Many apologies for the delay in response. I’m not only perpetually behind on everything, I’ve been digging around trying to find an answer to your question. I asked around some, though because we’re on break from school there are some people I won’t be able to reach for a while. You’ve asked a fantastic and challenging question. This is a very inadequate response, and I apologize. I just don’t know enough about this to be particularly useful.

A blogger I’ve talked to has a child who is visually-impaired in one eye. They use a device from Prentke Romich that’s been modified to fit his needs. I’m assuming one of their technicians worked with her to set up the device so he could use it. The downside is, devices like that are incredibly expensive and likely well outside your price range.

One alternative I guess is to use regular picture board pics but add Braille or texture to them. Teaching Braille obviously would take time and adds another layer of communication issues to work through. I’d imagine you’d quickly run out of different textures to use, but perhaps if you could just get a few ‘pictures’ into his communication vocabulary, you’d at least get a start. If there was any way to make those textures in some way correlate to the object in the picture (soft texture for ‘blanket’, for example) I’d do that. It might cause problems later if a child learns to associate things too literally that don’t really go together very well.

Another possibility is to add miniature versions of the actual objects and attach them somehow to a choice board. This would provide some 3-dimensional objects to understand by feel. This might work OK for things like food and such as there are plenty of small versions of those in the toy sections of stores. There are obvious limitations to this approach, but it might also be a way to get started.

I’d be reluctant to use raised shapes. My son can be very literal about things, and equating a raised circle with, for example, a car might mean that he’d associate circles with cars always rather than generalizing that circles exist in other places. I’m not saying it wouldn’t work, but I’m pretty sure it wouldn’t work for us.

[Note: The following assumes living in the U.S.]

For everyone living in the U.S. (don’t know enough about other countries, but feel free to comment if anyone does), I strongly suggest contacting your county agencies and schools for assistance and advice. Children under 3 can get help under Early Intervention, the contact info for which you should be able to get from a phone book or a local pediatrician. Over age 3, evaluations, services, and educational instruction go through the local school system. All of them have special education contacts, so start there. In your case, your student would most definitely qualify, and you have a federally protected and mandated right in the U.S. to services appropriate to your child’s educational needs.

Many places also have independent agencies that serve those who need assistive communication devices. It varies from place to place, but someone with a county agency or the local schools should be able to point you to any that are near you. Around here, we can get devices on loan to try out and professional advice on what would be most appropriate to our child. However, these organizations don’t exist everywhere. Also ask any local organizations that assist those with visual impairments. If that doesn’t help, go to the national organizations.

Also, if the child qualifies for Medicaid – which can be done because of disability rather than income – a communication device might be covered by insurance.

The American Speech-Language-Hearing Association (ASHA) has a lot of smart people working for and with them. It’s very likely someone at ASHA would know the answer to your questions. I suggest going to their site and contacting them.

I’ll ask around and see what else I can find out. I’m sorry I couldn’t provide more specific (or timely for that matter) information.

We’ve been exploring a number of picture methods lately with the challenge being that his reading skills seem to leap by the day, which makes us stop and rethink what system really would work best for him. It’s like trying to hit a flying receiver 40 yards downfield. He’s too fast for us lately!

They use a very elaborate picture system at school for schedules, identifying centers and tasks, filling in sentences for wants and needs (e.g., the “I Want ____” board, which I also keep meaning to write about), structuring activities that are hard to structure (like assembling lego blocks), and all sorts of activities.

At the moment, we’re transitioning into a hybrid picture-word system, where the picture of the item has the accompanying word under it. The goal there is to transition to some combination of very simple pictures with the accompanying word or just word cards with no pictures. This should help with extensibility, but an analog system of cards has its limits to be sure.

Like I said, this is like hitting a moving target at this point. He could be ready to read novels for all we know right now. As I posted in my reply to your other comment, keyboards – and most anything with buttons – are a perseverative and highly overstimulating thing right now for him. We are revisiting it on a regular basis in hopes of integrating it more into his communication routine. He can certainly find anything he wants on a QWERTY keyboard since he knows all of his letters now.

Which leads to another thing we’re about to start working on more intentionally – spelling. We plan to start with having him try filling in a letter of words he knows well. (e.g., ‘ r_d’ and have him add the ‘e’ – via flash card of ‘e’, one of those magnetic letters, or whatever – to make ‘red’) I think that would really move us along toward communication by keyboard or other letter system, among other skills.

And next time I’m at your house, I’m putting up a picture of enchiladas.