Skip to main content
Default avatar image

Bibliography on Pre-Linguistic Communication

Print Screen Share

This is a partial list of materials on this topic available from the NCDB Catalog Database.  If you have additional questions, please contact us via email at

Updated 2/2013

2005-0251 Analyzing Teacher/Child Interactions: What Makes Communication Successful? --Amaral, Isabel. DBI REVIEW, vol. 32, July-December 2003, pp. 12-18. (2003)The success of interactions between caregivers and learners with multiple disabilities depends largely on the ability of the caregiver to interpret and respond to the learner’s nonsymbolic forms of communication. This article describes a study that analyzed missed opportunities for communication (captured on video) between 2 children with multiple disabilities and their teachers and the results of an intervention process designed to reduce the number of missed opportunities. It found that teachers do leave many children’s behaviors unresponded to and that this number can be decreased through intervention. The article includes an opinion scale that was used to analyze communicative behavior.


Beginning Communication with Infants --Chen, Deborah. New York: AFB Press. Essential Elements in Early Intervention: Visual Impairment and Multiple Disabilities. Deborah Chen (Ed.) (1999) This chapter explains the developmental process of early communication, identifies how infants communicate before they use words, describes the potential effects of visual impairment and additional disabilities on early communication, and suggests strategies for supporting and increasing infants' early communicative behavior within the context of daily activities. Specific strategies to create opportunities for communication include responding contingently to infants' behaviors, developing turn-taking routines, and interrupting a routine. Information is also provided to aid in the selection of early communication options--expressive and receptive. Forms are provided to record the following: the functions of early communication behaviors, the selection of communication options, and routine analysis.


Building Literacy for Students at the Presymbolic and early Symbolic Levels --Downing, June E. Baltimore: Paul H. Brookes Publishing Co. Teaching Language Arts, Math, and Science to Students with Significant Cognitive Disabilities, Diane M. Browder and Fred Spooner (Eds.) (2006) This book chapter looks at literacy from a broad perspective as "ways of learning about and sharing information with others," a view that includes learners of all ability levels. It addresses recommended approaches for introducing literacy activities to students with significant disabilities who may just be beginning to learn about the use of symbols. Topics addressed include life experiences as a basis for literacy, the link between communication and literacy, augmentative communication systems, the importance of high expectations for literacy, making literacy accessible (adapting materials, following a student's interests, offering choices, identifying preferences), making use of natural opportunities for literacy instruction, creating meaningful literacy opportunities, the use of specific instructional strategies, prompt fading procedures, measuring effectiveness, data collection, and the use of a team approach. Publisher's website:


CHARGE Syndrome --Hartshorne, Timothy S.; Hefner, Margaret A.; Davenport, Sandra L. H.; Thelin, James, W. San Diego: Plural Publishing, Inc. (2010) The purpose of this book is to provide health professionals, families, and educators with a comprehensive view of the sensory, physical, and psychological challenges faced by children with CHARGE syndrome and to explore a variety of ways to overcome these challenges. It covers sensory issues, medical issues (during teenage and adult years as well as childhood), developmental issues (cognitive, social/emotional, toileting, sleep, changes over the life cycle), communication systems and language development (includes a chapter on the assessment of prelinguistic communication) , psychological issues (e.g., behavioral phenotype, psychiatric issues, experiencing pain, experiencing stress, parenting), and conclusions and questions for future research. Publisher's web


Comparison of Intervention Strategies for Facilitating Nonsymbolic Communication among Young Children with Multiple Disabilities --Siegel-Causey, Ellin. Monmouth, OR: Teaching Research Division, Oregon State System of Higher Education. Research on the Communication Development of Young Children with Deaf- Blindness, Michael Bullis (Ed.) (1989) This study tested propositions derived from Jan van Dijk's movement-based theory. It was based on two assumptions: (1) communication is facilitated by primary caregivers who are nurturing and (2) there should be direct physical contact between the adult and child during early intervention. The study examined the effects of movement intervention and passive intervention during social interaction. The purpose was to ascertain whether there are differences between the effects of movement intervention and passive intervention in promoting nonsymbolic communication behaviors in young children with severe disabilities. The participants were six children between three and five years of age who were identified as severely multiply handicapped and/or deaf-blind. The study used a modified, alternating treatments design that was modified to provide intervention blocks (successive sessions of the same stimulation) rather than rapid alternation of intervention. Overall, the results do not indicate that movement was effective in increasing behaviors among all children in the study. However, three participants showed a difference in their nonsymbolic behaviors during movement interaction. The author notes that it is important to emphasize that research directed toward individuals with the most severe disabilities is not commonly done, nor are treatment effects easy to demonstrate.


A Comparison Of Malaysian and Australian Speech-Language Pathologists' Practices with Children with Developmental Disabilities Who Are Pre-Symbolic --Singh, Susheel Joginder; Iacono, Teresa; Gray, Kylie M. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY, vol. 13, #5, 2011, pp. 389-398. (2011) The aim of this study was to explore the assessment, intervention, and family-centered practices of Malaysian and Australian speech-language pathologists (SLPs) when working with children with developmental disabilities who are pre-symbolic. A questionnaire was developed for the study, which was completed by 65 SLPs from Malaysia and 157 SLPs from Australia. Data reduction techniques were used prior to comparison of responses across questionnaire items. Results indicated that SLPs relied mostly on informal assessments. Malaysian and Australian SLPs differed significantly in terms of obtaining children's pre-verbal skills. A third of Australian SLPs listed the introduction of some form of symbolic communication as an early intervention goal, compared to only a small percentage of Malaysian SLPs. Regarding family involvement, SLPs most often involved mothers, with fathers and siblings being involved to a lesser extent. Overall, it appeared that practices of Malaysian SLPs had been influenced by developments in research, although there were some areas of service delivery that continued to rely on traditional models. Factors leading to similarities and differences in practice of SLPs from both countries as well as clinical and research implications of the study are discussed.


Developing Early Communication and Language --Crook, Carol; Miles, Barbara; Riggio, Marianne. Watertown, MA: Perkins School for the Blind. Remarkable Conversations: A Guide to Developing Meaningful Communication With Children and Young Adults Who Are Deafblind. Barbara Miles and Marianne Riggio (Eds.) (1999)This book chapter begins by outlining the major early stages of communication in children who are not disabled. It then provides detailed guidelines for how adults can create positive interactions that promote early communication development for children who are deaf-blind. Specific guidelines include responsiveness to a child's movements, use of touch cues, facilitating the use of hands to explore objects and people, facilitating taking turns, and inviting access to conversation using gestures, words, pictures, or objects used as symbols. Other topics include strategies for developing nonverbal, gestural communication (body movement, play with toys, outdoor play, play with sounds, creative play with "messy" and tactual materials, play with peers, and learning during natural daily activities); increasing a child's exposure to words; and developing oral language.


Dimensions of Communication: An Instrument to Assess the Communication Skills and Behaviors of Individuals with Disabilities --Mar, Harvey H., Ph.D; Sall, Nancy, Ed.D. New York: (1999) An assessment instrument designed to help teachers, educational specialists, speech-language therapists, psychologists, and other service providers evaluate the communication skills of persons with multiple disabilities including severe or profound mental retardation and deafblindness. Designed primarily for persons whose communication behaviors are basic, nonconventional, and/or nonsymbolic, but also can be applied to individuals with more sophisticated language skills. Divided into two parts. Part I addresses developing a communication profile and Part II addresses designing an intervention plan. A case illustration giving examples of the steps is included at the end of the booklet.


Encouraging Early Communication --Chen, Deborah. Logan, UT: SKI-HI Institute, Utah State University. Understanding Deafblindness: Issues, Perspectives, and Strategies. Linda Alsop (Ed.) (2002)Very young children learn to communicate during every day activities, family routines, and interactions with caregivers. Young children who are deafblind may communicate in ways that are not easily understood and may not have access to conventional spoken communication or sign language. Thus, promoting early communication development is an important goal. This chapter discusses key topics related to this goal and provides practical strategies to assist service providers. It also discusses the differences between the words, speech, language, communication, and preintentional and intentional communication. Selected adaptations to encourage communication with young children who are deafblind are discussed, including building on a child's preferences, using predicable routines, and using turn-taking games. The chapter concludes with a section on beginning to promote symbolic communication using key word signs.


Enhancing Nonsymbolic Communication Interactions among Learners with Severe Disabilities --Siegel-Causey, Ellin; Guess, Doug. Baltimore, MD: Paul H. Brookes Publishing Co. (1989) This book explores the educator's task of developing communication and interactional skills among students with severe and multiple handicaps who do not possess a formal symbolic system, such as speech or signing. This approach assumes that the student is an active, dynamic participant whose latent, subtle nuances of behavior can be observed and responded to by teachers and caregivers, and be further expanded and developed into interactional skills. Availability: Paul H. Brookes, (800) 638-3775. Publisher's web site:


Enhancing the Nonsymbolic Communicative Behavior of Children with Multiple Impairments --Downing, June E.; Siegel-Causey, Ellin. LANGUAGE, SPEECH, AND HEARING SERVICES IN SCHOOLS, October 1988, pp. 338-348. (1988)Communication intervention for children who do not make use of speech or other symbolic means is a critical concern for educators and therapists responsible for programming. This article addresses the need to identify the unconventional nonsymbolic behaviors of children with severe, multiple disabilities. Suggestions are provided to improve the frequency and quality of communicative interactions by building on the current behavioral repertoire of the individual. Emphasis is placed on the dyadic nature of communication exchanges and the need for both communicative partners, the child and the professional, to modify their communication behaviors to improve interactions.


First Things First: Early Communication for the Pre-Symbolic Child with Severe Disabilities --Rowland, Charity, Ph.D.; Schweigert, Philip, M.Ed. Portland, OR: Oregon Health & Science University. (2004) This book describes instructional strategies for teaching early communication skills to children with severe disabilities who are not yet ready to use symbols to communicate. It includes an explanation of pre-symbolic communication, an overview of pre-symbolic instruction, and information about how to assess a child's current communication skills and determine a child's preferences. It provides strategies for teaching children how to use pre-symbolic behaviors such as gestures, facial expressions, vocalizations, and switches to gain attention, to request more, and to communicate choices (choice-making). Cost: $43.00. Available from OHSU Design to Learn Products: Phone: 888-909-4030, ext. 108. E-mail: Publisher's web site:


Gestures Expressed by Children Who Are Congenitally Deaf-Blind: Topography, Rate, and Function --Bruce, Susan M.; Mann, Allison; Jones, Chelsea; Gavin, Mary. JVIB, October 2007, Volume 101, Number 10, pp. 637-652. (2007) This descriptive study examined the topography, rate, and function of gestures expressed by seven children who are congenitally deaf-blind. Participants expressed a total of 44 conventional and idiosyncratic gestures. They expressed 6–13 communicative functions through gestures and 7 functions through a single type of gesture. They also expressed idiosyncratic gestures and used specific gestures for functions other than those that are typically associated with those gestures.


he Impact of Congenital Deafblindness on the Struggle to Symbolism --Bruce, Susan M. INTERNATIONAL JOURNAL OF DISABILITY, DEVELOPMENT AND EDUCATION, vol. 52, #3, September 2005, pp. 233-251. (2005)Most children who are congenitally deafblind are severely delayed in their communication development and many will not achieve symbolic understanding and expression. This article discusses developmental markers cited in the research literature as predictive of or facilitative of the development of symbolism. These markers include the growth toward more abstract representations, the rate of intentional communication, joint attention to objects and others, achievement of abstract play, consonantal and interactive vocalizations, distal gesture, varied early vocabulary and categories, use of varied cues for recall, object permanence, 1:1 correspondence, cause-effect, discrimination skills, and imitation. The impact of congenital deafblindness on the achievement of these milestones, is presented, along with compensatory strategies to support the child's development.


Importance of Shared Communication Forms --Bruce, Susan M. JOURNAL OF VISUAL IMPAIRMENT & BLINDNESS, vol. 97, #2, February 2003, pp. 106-109. (2003) This study addresses the importance of shared communication forms among teachers and children who express themselves at presymbolic to early symbolic levels of communication. It looks at two different classrooms with students who are deaf-blind and the forms of communication used between student and teachers. Looks at how accessible communication was to the students.


Increasing Communication in Children with Concurrent Vision and Hearing Loss --Brady, Nancy C.; Bashinski, Susan M. RESEARCH AND PRACTICE FOR PERSONS WITH SEVERE DISABILITIES, vol. 33, #1-2, pp. 59-70. (2008) Nine children with complex communication needs and concurrent vision and hearing losses participated in an intervention program aimed at increasing intentional pre-linguistic communication. The intervention constituted a pilot, descriptive study of an adapted version of prelinguistic milieu teaching (A-PMT). In A-PMT, natural gestures and vocalizations were targeted in child-focused, one-on-one activities conducted by a member of the project staff. Adaptations included using more physical prompts than in other forms of PMT and using means other than directed eye gaze to determine directionality of gestures. All nine participants increased their rates of initiated, intentional communication substantially during the course of intervention; in addition, each participant acquired new forms of natural gestures. Results were limited primarily to requests (as opposed to other communication functions). Discussion centers on how to promote more generalized communication developments in future implementations of the program.


Intentional Communication Acts Expressed by Children with Severe Disabilities in High-rate Contexts --Bruce, Susan M.; Vargas, Claudia. AUGMENTATIVE AND ALTERNATIVE COMMUNICATION, December, 2007, vol. 23, #4, pp. 300-311. (2007) The purpose of this study was to identify the rates of communication expressed by 17 children with severe disabilities (7 deaf-blind) in high-rate school contexts while piloting a new coding system used for intentional communication acts (ICAs). The following characteristics were used when coding ICAs as they were expressed in both child-initiated and adult-initiated communicative interactions: joint attention; form of communication; use of pause, persistence, repetition, and repair; expression of pleasure or displeasure when understood or misunderstood; expression of pleasure or displeasure to communication partner's message; and evidence of comprehension. Children communicated 1.7 to 8.0 ICAs per minute in the highest rate contexts. Nine of the 34 high-rate contexts were speech clinical sessions and six were activities that included eating; 30 were familiar activities, and four were novel activities.


Nonsymbolic Communication Development: Theoretical Concepts and Educational Strategies --Siegel-Causey, Ellin; Downing, June. Baltimore: Paul H. Brookes Publishing Co. Innovative Program Design for Individuals with Dual Sensory Impairments. Lori Goetz, Doug Guess, and Kathleen Stremel-Campbell (Eds.). (1987)Chapter 2 stresses the importance of nonsymbolic behaviors in the development of communication for persons who do not make use of symbols. An attempt is made to focus on the basic comunicative behavior of individuals with severe multiple sensory and/or mental impairments. The importance of early assessment and social interactions are discussed and strategies for intervention and instruction are offered.


Nonsymbolic Communication in Early Interactional Processes and Implications for Intervention --Siegel-Causey, Ellin; Ernst, Barbara; Guess, Douglas. Monmouth, Oregon: Oregon State System of Higher Education, Teaching Research Division. Communication Development in Young Children with Deaf-Blindness: Literature Review. Glen Fielding and Michael Bullis (Eds.). (1988) This chapter provides an overview of early communication exchanges and identifies variables that might affect the development of communicative competence. Specifically, it focuses on the development of nonsymbolic, prelanguage communication and the interactional context within which it occurs. First, important aspects of nonsymbolic, prelanguage communication are reviewed, focusing on caregiver sensitivity and responsiveness to infant visual, gestural, and vocal behaviors. Then, salient features of caregiver communication behaviors are examined. The second section presents early communicative behaviors between caregivers and infants as an evolving interactional process, including caregiver sensitivity, timing, contingency and predictability. These aspects are examined in relationship to both the normally developing infant and the child with deaf-blindness who is at the nonsymbolic level. The final section explores differences in interactional patterns of caregivers with children displaying disabling conditions, covering such areas as caregiver initiation, overstimulation, directive and controlling behaviors, and differences in interactional patterns over time.


Prelinguistic Communication Intervention: Birth-to-2 --Stremel-Campbell, Kathleen; Rowland, Charity. TOPICS IN EARLY CHILDHOOD SPECIAL EDUCATION, vol. 7, #2, pp. 49-58. (1987)Suggestions for narrowing the discrepancy between the knowledge base of early communication development and the implementation of effective communication interventions for severely handicapped infants and young children are offered, including strategies for facilitating emerging language development, increasing positive interactions with infants, and improving preservice and inservice professional training.


Promoting Learning Through Active Interaction: A Guide to Early Communication with Young Children Who Have Multiple Disabilities --Klein, M. Diane, Ph.D.; Chen, Deborah, Ph.D.; Haney, Michele, Ph.D. Baltimore: Paul H. Brookes Publishing Co. (2000)The Promoting Learning Through Active Interaction (PLAI) curriculum is designed primarily for infants, preschoolers, and young children with severe or multiple disabilities (including deaf-blindness) who are not yet initiating symbolic communication and who have a limited repertoire of communicative behavior. It can also be used with older children who have not yet developed intentional communication. The curriculum consists of a Caregiver Interview to identify a child's current communication abilities and 5 modules: 1) Understanding Your Child's Cues; 2) Identifying Your Child's Preferences; 3) Establishing Predictable Routines; 4) Establishing Turn Taking; and 5) Encouraging Communicative Initiations. The curriculum also contains handouts and recording sheets in both English and Spanish. A video (Promoting Learning Through Active Interaction: An Instructional Video) is also available in English and Spanish. Publisher's web site:


Promoting Learning Through Active Interaction (PLAI): An Instructional Video --Chen, Deborah, Ph.D.; Klein, M. Diane, Ph.D., CCC-SLP; Haney Michele, Ph.D. Baltimore: Paul H. Brooks Publishing Co. (2000) This video and accompanying viewing guide demonstrates key strategies to promote communication in infants and young children who have severe disabilities, including visual impairments, through five modules. These modules include: 1) Understanding Infant Cues; 2) Identifying Infant Preferences and Dislikes; 3) Establishing Predictable Routines; 4) Establishing Turn Taking; and 5) Encouraging Initiation of Communication. The video should be used with the curriculum, which is designed for service providers working with infants and young children with severe disabilities who are at a presymbolic level of development. Available in Spanish.Order from: Customer Service Department, Brookes Publishing, P.O. Box 10624, Baltimore, MD 21285-0624, Tel. 800-638-3775, FAX 410-337-8539. Publisher's web site:

2010-0105 Teaching Prelinguistic Communication Monmouth, OR: National Consortium on Deaf-Blindness, Teaching Research Institute, Western Oregon University. PRACTICE PERSPECTIVES, #1, September 2009. (2009)This publication describes the findings of a study conducted by Nancy Brady and Susan Bashinski on the use of adapted prelinguistic milieu teaching (PMT) for children who are deaf-blind. In adapted PMT, an instructor, working one-on-one with a child, uses a variety of strategies to teach and encourage children to use gestures and vocalizations to communicate intentionally. This is the fifth in series of publications called Practice Perspectives, designed to increase the use of current information resources through the development of easily understandable products in accessible formats. Available on the web: Publisher's web site:


There's More Than One Way to Hold a Conversation --Nelson, Catherine. LIVING AND LEARNING TOGETHER, vol. 1, no. 2, October 1994, pp. 4-6. (1994)Nelson discusses the nature and importance of nonsymbolic communication, especially to the deaf-blind child. She emphasizes the need for caregivers to recognize and respond to approach and withdrawal cues of the deaf-blind child. The importance of establishing a meaningful focus in any conversation to create a need for communication in the child is also stressed.


Use of Gesture Development in Profiling Children's Prelinguistic Communication Skills --Crais, Elizabeth R.; Watson, Linda R.; Baranek, Grace T. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY, vol. 18, February 2009, pp. 95-108. (2009)Profiling a child's strengths and challenges can help in making decisions regarding eligibility, diagnosis, and intervention. It is particularly important for children who are not yet talking, due to the variability in production skills and the lack of guidelines as to which children are "at risk" for communication deficits versus those who are "late talkers." One area underutilized in profiling is gesture development, despite the fact that research has indicated that the amount and type of gesture use can help in early identification and is predictive of later language. To guide practicing professionals and researchers in using gesture development to profile children's communication skills, this article provides an overview of the types of gestures and their development, describes assessment methods and tools to document gesture development, pinpoints behaviors and factors important in identifying children with disabilities, and ends with brief examples of using profiling in assessment and intervention.

NCDB : The Research Institute : Western Oregon University : 345 N. Monmouth Ave. : Monmouth, OR 97361
Contact Us: 800-438-9376 |

Tour This Page Website Help
Help for this page

Help Guides & Tutorials