There are six phases to implementing this communication system.

1. Exchange single pictures

2. Teach them to use the pictures in different settings and with different people, not just the original teacher.

3. Child learns to choose between two or more pictures to get the desired item. These are usually stored with pictures that are secured with velcro and are easily accessed.

4. The child learns to construct simple sentences for instance "I want ___".

5. Responding to questions asked like What do you want? By choosing the picture.

6. The child begins to learn to comment in response to questions asked. For example, what do you smell? and the child would reply with "I smell _____"

Teachers may have a large blown up copy of a core board at the front of their classroom to model communication for students. The most important part of a core board is that the pictures stay in a fixed position. Only allowing a few symbols at a time to be shown when learning is important. Having too many symbols in the beginning can be overwhelming. Most importantly in implementing this system is adult support in modeling and practice.

To implement this system, you will need to do the following:

1. Choose the right device. Taking into consideration a persons needs, cognitive and physical abilities, and the overall goal for their communication needs.

2. Training- If a person isn't trained properly on how to use something, the effectiveness of it's intent can decrease dramatically. Just as when we explain any new concept, we must train step by step.

3. Fostering an environment that encourages communication. Keeping the device handy, modeling it's usage, being patient and supportive when they are learning as well as using peer tutoring can all foster positive communication habits.

(Center for Medicare Advocacy, n.d.)

Implementing this device can feel more natural and using it independently in turn taking can be helpful. This is a great first minimal electronic type of AAC that can be used whenever the teacher is ready to use it. It does happen to be one of my favorites for recording routines. (SLPCarrie, 2017)

"Visual activity schedules include visuals to support language and task order, explicit task steps or activity locations to support successful transitions, and embedded behavioral strategies to make learning more explicit (e.g., places where choices are possible; clear ends to activities resulting in reinforcement or preferred items/people/activities)"(Tuck et al., 2024).

When a student is able to independently use their visual schedule that is when you know that they have mastered the system. Fading support should always be used during teaching the system.

The three essential components of DTT, are the instructor presenting an instruction (i.e., the discriminative stimulus; the instructor says, “Point to the picture of a dog”), waiting for the learner to respond (i.e., the behavioral response; the child points to the picture of a dog), and the instructor providing a consequence (i.e., reinforcing stimulus; the instructor says, “Great job pointing to the picture!”) (Fingerhut & Moeyaert, 2022).

DTT breaks down a concept into steps that can each be taught then when put together forms the whole concept.

One of the major things that is required with DTT is making sure the learner's attention is secured on the task at hand. If a learner is not paying attention, then fidelity cannot be met.

When analyzing the efficacy of DTT the scoring that is kept throughout the sessions can be given a grade and you can visually see the percentage correct with independence.

Measuring effectiveness can be done by keeping data on the desired outcome of the story. For instance, a story about keeping your clothes on at school would be read daily to the student have the unwanted behavior. Keeping a frequency of how often the student removes their clothing would assist in knowing how well the story is helping with understanding the concept.

A social story must:

1. Have a goal

2. Include a two-step discovery process

3. Contain a title and introduction that identify the topic, a body that adds detail, and a conclusion that reinforces and summarizes the information

4. Has a format that is tailored to the individual abilities, learning style, talented, interests, and attention span of the audience

5. Have a patient and supportive voice along with vocabulary that:

   • Has exclusive use of first- and/or third-person perspective statements (no second-person “you”)

   • Contains past, present, or future tense

   • Has a positive, patient tone

   • Is literally accurate

   • Has an accurate meaning

6. Answers questions about where, when, who, what, how, and why

7. Contains descriptive and coaching sentences (sentences that guide behavior)

8. Has language that describes more than it directs

9. Is constantly revised

10. Has a plan for editing and implementation

PRT targets areas of a child’s development instead of working on one specific behavior.

Pivotal areas include:

• Motivation

• Response

• Self-management

• Initiation of Social opportunities

Examples:

1. Transitioning.

2. Chores.

3. Routines.

4. Meals.

This type of therapy uses natural motivations to promote social behaviors.

Data should be kept on how effective the behaviors are being changed. Data can be graphed over time to show a trend in effectiveness. This type of system does take time. Since PRT promotes social interactions, it helps both receptive and expressive language areas, as input and output is both needed.