Scenarios
Scenario 1: Miriam
(this case example can be used for children from non-English speaking backgrounds, oral or laryngeal problems precluding them from being able
to produce voice, or children with tracheostomies that can not use a speaking valve or produce sound around their trache)
Miriam is 6 years old and from a non-English-speaking background. She has good language and communication skills in her first language but is
unable to communicate with Hospital staff due to her difficulty with English. An augmentative communication system is devised for her in
conjunction with herself, family and Hospital staff. Miriam is taught how to use the system by the Nursing staff and Speech Pathologist via an
Interpreter. The augmentative communication system involves Picture Communication Symbols (PCS) pictures and written words and phrases
in a book/flip page format. The pictures are arranged in categories with a list of contents for the categories on the first page. Examples of
categories include:
| - Feelings | - Pets |
| - Miriam’s interests | - Movies |
| - Foods | - Friends |
| - Drinks | - Relatives |
| - Clothes | - School |
| - Places | - Hospital Staff (eg. medical, allied health, diversional) |
| - Commands | - Special events |
| - Body parts | - Hospital procedures (eg. investigations, surgery) |
Scenario 2: Thomas
Thomas is a 12 year old boy who is admitted for treatment after suffering a traumatic brain injury in a motor vehicle accident. At this stage of his
recovery he is still confused and cannot remember information from day-to-day. This is rapidly improving. Thomas is trying to communicate
but he can only make sounds and some slurred words. He tires quickly and is easily overwhelmed when he is overstimulated. A picture board is
devised for him in conjunction with his family and staff using PCS symbols. The board is basic and includes pictures about his daily needs,
feelings and family. The Staff have involved the Speech Pathologist and Occupational Therapist to assess how many pictures should be placed
on Thomas’ board at one time and where to place them for him to access them easily. Examples of pictures include:
| - Yes | - Radio |
| - No | - TV |
| - Mum, Dad, Siblings | - Go away |
| - Hungry | - Pain |
| - Thirsty | - Family members (eg. mum, dad, brothers, sisters) |
| - Toilet | - Feelings (hot, cold, sick, tired etc) |
| - Go outside | - Bed |
| - Tired |
Scenario 3: Jessica
Jessica is a delightful 10 year old girl with cerebral palsy and moderate intellectual disability who is in a wheel chair. She is admitted for
treatment and investigations. Jessica cannot communicate her needs verbally but is able to use eye gaze and some gross pointing with fist to
point to a small range of pictures. She attends a school for special purposes and they use a simple picture communication system there. A simple
PCS picture board is made up fer her here by the Staff to help her communicate some needs. Consultation with Jessica, her family, Staff caring
for her, a Speech Pathologist and an Occupational Therapist is needed to determine what and how many pictures need to be included on Jessica’s
board, and how she will learn to use and access them. Liaison with Jessica’s school and treating Speech Pathologist is required to gain
information about any existing augmentative communication systems Jessica may be using there.
| 
