Student Growth: Juan Carlos
Juan Carlos is a 7–year old male with a diagnosis of Autism Spectrum Disorder. He is a non-verbal communicator that communicates primarily through gestures, facial expressions, vocalizations, and occasionally uses picture symbols or his dynamic display speech generating device for a variety of functions including directing, requesting, and commenting. Juan Carlos relies on visual schedules, intermittent breaks, token systems, and extended response times to maintain focus and complete presented tasks. Receptively, he is able to follow one-step directions with visual supports. Expressively, Juan Carlos can make requests for desired items (utilizing picture symbols, speech generating device, and or gestures) label feelings by selecting the appropriate cell (i.e., “happy”/ “sad”/ “angry”), and greet familiar peers and adults by selecting appropriate cells on a speech generating device (i.e., “hello”/ “goodbye”) and/or waving. He requires a total communication approach, including the use of visual supports, gestures, and modeling of language.
Annual Goal 1: Juan Carlos will follow one step directives that contain action words of come, color, point to and show me given prompts and models 4 out of 5 times over 5 sessions determined by the speech therapist using data collection and/or observations
Annual Goal 2: Juan Carlos will identify items and will imitate or approximate labels for toys during structured play activities given prompts and models 4 out of 5 times over 5 sessions determined by the speech therapist using data collection and/or observations
Annual Goal 1: Juan Carlos will engage in social interactions with peers and familiar adults utilizing his speech generating device by producing core vocabulary words “hi”/ “bye”/ “please”/ “thank you” in 4/5 trials over three consecutive sessions during structured/unstructured tasks as measured by check lists and teacher/provider observations
Annual Goal 2: Juan Carlos will utilize his speech generating device to respond to “yes”/ “no” questions directed towards him in 8/10 trials over three consecutive sessions during structured/unstructured tasks as measured by check lists and teacher/provider observations
Annual Goal 1: Juan Carlos will utilize his preferred mode of communication (i.e., picture symbols/dynamic display speech generating device) to express noun labels when presented with a picture/object and asked, “what is this?” in 8/10 trials over three consecutive sessions during structured/unstructured tasks as measured by check lists and teacher/provider observations
Annual Goal 2: Juan Carlos will respond to factual "What", "Who" and "Where" questions when presented with a short story and/or visual scene in 8/10 trials over three consecutive sessions as measured by check lists and teacher/provider observations
I first began working with Juan Carlos when he entered kindergarten as a nonverbal communicator. At the start of services, he relied primarily on head nods, limited gestures, and inconsistent eye contact to express wants and needs. He did not have access to a speech-generating device and demonstrated significant barriers to functional communication across classroom, therapy, and social settings. Without a communication system in place, he was dependent on adults interpreting him correctly, which limited his independence and access to learning. As his speech-language pathologist, my first priority was simple but urgent: give him a voice.
I immediately introduced the Picture Exchange Communication System (PECS). My goal was not just compliance with exchanges, but helping him understand that communication is powerful. With consistent modeling, reinforcement, and close collaboration with his classroom team, he quickly progressed from single-picture exchanges to combining words into simple phrases. He began initiating exchanges rather than waiting to be prompted. He demonstrated strong visual learning skills, intentional communication, and readiness for a more robust, language-generating AAC system.
I conducted a comprehensive assistive technology evaluation. I trialed multiple applications to determine the most appropriate system, including GoTalk NOW, Proloquo2Go, and LAMP Words for Life. GoTalk NOW provided accessible visuals but was too limited to support long-term language expansion and generative communication. Proloquo2Go offered a well developed vocabulary however, its organization and navigational complexity exceeded Juan Carlos' processing and motor planning abilities at the time. LAMP Words for Life aligned best with his strengths. The consistent motor patterns and emphasis on motor planning supported automaticity and reduced cognitive load, allowing him to focus on language rather than navigation. Based on dynamic assessment data, classroom observation, and trial performance, I recommended LAMP Words for Life as his long-term AAC system.
Juan Carlos has now used his device for over one year. Through structured therapy sessions, classroom integration, modeling, aided language stimulation, and caregiver collaboration, he has demonstrated measurable growth in functional communication. He can now independently initiate greetings with peers and adults (“hi,” “bye”), use social courtesies (“please,” “thank you”), respond to yes/no questions directed towards him, use core vocabulary to create 2–3 word phrases to request desired items, and initiate communication without prompting in both structured and naturalistic settings.
By transitioning him from no device, to PECS, and then to a motor-planning–based speech-generating system, I supported not only immediate communication access but also the development of language and communication skills. His progress reflects the power of timely AAC implementation, careful system selection, and consistent intervention. He entered kindergarten communicating through minimal gestures and now independently generates multi-word utterances through his device, demonstrating both growth and limitless potential.
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