I adapt EVERYTHING with actual objects or pieces of actual objects and make these part of the child's communication system. If using Boardmaker symbols, make them large enough that you can attach the adaptation. Make a name symbol for the child (his picture framed with a textured material). Start with a few symbols of common objects or activities (I made adapted symbols for a daily schedule). One I used with a child with a profound intellectual disability, blind, and deaf was the Boardmaker symbol for bus and a set of keys attached. Everytime we went somewhere on the bus she was given this symbol. I instructed her mom to do the same--everytime they were going to go somewhere in the family van to give her the keys. It was hoped that she would develop anticipatory behaviors from these associations.
I also send these adapted symbols with the child to their next class--afterall it is their communication system and should be something that can be built on also.
Good luck--I consider these students my most challenging (and most rewarding).
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