• Texarkana Therapy Center

What is Total Communication?

Updated: May 26

Article by: Lori Beth Stewart, M.A., CCC-SLP

Hello! Today we will be talking about Total Communication, what it is, why it is important, and what it looks like at home and in therapy. What is Total Communication?

Well, Total Communication is an approach that encourages all types of communication, whether they are verbal or nonverbal.

We will get into different types of nonverbal communication a little later, but as adults we often use nonverbal communication in our daily life. For example, if you spilled water on yourself and needed to ask for a paper towel that was out of reach you might point and say, “Give me that!” instead of, “Give me the paper towel please.” Here’s why this approach is useful:

1) Research has shown that using nonverbal communication does NOT slow down speech or language development.

None of the 27 cases [using nonverbal communication] demonstrated decreases in speech production…and the majority (89%) demonstrated gains in speech” (Millar, Light, & Schlosser, 2006)."

Using nonverbal communication such as signing, gesturing, or using a high-tech AAC device does not mean giving up on verbal speech. In fact, these methods can be a stepping stone which makes communication easier to access. In many cases, using other forms of communication accelerates their speech and language development (Ashawire, 2014).

2) Total Communication is useful for a variety of different populations.

Populations who may benefit from Total Communication:

  • Children who are pre-verbal (they are babbling but not yet using words)

  • Children who are nonverbal (they do not have sufficient verbal speech vocabulary in order to express basic wants, needs, feelings, etc.)

  • Children who have Childhood Apraxia of Speech (CAS) which makes it difficult for them to coordinate oral movements to produce speech

  • Children who have Autism Spectrum Disorder (ASD) which results in difficulty with various social skills

  • Children who are shy about using their words around others

3. Nonverbal communication can be a good resource to fall back on when things get tough.

In my experience, some children who are self-conscious, have sensory deficits, or have been diagnosed with Autism Spectrum Disorder, cannot always rely on verbal speech to express how they are feeling or what they are wanting. If they are feeling overwhelmed with a specific situation, they may find it much easier to sign “all done,” push a picture symbol for “stop,” or give me a card that says “Break please” than to say any of these words verbally.

So How can Children apply Total Communication?

1. Types of Nonverbal Communication

  • · Touching picture symbols on a low-tech board or high-tech device

  • · Using sign language

  • · Pointing

  • · Using other gestures such as waving

  • · Touching or grabbing desired objects

  • · Leading an adult to a desired object

  • · Giving an object to an adult to ask for help (such as a box of toys the child cannot open)

2. Using Words and Nonverbal Communication at the Same Time!

Once a child starts picking up and using several new words (whether verbally, nonverbally, or both), one of the next big steps is combining words to make functional phrases. This usually does not happen until your child knows and uses at least 50 different words on their own. Once your child starts consistently using one-word requests you can work on expanding their utterances to two-word phrases while modeling the nonverbal method that works for them. If he or she says or signs, “juice,” you could say, “Okay! Want [add sign for want] juice [add sign for juice].” For a total communicator, this may result in a combination of signing/touching a picture and using a word. For example, a child who is using sign language and talking verbally, she may sign, “want” and then say, “juice.” Even though this sounds like a one-word request, it is actually an attempt to combine two words and it should be highly praised!

3. Consistency Across Environments

Whatever approach you take with your child, it is imperative that he has consistency across his home, school, church, and therapy environments. If you are encouraging him to communicate in any way he can, but his grandma does not know that and she asks him to use his words instead of signing or using picture symbols, then little man might be really confused about what is expected. Especially when he is just learning to communicate, every communication attempt should be praised. Later on you may not praise him every time he signs “more,” but you should still respond to every communication attempt. For example, if little man has been signing “more” for a few weeks consistently, you may not say “Yay! Good job! Thank you for saying more!” but you might say, “Oh okay, you want more juice. Here you go, here’s some more.”

I hope this blog has given you some ideas about how to use Total Communication. If you are wondering if your speech therapist is using a Total Communication approach, start a conversation and find out their thoughts about using nonverbal communication in combination with verbal speech. Remember, using nonverbal communication is often just a stepping stone on your child’s pathway to using verbal speech. Have fun communicating in new ways!

Article by: Lori Beth Stewart, M.A., CCC-SLP


If you are not in therapy and you are wondering if your child may be falling behind in the areas of speech and/or language, please try our online screening tool. You will be given a survey of age-appropriate milestones for speech, language, gross motor skills, fine motor skills and sensory processing for children ages 1-6.


If you would like like further information of developmental norms you can use to gauge where your child is in reference to other children their age using this resource. https://www.asha.org/slp/schools/prof-consult/norms/

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Texarkana Therapy Center is a pediatric therapy clinic located in Texarkana Texas. We are committed to seeing our children grow, learn, and excel in all areas of their lives. Our team offers a multi-disciplinary approach through speech, physical, and occupational therapy. We are dedicated to providing exceptional care in a loving and nurturing environment for our patients and families.

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