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Augmentative communication is intended for children who: have developmental and cognitive delays, have behavioral challenges which are impeding speech, are pre-verbal, and have other language delays. (Burkhart, 1993)

Augmentative Communication and Assistive Technology in Early Childhood Music Therapy Rebecca Wellman, PhD, MT-BC/DT Chicago, IL Communication often is a challenge for many children with special needs. To support them in their expressive language needs, children may use various levels of augmentative communication and assistive technologies.


The following chart is designed to give some examples of low tech and high tech communication alternatives and how they can be used within a music therapy session.

Use in Music


Using American Sign Language or child adapted signs to communicate (Skau & Cascelle, 2006).

Therapists can use signs in conjunction with their voices to communicate with the children. Children can use signs to make their desires known. Signs can also be used within songs to help teach, reinforce, and utilize new sign vocabulary.


Using the actual objects as communication to Using tambourines, bells, etc. to make choices. reinforce the verbal interactions or as part of a schedule of activities within the therapy session.

Representative Objects

Using smaller objects to represent choices.

A plastic dog could represent “How Much is that Doggie in the Window;” a small stop sign could tell others to stop or that they are all done.


Using actual photos of instruments and objects for choice making or communication.

A picture of a tambourine and a picture of a spider for “Itsy Bitsy Spider” could be used for choice making or communication.


Using BoardMaker® or clip art to provide pictures for choice making or basic communication (DynaVox Mayer-Johnson, 2009; Stephenson, 2009).

BoardMaker® pictures can communicate choices, scheduling, or indication of needs.

Picture Exchange Communication System (PECS)

This is a more complex use of pictures for communication. PECS develops over five specific tasks and comprehension stages starting with learning to communicate by using pictures to convey needs and ending with full sentence structures (Pyramid Educational Consultants, 2010).

Music therapists may be using some of these techniques within a session, but it is advisable to have training or assistance from a speech therapist when utilizing this specific system.


A speech therapist or other communication expert can provide support to music therapists to ascertain which levels of augmentative communication and assistive technology are right for the children with whom they work, and which are easily accessible within music therapy sessions (McCarthy, Geist, Zojwala, & Schock, 2008).

Technique Description


Assistive technology works well with children who: have strong cognitive abilities but have motor difficulties, have uncertain cognitive abilities and motor difficulties, have developmental delays, or have fine motor involvement. (Burkhart, 1993; Edyburn, 2000).

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Additional early childhood music therapy resources available at

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Additional early childhood music therapy resources available at