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Using Total Communication strategies to support students with Processing Disorders

Written By: Ella Waude
5 min read
Total Communication approaches disadvantage nobody, but they can empower so many

Total Communication has been developing since the late 1960s when Roy Holcomb designed a holistic approach to enabling effective communication (Stewart, 1992). Teachers interpret the approach in numerous ways, and many deviations exist, but the key philosophy is that it provides a range of strategies for communication and values the interaction between individuals over all else.

Modern Total Communication includes the use of speech, symbols, photographs, electronic devices, routines, eye pointing, objects of reference, sign language and constant opportunities for developing communication in an individual’s preferred method. Using Total Communication strategies can be key to a non-verbal learner becoming verbal, a verbal learner increasing in confidence, or a non-verbal learner developing an efficient and effective method of communication.

What are Processing Disorders?

‘Processing Disorders’ is a broad term that describes impairment in the way one or more of the senses process information. More specifically, the impairment may be auditory, visual, linguistic, sensory or affect memory.

It may be possible to pinpoint the issue as something particular, for example, difficulty with auditory sequencing (i.e. recalling the order in which sounds were heard, so messages appear jumbled). Equally it may not be possible to pinpoint the precise processing difficulty.

The way in which processing disorders present can vary widely and are unique to the individual. It is also important to bear in mind that, even if an individual does not have a processing disorder diagnosis, there are many other conditions which may affect their ability to process the world, for example, Autism Spectrum Disorder, and this difficulty can display through a variety of frustrated behaviour as the examples below detail.

When is Total Communication useful? Some case study examples


Hattie (a hypothetical example) has been diagnosed with a disorder that has a mild effect on her linguistic and memory processing skills, as a result of a broader condition which affects her nervous system. Without Total Communication support, she becomes withdrawn because the cognitive load (the amount of information the brain can understand at any one time) has been too high, and therefore overwhelming.


Brian (another hypothetical example) has a linguistic processing disorder, which is directly related to his diagnosis of Autism Spectrum Disorder. Without Total Communication support, he is known to shout and displays challenging behaviours as he becomes overloaded with information he cannot process.

Although predominantly verbal communicators, both learners have receptive language skills (understanding of what is being said to them) and expressive language skills (the ability to communicate thoughts and feelings successfully to another) that are underdeveloped compared with their cognitive skills, and this can cause frustration. In the classroom, we support both learners through an immersive Total Communication approach that includes Sign Supported English (signs that accompany spoken language, in the same order as spoken English). There are several benefits; for Brian, for example, sign language helps him to both process and retain information that he would struggle with if presented only orally. Meanwhile, Hattie uses signing as a tool when her speech is unclear, or she cannot identify the word that she needs.


Josie (another hypothetical example) has profound processing difficulties in all areas. She has access to pictures which she exchanges for an item; for example when handed a picture of an apple, an adult will give her an apple. She sees this communication repeatedly modelled throughout the day by an adult and is encouraged to participate.

Routines are also a helpful Total Communication strategy which reduce unnecessary cognitive load, enabling learners to understand what is coming next within their day and increasing their feelings of safety, which supports learning. Objects of reference are another way to give clues for communication; a wooden spoon and a bowl can mean cooking. Symbols and photographs for learners with a moderate learning disability are used to prompt memory and provide opportunities for developing communication skills without overwhelming their processing capabilities.

By giving learners access to information in ways that are easier to process and accessible to them, we are not only including them in education but valuing their rights as a human being.

Where and when should it be included?

The hypothetical case studies above illustrate possible benefits to Total Communication approaches. Without it, these learners might struggle to access their learning, and more widely, everyday life. By giving the learners access to information in ways that are easier to process and accessible to them, we are not only including them in education but valuing their rights as a human being as well as the relationships that are built as a result.

In the ever more inclusive classroom, it is important that teachers take steps to embed appropriate Total Communication, even in the absence of individuals who have processing disorders because it can also support learners for whom English is an additional language. The approach requires some thought and commitment to either creating or finding resources and to both learning and embedding this method into everyday practices.

However, Total Communication is not entirely about the availability of resources or ability to use a signing system. It is about ensuring there are consistent and persistent opportunities for individuals to communicate, in whichever way is effective for them, and to develop their communication skills in a way appropriate to them. It includes ensuring access and modelling appropriate communication (Waldo et al., 1981).

It is essential to offer a range of strategic options and support for communication and enable learners to better access the world around them. Precisely how that will look is a decision for the teacher in the classroom and the school as a whole. Where a specific need exists it is also important to involve the learner and the family (in line with the SEN code of practice), and where possible speech and language therapists and occupational therapists in sharing strategies and setting targets; a coherent approach is of the most benefit.

Where to start?

If there isn’t any current provision to embed Total Communication, begin with the conversation as a teaching group.

Symbols or photographs on class trays are an easy way to start, and pre-made resources are readily available on the internet. There is also a wealth of basic signing videos available, for free, on YouTube. Here are a number of links to get you started:

  1. is a great place to learn more. Gloucestershire Total Communication website has a wealth of knowledge about the philosophy of the approach and information about objects of reference.
  2. has a wealth of resources including labels for trays and pictorial communication cards. Some resources are available for free and some ask that you subscribe to their service
  3. is a free online signing dictionary. The videos from Sign Station in particular are brilliant, but be aware that Karl O’Keeffe’s videos are Irish Signs not British (a subtle but important distinction).
  4. has a range of videos demonstrating a range of signs for everyday use. Begin incorporating keywords into your vocabulary and sign as you speak, building up your use as your knowledge increases.
  5. has a range of videos demonstrating how to model communication, even for very complex learners. You can also see their PODD system for non-verbal learners and how they use these every day.

There are also many local Total Communication packages on offer across the country which a school can buy into. Just start somewhere; Total Communication approaches disadvantage nobody, but they can empower so many.

  • Ferguson, M (2011) Communication, Listening, Cognition and Speech Perception Skills in Children With Auditory Processing Disorder (APD) or Specific Language Impairment (SLI). Journal of Speech, Language and Hearing Research. Vol 54: 211-227.
  • Gills, E et al (1990) Total Communication for Children with Down Syndrome? Patterns Across Six Children. Annual Conference of the American Speech-Language-Hearing Association.
  • Hart, C (2011) Can We, Can’t We, Can We, Can’t We, Can We Help Him Join the Dance? The Need for Multimodal Processing in the Move Towards Meaningful Communication. Journal of Child Psychotherapy. Vol 37(1): 16-30.
  • Oliveras-Rentas, RE, Kenworthy, L, Roberson, RB, Martin, A and Wallace, GL (2011) WISC-IV Profile in High Functioning Autism Spectrum Disorders: Impaired Processing Speed is Associated with Increased Autism Communication Symptoms and Decreased Adaptative Communication Abilities. Journal of Autism and Developmental Disorders. 42::655-664.
  • Stewart, D (1992) Initiating Reform in Total Communication Programs. The Journal of Special Education. 26:68-84.
  • Waldo L, et al. (1981) Total Communication Checklist and Assessment. Early Childhood Institute.
  • Wallach, GP (2011) Peeling the onion of auditory processing disorder: A language/curricular-based perspective. Language, Speech, and Hearing Services in Schools, 42(3): 273-285.
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