As the public schools assume responsibility for the education of more severely and multiply handicapped students, special education teachers and speech pathologists increasingly encounter students for whom traditional verbal language programming is not appropriate. With these students the challenge is to develop functional communication through nontraditional communication systems. These systems are referred to as auxiliary (nonvocal) language programs; they include manual communication, communication aids, and communication codes (Nietupski & Hamre-Nietupski, 1979).The decision to initiate an auxiliary communication program cannot be made by a single teacher or clinician. Integrated consideration must be given to the language, cognitive, social, emotional, and physical characteristics of the student. It is a decision, therefore, requiring complex professional judgment based on input from members of a variety of disciplines (e.g., special education, speech pathology, physical therapy, occupational therapy, and psychology) and the student's parents.
THE SEVEN-STEP DECISION-MAKING SEQUENCEWe are proposing here a seven-step stquence for decision making to assist the interdisciplinary team in making a systematic and logical communication programming decision (see Figure 1). This decision sequence will guide the team from the initial consideration of a student's verbal potential, through the selection of an appropriate alternative nonvocal program, and finally to the procedure necessary for successful program initiation.
DecisionStep 1: Should a Nonvocal System be Considered?The first decision to be made upon a student's referral for auxiliary communication training is whether a nonvocal system is appropriate for the student at this time.