There is very little specific information about literacy development and people with a severe communication impairment. The available research indicates that children with a severe communication impairment generally get fewer opportunities to practice emergent and early literacy skills than their peers (e.g. Light & Kelford-Smith (1993)). Practical experience, however, suggests that they often need more practice than their peers to learn and consolidate these skills. Generally, we need to look at the literature about literacy development in children without a severe communication impairment and use this as a base for classroom and home practice. We need to adapt classroom materials so that students with a severe communication impairment can do the same types of activities as other students, but more of them!

Phonemic Awareness

The single greatest predictor of whether a student will become a proficient reader is their phonemic awareness at the beginning of school (Adams, 1990). There is some question as to whether a severe communication impairment automatically leads to difficulties with phonemic awareness (see Sandberg and Hjelmquist (1996)) however, it has been shown that phonemic awareness can often be linked to the literacy environment in the child's pre-school life. See Light and Kelford-Smith (1993) and Blischak (1994) for a discussion of differences in the pre-literacy environment in disabled children and non-disabled peers.

Providing a range of activities for students with a severe communication impairment to help develop their phonemic awareness is very important, both at pre-school and early in their time at school. These could include letter games, recording sounds on a voice output communication aid for them to use in a game, reading books which focus on a letter, etc. There are a number of mainstream books around which provide examples of phonemic awareness activities, many of which can be adapted for use with a voice output communication aid, for example, "A Sound Way" by Elizabeth Love and Sue Reilly.

A two cell MACAW overlay for sound play with cars and trains

Phonograms

One of the most successful ways of increasing phonemic awareness has been through the use of phonograms, i.e. words which sound much the same, e.g. sat, fat, mat, hat, pat, etc. These words can easily be demonstrated to be broken into two separate parts (beginning and end sound, known as the onset and rime), hopefully leading to the understanding that words can be broken into phonemes!

32 cell MACAW overlay for target sound -an*

*Overlay from Creative Communicating website.

MACAW overlay for participating in reading "Cat in the Hat" by Dr. Seuss

Word and Syllable Awareness

It has also been shown to be of great importance to teach students word and syllable awareness. Both of these skills are just as important as phonemic awareness. See Adams (1990) for general research in this area and Hielmquist, Sandberg and Hedelin (1994) for some specific information about people with severe communication impairment.

Most children have only minor difficulty with syllable awareness as syllables are obvious in spoken language (marked by volume changes, jaw movements, etc.). However, many students find word awareness very tricky. Activities often recommended are: reading and pointing word by word, playing standard games such as Fish with word cards, hitting different bells for each word in a sentence, etc. Students with severe communication impairment may have even more difficulty with many of them are accustomed to boards or overlays where a single symbol represents a whole sentence. When designing overlays we should consider making some overlays in which students need to string together a sentence word by word. Also, we should read books to students using overlays/boards ourselves so that they can see how symbols or words on an overlay can be combined to produce a sentence.

8 cell MACAW overlay for reading "Dan the Flying Man" from the Story Box series

*Overlay based on board by Louise Dunne from August 1998 AGOSCI News

Print Awareness

In a print-rich environment, children naturally acquire insights about print. For example, the knowledge that it is different from other kinds of visual patterns in our environment — it is consistently print, it is everywhere; different samples of print are used in different ways (e.g., junk mail, signs, books, etc.); print holds information; print can be produced by anyone. Children with reading difficulties often start school with little or no print awareness. They don't know what a letter or word is, they don't know that print reads from left to right; they don't know that print is a code for words and sentences; they don't know the front from the back of a book or that a word, when recognized, should be meaningful. Most of these activities should be done all day, every day in the child's environment. For children with physical disabilities this often requires positioning them so that they can see their family writing, reading, etc.

One early print awareness activity is to encourage recognition of environmental print, e.g. McDonalds, Rice Bubbles, etc. Most students recognize these words when accompanied by the logo, context, etc. and these can be used as a jumping off point for going on to focus on the text, pointing out differences in word length, number of syllables, and then on to letters.

16 cell MACAW overlay for matching text to "Environmental Text"

Letter Awareness

For pre-school age children it is considered important to teach letters and their sounds together. Teaching letters through letter names still gives a hint of their phonemic significance and gives children a solid mnemonic peg to pin the letter shapes onto. Teaching letter sounds may be confusing as there are many sounds per letter. Most children learn the letter names first through activities such as the alphabet song and watching Sesame Street.

Many students spend time copying and tracing letters to increase their letter awareness. This is useful, and for students with a physical disability matching activities could be done. However, it has been shown that many students are greatly assisted by a visual discrimination program that forces attention to the subtle but distinctive differences between letters. It is important to note that "solid familiarity with the visual shapes of individual letters is an absolute prerequisite for beginning to read" (Adams, 1990).

Many early primary school teachers assume that students have good print and letter awareness from their experiences prior to beginning school. Consequently, activities are presented which are designed to build on this base knowledge. However, as mentioned earlier, students with disabilities are likely to have come from a less print-rich environment and, consequently, will often have a lesser degree of print/letter awareness than their peers.

32 cell MACAW overlay for singing the alphabet song

Use of Pictures / Pictograms

Overall, the current research shows that use of pictures neither harms nor helps children's development of reading. See Adams (1990) for an overall review of the literature in this area and Bishop, Rankin and Mirenda (1994) for an article specifically relating to pictogram use with augmentative and alternative communication system users.

Generally, if the goal is to help children identify an unfamiliar word, then pictures may help. If the goal is to induce children to learn about the details of print accompanying pictures may be diversionary. So….if children are having very limited success with literacy,, use of pictures may be a good confidence boost, but there should be a program for fading out the picture use .

Series of 8 cell MACAW overlays for "Dan the Flying Man"
demonstrating fading picture support

Reading Books - "Storytime"

Storytime and reading is a very important activity in literacy development — as you can imagine! Musselwhite & King-de Baun (1997) present the concept of books for learning and books for enjoyment. Books for learning are books which are read repeatedly. Books for enjoyment are books which are read once or twice.

Most children select their own books for learning — books which they choose to have read again and again and become familiar with the storyline so that they can anticipate, retell the story to others, etc. Adults often find this repeated reading tedious and as a result many children with a severe communication impairment, who are often reliant on adults to choose their books for them, don't get opportunities to do this. It is important to promote student participation in the process - choosing books, commenting on the book, pointing to pictures, completing phrases, retelling the story, discussing the story. It is also important to develop generic overlays for reading books for enjoyment, with the sorts of language children normally use in this situation.

16 cell MACAW overlay for reading a book for enjoyment based on listening to a 4 year old child

16 cell MACAW overlay for retelling the storyline of the novel "So much to tell you"

Other useful activities

Other types of activities which can be useful for developing emergent and early literacy skills in a range of areas are:

• Rhymes - introduce spelling sound correspondences
• Use of repeated line books - anticipation and predictability
• Poetry - children can use their ability to think about context and phonology in predicting words
• Songs - to experience rhythm, and often a story line
• Oral language activities - these are an important precursor / support for literacy which are often overlooked.

Below is a list of useful references in the area. The text by Musselwhite and King-de Baun (1997) is particularly good for emergent literacy ideas in the area of severe communication impairment. Their website is also a useful reference point — go to www.creative-comm.com.

References
Adams, M. (1990) Beginning to read: Thinking and learning about print. Cambridge, MA: MIT Press.
Australian Group on Severe Communication Impairment newsletter August 1998 - themed issue on literacy.
Bishop, K., Rankin, J. & Mirenda, P. (1994). Impact of graphic symbol use on reading acquisition. AAC, 10(2).
Blischak, D.M. (1994). Phonologic awareness: Implications for individuals with little or no functional speech. AAC, 10(4).
Hjelmquist, E., Sandberg, A.D. & Hedelin, A. (1994). Linguistics, AAC, and metalinguistics in communicatively handicapped adolescents. AAC, 10(3).
King-deBaun, P. Storytime Just for Fun!: Stories, symbols and emergent literacy activities for young children. Utah: Creative Communicating.
Light, J. & Kelford-Smith, A. (1993). Home literacy experiences of preschoolers who use AAC systems and of their nondisabled peers. AAC, 9(2).
Love, E. & Reilly, S. (1995) A Sound Way. Melb.: Longman.
Musselwhite, C. & King-de Baun, P. (1997) Emergent Literacy Success: Merging Technology and whole language for students with disabilities. Utah: Creative Communicating.
Sandberg, A.D. & Hjelmquist, E. (1996). Phonological awareness and literacy abilities in nonspeaking preschool children with cerebral palsy. AAC, 12(3).