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Tip of the Month – April 2018: Increasing communication opportunities for adults with complex communication skills

Increasing communication opportunities for adults with complex communication skills


A great way to encourage adults with complex communication needs to increase their communication skills is to give them a sense of control. This can be achieved by continually providing opportunities for the individual to have a say in some element of what they are doing.


Equipment needed:

  • A step by step (Ablenet or DTSL)                 



  • a low tech white board                       


Goal: To maximize active participation in life routines. To teach the skill of moving through a range of choices and selecting or rejecting each option.

How to set this up:  Sit with your client/family member and co script (talk through) with them a list of choices that are available.  Record each choice onto the Step by Step or draw/write it on a whiteboard with them beside you. Make sure you add ‘something else’ as an option at the end in case they don’t want any of the things listed.

Within any appropriate natural context think of at least 3 choices that the person can choose between, e.g. walk to the shop/walk to the park/walk by the river or have a coffee/have a tea/have a juice.

Make sure you are giving opportunities that matter to the individual, make sense to them, can be understood and can be discriminated from each other.

Don’t just offer choice with tangible objects…aim for choices around… who/what/when/how/where/how many


Now the individual is ready to make a choice. They can either…

  • Scroll through each option by pressing the top of the step by step to hear it spoken out loud and then reject or accept each option they hear


  • You can scan through each item on the whiteboard list for them.


How to reject or select each item? 

The individual will make a choice about each by indicating yes or no. This could be with a nod or shake of their head, a verbalization or by using YES NO visuals. See attached photo and previous tip of the month talking about teaching yes and no to reject and select. https://www.talklink.org.nz/?s=yes+no



  • Remember to allow lots of time for them to process each option and wait in silence rather than jumping in with a prompt while they are making up their mind.
  • Make sure you always add ‘something else’ or ‘none of these’ so the person is not stuck with making a choice from something she or he does not want. No choice is a choice.
  • You should have at least 3 choices and ‘something else’ on your list.
  • Always model you making a choice using that system first so the individual knows what to do.


Possible activities with choices:

  • Where to go on community walk
  • What to eat or drink at meal or snack times
  • Which YouTube clip to watch
  • Who to sit by at home or at day placement
  • The order of doing chores
  • Which item to eat from lunchbox first, e.g. banana/sandwich/fruit
  • Choice of iPad games
  • Colour in an art or craft activity
  • What to cook in a cooking session
  • Which music to listen to
  • Choice of body parts for massage


References: ideas adapted from Linda Burkhart training in New Zealand in 2016.


To download the April Tip of the Month, click here.

Created by Polly Thomas (TalkLink Teacher) on 12/12/2016.

Permanent link to this article: http://www.talklink.org.nz/index.php/2018/04/03/tip-of-the-month-april-2018-increasing-communication-opportunities-for-adults-with-complex-communication-skills/

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