Picturegraph (Compic) Assisted Communication System

What is it Compic?

It is a set of simple line drawings or signs which stands for a word. (To help the neuro-typicals who may need to communicate with the person with ASD, the word is written underneath). As each word has its own card all sorts of sentences can be compiled, resulting in a full language code, as useful in communicating as is writing. Several codes exist, but at ISADD we prefer Compic because of its simplicity.

Why do children with ASD need Compic?

There are several reasons, and not all will apply to all children:

  • Children with ASD are visually very alert and their visuo spatial learning is often excellent while their language lags behind or just seems not able to get started. Compic is visual.
  • They are visual learners and have good memories for Gestalts (all at once – like photographic memory) while memory for sequences is poor. Spoken language is a sequence with no residual clues. Compic sentences can be remembered as a total picture – and can be rechecked if needed.
  • Many have auditory processing issues which make it difficult for them to note subtle sound patterns in the speech range, and many others learn to ignore language as they have no interest in the speakers or their messages. Most will have poor listening skills, even if they may have a good ear for music. Compic helps them differentiate words which sound similar but look different.

Some learn by echoing full sentences and trying to understand their meaning. So “shut the door “ is learnt as a single entity which is a specific instruction, and the child does not know it is made up of three words which can be used in different situations. Compic allows words to be associated with their referents and later allows the child to make original sentences with the words learnt.

Many have very poor retrieval for sound patterns and some have expressive aphasia, but good visual memories. These are the children who understand what is said but find it difficult to say find the words they need in order to say something. This can be very frustrating for them and often leads to tantrums as their needs are not met. For them Compic works as a communication code; the child can make his wishes clear in a Compic sentence which will be understood by all, and if little else is achieved, at least needs are met.

  • Many however, especially if Compic is introduced early and much practice is given, will improve further… For them, practice achieved strong associations and Compic will have become a mediator to spoken language. When wanting to talk they will think in a Compic sentence, remembers the sound patterns their Compics stand for and repeat these verbally.
  • This also works in reverse and if they hear a sentence they cannot easily understand they will translate it into Compics which are meaningful to them thus overcoming receptive aphasia.
  • Many children learn to read without needing much teaching as they become aware of the words on the bottom of the card, and the written words can take over as they grow older and more and more school communication demands reading and writing.

Why is Compic better than other visual supports which are often recommended by speech therapist?

Makaton and signing has been used in the past, and though it can give children a small boost at the start, teaching to achieve language is not easy for the following reasons.

  • Children with ASD do not look at people and often do not imitate actions in which case teaching must be done with manual prompts which will be difficult to fade.
  • We know they have difficulty interpreting gestures and they do not look sufficiently, so they will find it very difficult to ‘read’ Makaton addressed at them. Some signs are very similar and actions are fast (try shoe and cat for example).
  • If they have difficulty remembering sequences, then they will not cope with the full Auslan or grammatical sign language. They may just pick up some single words in Makaton which is only a set of signals – not a complete language code.
  • Then again – even if they did acquire it – who would they converse with? Unfortunately I have noted that even family members find it too hard to learn and often give up. Yet every one can read.

We could try photographs and they are often used in special schools to teach children to make choices.

  • Contrary to popular belief photographs are not easier to see if the child is young or low functioning. To work out what is on a photo the child has to have acquired representational thought abilities which happens by 18 months of age. However in children with ASD this is often delayed or weak. They see the picture not as a representation but as a rectangle with various colours displayed on it. Simple line drawings are easier to discriminate and to remember.

Photographs are overly specific and it is difficult to use them to teach more generic meanings. For example the concept of mother cannot be represented effectively by a photo of the child’s mother if you are trying to explain grandmother’s situation or the cat that has just had kittens.

Coloured diagrams are also now popular, can be downloaded for free and are used in Special schools as PECS has become more popular.

However when we need to specify colour in a sentence it can be most confusing to the child if the noun picture is in a different colour.

There are legitimate complaints made that Compic often does not have sufficient picturegraphs to meet the child’s needs.

  • It is not difficult to create simple diagrams as needed and this has been done, especially to indicate specific foods the child may like or which may be relevant on different cultures.
  • Also a committed mother who has an art background has produced lots of ASD specific Compic based social stories – check out her website.

 

How does ISADD use Compics to facilitate language acquisition?

using compic assisted communicationThe child is taught to associate a specific Compic to a large group of items sharing that noun, and is then taught to show a Compic on a sentence maker when asked “What is this?” and shown an object. The adult reads the Compic in a normal voice as the child points to it. This develops basic labelling skills which bypass the problems ASD brings, and also provides opportunity for the child to make a solid association between the Compic and the sound of the word.

Simultaneously the child is taught to exchange the Compic for a desired object. Exchange, a concept developed further by Bondi with PECS is a way of ensuring that the child communicates his needs to a person, not just makes a statement at the table. To this end we need the child practicing exchange at a distance and practising to get the attention of the adults in his life. This concept cannot be taught at the therapy table and families need to rally to their child’s support and provide multiple opportunities for exchanges to take place. Most children have sufficiently good visual discrimination to start with a full strip, if only focussing initially on the key word. There are several rules.

Do not ask the child “What do you want?” as this prompt will be difficult to erase and the child will not ask spontaneously without an invitation.

Do not make the child read the sentence out loud, but read it for him in a normal voice while he/she points to the words. The child’s attempts to struggle with recall of sound pattern and how to produce it leads to a very strained voice, typical of many children with ASD. If parents want to work towards a natural and easy voice from a relaxed child, they need to be patient. Most children eventually begin to join in the last word when they are ready and confident.

As the child has to learn not just nouns but also adjectives, verbs, prepositions, pronouns and articles, organising the Compic becomes a chore. This is helped by colour coding the Compic book and by providing templates for a wide range of sentence types. The templates help the child sequence words within a sentence and can be used in the fading of Compic, as the child is reminded of the sentence structure needed.

What exactly are the benefits to the child?

  • Frustration levels are reduced while language is being acquired.
  • Early Compic schedules, calendars and timetables assist in organization and planning.
  • Most will acquire speech in normal tones – some will need more practice and oral / phonological support as well.
  • The level of language acquired will depend on the age commenced and the child’ s learning capacity, our ability to reduce self stimulatory behaviours.
  • The level of social language acquired will depend on the child’ s social development.

Many will find learning to read and write, and/or developing keyboard skills easy. Those who found language not difficult ( those with a diagnosis of high functioning ASD and AS) will benefit from the support in sentence structuring and organization.

Will all children learn to talk?

Unfortunately the answer is ‘no’. There are three major reasons for this.

  • The child who came to the program too late and was too old and the brain has lost its ability to specialize in language. Once the brain looses flexibility it becomes very difficult to develop something new. Despite this basic communication with Compic requests and time tables can be established and this reduces frustration. Some level of keyboard skill may still be possible.
  • The child who has complex Autism with complications such as major Epileptic involvement, uncontrollable self stimulation, and potentially reduced ability to learn. Such children can still cope with single Compics to express their needs and to be informed with schedules of what will happen next, thus reducing anxiety.
  • The child who has severe Dyspraxia and/or Dysarthia and thus cannot control the speech mechanism. These children will acquire receptive language but will need to rely heavily on Compic and later on their keyboard skills for expressive communication.

How can parents get the best benefit from Compic use for their children?

There seems to be a lot of confusion among new parents regarding Compic and its value. Hopefully this article clears this and answers the many questions raised. Above all you need to rest assured that giving your child support in language learning will not harm, it will only assist the development of spoken language. Parents however are the” make it or break it” factor as communication with parents is more important than communication with therapist. Parents can bring communication into the everyday world, and away from the therapy room. It is therefore important for parents to feel confident in using Compic. What do parents need to do?

  • Teach the child the power of communication – use exchange at every possible opportunity and then create some more (eg – give the yoghourt on request, and then wait for a requests for a spoon).
  • Teach that communication is to people – the strip is brought, the cards pointed to and the child must give you eye contact. Too many children with ASD who do speak, speak to the room at large and no too people.
  • Teach the child to freely make a request when he needs something, and not to wait for a prompt, be it the often heard “What do you want?” or even just pointing at the ‘menu’.
  • Teach the child that communication is available at all times, and not just something we do at home, which means taking the Compic book wherever you go. I despair when I find out that the Compic book is kept in the cupboard or in the therapy box, or when families go on holiday without it. If you relied on hearing aids would you leave them at home in the cupboard? Remember that the Compic is the child’s first language, and if he can use it and frustration can be avoided, there will be fewer tantrums. Ask your Case Manager how best to make the book more portable.
  • Remember that Compic works only if we have taught the child the specific words. If you are well aware of the program and the new word lists which track word acquisition you will have no difficulty.

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