use a single finger to select a button on a touch screen. Some of these systems may have written words, others may have photographs, some may have symbols, and many may have a combination of those tools. Different systems may be organized in different ways.
Remember, no one of these methods is right or wrong; it’s all about finding the best combination of these communication methods that works best for the individual.
Why Total Communication?
For many people with communication challenges due to a stroke, traumatic brain injury (TBI), neurodegenerative disorder like ALS, or a developmental condition like Autism, total communication can be an incredibly powerful approach. Some days it may be easier and more comfortable for an Autistic child to communicate using their device. Other days it might be easier for them to use signs or verbal approximations. In some situations, a person who has aphasia after a stroke might find it easier to quickly write down what they want to say; in other circumstances they might prefer to communicate verbally.
In short, the more flexible we as a society can be in accepting and accommodating whatever form of communication someone might use most successfully, the better we can enable our fellow humans to communicate. Reach out to a speech-language pathologist today if you have questions about how to maximize your own communication modalities, or your loved one’s, and ask if a total communication approach might be right for you!