Communication partner strategies

• Approach family: Communication partner strategies
• Primary purpose: Change how other people notice, understand, support and respond to a young person’s communication
• Primary discipline: Speech and language therapy
• Contributing disciplines: Education, occupational therapy, psychology, health, social care, family support and whole-setting leadership
• Typical settings: Education, home, health, care, transport, community and work-transition settings
• Typical partners: Family members, teachers, support staff, clinicians, peers, carers, employers and community staff
• Typical tier: Universal, targeted or individualised, depending on communication need and context

Communication partner strategies deliberately change the behaviour of the person receiving and responding to communication. The communication partner may alter their pace, language, positioning, questions, wait time, use of visual or AAC modes, interpretation, confirmation, modelling, opportunities, response or repair.

The approach begins from a relational fact: communication success is not produced by one person alone. A young person may have communication differences or impairments, but access also depends on whether other people recognise their modes, make sufficient time, provide an accessible route, respond contingently and repair misunderstanding without blame.

This is an umbrella practice family, not a named programme. A communication passport, a staff handout or the instruction to “use simple language” is not, by itself, an implemented intervention. A usable record identifies the partner behaviour to be changed, how partners will learn it, the contexts in which it will be used, and the effect on the young person’s communication and participation.

Communication partner strategies may be components of named approaches such as Preschool Autism Communication Trial (PACT), Hanen programmes, Enhanced Milieu Teaching, responsive interaction approaches, naturalistic developmental behavioural interventions or AAC partner instruction. Those programmes have distinct protocols and evidence and should not be treated as interchangeable with A017.

The approach may work alongside, but is not the same as:

• A018 AAC and multimodal communication, which concerns access to, selection and development of communication modes and systems;
• A006 Visual and anticipatory supports, which make information, sequence, choice and change more visible;
• A020 Explicit instruction and modelling, which directly teaches knowledge or skills to the young person;
• A003 Co-regulation and A001 Low-arousal approaches, which primarily address relational and interpersonal conditions around arousal and distress;
• A005 Environmental adaptation, which changes broader physical, sensory, social, temporal or task conditions;
• A022 Peer-mediated approaches, which deliberately recruit and prepare peers within a defined participation or learning intervention;
• speech and language therapy as a service, assessment or professional role.

Describe communication across contexts

Identify how the young person receives and expresses communication when comfortable, busy, tired, distressed, in pain or with unfamiliar people. Include speech, vocalisation, gesture, facial expression, body movement, sign, objects, pictures, drawing, writing, typing, AAC and silence. Do not use “non-verbal” as shorthand for having no communication.

Record sensory, motor, language, literacy, memory, hearing, vision and access factors that affect the interaction. A person may understand more than they can express, express more through one mode than another, or use speech in one context and need AAC in another.

Choose a meaningful interaction goal

Begin with the person’s purpose, not an adult preference for a particular form. The goal may be to refuse safely, report pain, join a conversation, understand a lesson, ask for clarification, make a choice, repair a breakdown, tell a story or communicate during shutdown. Select the contexts and partners that matter to that goal.

Specify the partner behaviour

Choose a small number of observable changes. Examples include allowing an agreed processing interval before repeating; asking one question at a time; using a preferred visual or AAC mode; modelling a message without requiring imitation; responding to all credible attempts; or confirming an interpretation before acting.

“Be patient”, “support communication” and “use visuals” are intentions, not reproducible partner behaviours.

Teach partners actively

Effective partner preparation commonly combines explanation, demonstration or video, rehearsal, practice in a real interaction, feedback and follow-up coaching. Information alone may improve awareness without changing behaviour. Training should include the reason for the strategy, examples and non-examples, what to do when communication breaks down, and how to avoid over-prompting.

Create authentic opportunities

Make useful communication possible throughout ordinary routines. Opportunities should allow a range of functions—commenting, refusing, asking, joking, sharing information, protesting and changing one’s mind—not only answering adult questions or requesting items.

Do not manufacture communication by withholding food, drink, pain relief, a regulation aid, access to the toilet or another essential need. A partner can pause and offer an accessible route without making dignity or safety conditional on performance.

Respond and expand without taking over

Notice the message, acknowledge it and make a response that shows communication had an effect. A partner may model a slightly fuller form, add vocabulary, reflect the message back or provide the requested repair. Modelling is an offer of language, not a demand to copy.

Interpret behaviour cautiously. Actions can have communicative effects without adults knowing the person’s intention. Use formulations such as “I think you may be telling me ‘stop’; is that right?” and seek confirmation through an accessible route.

Repair collaboratively

Communication breakdown is shared work. The partner can say that they have not understood, preserve the person’s dignity and try a different route: slow down, reduce choices, write or show the key information, ask the person to indicate the important part, involve a trusted partner or return later. Avoid presenting misunderstanding as the young person’s failure.

Spread competence and sustain it

A strategy that works only with one expert partner leaves the young person vulnerable. Identify essential partners, train new staff, keep the communication plan current and provide booster coaching. Preserve individual knowledge without making one family member, assistant or clinician the permanent translator.

For a pupil using a personal radio aid, specify the adult's actions: receive and return the microphone discreetly, use or mute it for the relevant interaction, and follow the agreed fault route. Coordinate this with the equipment plan in A005. Continue preferred modes and shared repair; functioning equipment alone does not establish understanding. National Deaf Children’s Society (NDCS) guidance.

Monitor both sides of the interaction

Measure whether the partner used the agreed strategy and whether the young person gained meaningful communication access. Improved partner fidelity without improved access is not enough; improved performance during coached sessions without transfer to ordinary contexts is not enough.

Communication partner strategies can include:

• addressing the young person directly rather than speaking only through a companion;
• finding out and using the person’s preferred communication modes;
• positioning so that relevant speech, face, signs, objects or displays are accessible without demanding eye contact;
• gaining attention in an agreed, non-startling way;
• reducing unnecessary language and presenting one idea or question at a time;
• using concrete wording while preserving age respect and intellectual dignity;
• pausing long enough for processing, initiation and response;
• resisting the urge to fill silence, guess immediately or repeat rapidly;
• balancing comments with questions so interaction does not become an interview or test;
• using open questions, structured choices or yes/no routes according to the person and purpose;
• checking that a reliable “yes”, “no”, “stop”, “not sure” and “something else” route is available;
• showing key words, pictures, objects, signs, written choices or AAC symbols while speaking;
• modelling communication in the person’s AAC system without taking control of the device or requiring imitation;
• keeping the person’s communication system available, charged, within reach and populated with relevant vocabulary;
• treating refusal, correction and withdrawal as communication to be respected and clarified;
• responding to attempts that are subtle, incomplete, unconventional or delayed;
• expanding a message without implying that the original form was unacceptable;
• narrating a repair: “I misunderstood. Let me try another way.”;
• confirming interpretations before making consequential decisions;
• revisiting communication after distress when speech or action has become more available;
• protecting privacy and speaking with the young person separately when appropriate;
• using an interpreter rather than treating limited shared language as limited ability;
• recording what partners should do, not only what the young person is expected to do.

No single strategy is universally accessible. Shorter language may help processing but can become vague or infantilising. Open questions can support agency but overload someone who needs structured choices. Waiting can create space but feel like pressure if the partner stares expectantly. A visual prompt can support understanding or become coercive if it is repeatedly used to drive compliance. The person, message and context determine the fit.

Tier 1 — Universal communication access

Build a shared baseline for all staff and environments: direct address, sufficient time, accessible information, respect for multiple modes, clear repair, and an expectation that communication partners adapt. Universal practice should include induction, observation and feedback rather than a poster of tips alone.

Tier 2 — Targeted partner strategies

Train selected partners for a recurring context or group need—for example, supporting comprehension during practical lessons, expanding communication functions in play, enabling contributions in a group, or recognising communication during distress. Define the partner behaviours and monitor use in the natural setting.

Tier 3 — Individualised partner plan

Develop a personalised plan where communication is complex, variable, high stakes or closely linked to safety, health, consent or decision-making. Speech and language therapy assessment and coaching may be required, alongside occupational therapy, psychology, health or specialist education input. The plan should cover preferred modes, access, reliable responses, important vocabulary, repair, partner actions, authorship and review.

This is a constructed illustration of the approach, not a reported case or an observed outcome.

Imagine a pupil who finds rapid questions during a busy transition difficult and prefers typing or pointing to an agreed response card at those times. The team agrees with the pupil how adults will address them, offer the available routes and allow time without adding repeated questions. Partners practise those actions and receive feedback; the card alone is not treated as the intervention.

Review would check whether the chosen routes were available, whether adults followed the agreement, whether the intended message could be expressed, and how much effort or pressure the exchange involved. The pupil’s account would remain separate from adult observations. If one partner is more responsive than others, the next question concerns partner practice and continuity rather than assuming the pupil’s communication has changed everywhere.

1. Why the evidence boundary matters

“Communication partner strategies” can describe anything from pausing after a question to a manualised parent-mediated programme delivered with specialist video feedback. It can involve a teacher modelling symbols, a clinician restructuring questions, a peer learning how to wait, a hospital team using a person’s preferred yes/no response, or a family learning a naturalistic language technique. These are not one intervention.

The evidence must therefore be attached to a defined component or package. A positive trial of a manualised preschool programme does not prove that all adults have been effective because they were told to “follow the child’s lead”. Evidence that partners learn aided augmentative and alternative communication (AAC) modelling does not prove that the same training improves every language, participation or wellbeing outcome.

Phoenix treats A017 as an enabling practice family. The working question is: Does a specified and teachable change in partner behaviour improve a communication outcome valued by the young person, and does it transfer to the people and places where that communication matters?

2. Communication access is relational and rights-based

Communication difficulties can arise from a person’s language, sensory, motor, cognitive or regulatory needs. They can also arise because the listener speaks too quickly, recognises only speech, supplies inaccessible choices, controls the communication system, misses early attempts or fails to repair. The interaction is the unit of concern even when one participant has an identified impairment.

Royal College of Speech and Language Therapists (RCSLT)’s learning-disability position paper describes inclusive communication as shifting responsibility beyond the person experiencing difficulty to those communicating with them. It notes that changing practice requires more than awareness: partner behaviour, values and attitudes matter. National Institute for Health and Care Excellence (NICE) guidance on children and young people’s experience of healthcare recommends identifying preferred forms, using verbal and non-spoken methods, pausing for response, trying alternatives when communication is difficult and respecting times when a child or young person does not wish to communicate.

These principles support dignity and participation, but do not settle every intervention question. A rights-based reason to provide access can exist even where experimental evidence for a particular training format is limited. Conversely, good intentions do not show that partners changed practice or that the person gained access.

3. Direct evidence from AAC partner instruction

The most directly aligned research concerns partners of people who use augmentative and alternative communication. A 2015 systematic review of thirteen studies, rated as moderate in methodological quality, reported positive findings for partner skills and children’s communication. Several studies reported large effects and maintenance one to two months after intervention. The review also highlighted device knowledge, understanding of communication targets, timing and support across contexts.

A related 2015 systematic review and meta-analysis included seventeen single-case experimental-design studies with fifty-three participants who used AAC. It reported strong intervention effects across the included studies. Most evidence concerned children under twelve, commonly with autism or intellectual or developmental disability. Frequently taught partner behaviours included aided AAC modelling, expectant delay and open-ended questions. Common instructional components were explanation, instructor modelling, guided practice and role play.

These findings are encouraging and unusually specific about what partners were taught. They remain a small, predominantly single-case evidence base. Improvement-rate-difference estimates are not interchangeable with effect sizes from large randomised group trials, and the population, communication modes and outcomes limit generalisation.

A 2019 scoping review of aided AAC modelling located twenty-nine studies involving more than 157 peer partners and 100 adult partners. Training commonly combined oral instruction, modelling, practice and performance feedback, with concurrent coaching or follow-up support. The authors identified a need for better reporting and stronger implementation-science methods. This reinforces an important distinction: partner strategy is not simply advice; it is behaviour change requiring active teaching and support.

4. Evidence from parent-mediated social-communication work

Parent-mediated autism research supplies a second, broader evidence strand. A Cochrane review of randomised trials found statistically significant proximal changes in shared attention and parent synchrony, but did not find clear gains for most primary language, communication, adaptive-behaviour or parent-stress outcomes. The authors judged the wider child-outcome evidence uncertain and highlighted the need to monitor parent stress.

A 2019 meta-analysis of twenty-five studies involving 804 parent–toddler dyads found a robust association between parent verbal responsiveness and child communication. Interventions increased parent responsiveness but, across the included evidence, did not significantly increase child communication. This is a useful warning against treating change in the mediator as proof of change in the young person’s outcome.

A 2024 meta-analysis of twenty-one studies of manualised parent-mediated play-based interventions for preschool autistic children reported pooled improvements in social communication and language. The social-communication analysis included twenty studies and 1,131 children, with a medium pooled effect and very high heterogeneity. The language analysis included fifteen studies and 845 children, also reporting a pooled improvement with substantial heterogeneity. These results apply to defined, multi-component preschool programmes—not to every partner strategy, age group or setting.

PACT offers a prominent example of a manualised model in which trained therapists use video feedback to increase parental sensitivity and responsiveness. Its trial and follow-up findings contribute to NICE recommendations for developmentally adjusted social-communication intervention with parent, carer or teacher mediation. PACT is not synonymous with A017, and its outcomes should not be transferred to a local strategy sheet or uncoached staff briefing.

Family feasibility when selecting a named profile

Alongside the programme's target and training method, record the family's preferred language and interpretation needs; travel and sibling-care arrangements; opportunities to observe and practise with feedback; and the expected home-practice, recording and follow-up workload. Identify what the service will provide, what is negotiable and who will resolve access barriers. Check local service arrangements rather than importing another jurisdiction's delivery assumptions. Record caregiver workload separately from the young person's preferences.

A 2024 qualitative study interviewed five Spanish-speaking mothers in New Mexico whose bilingual children, aged 4 years to 5 years 7 months, had received school speech therapy. Accounts included difficulty accessing observation through English-only communication, transport and childcare barriers. Interviews occurred during the 2020 pandemic and were translated for analysis. These caregiver accounts inform feasibility questions; they are neither direct child testimony nor comparative evidence for a parent-mediated programme, and cannot describe UK services generally. Irizarry-Pérez and colleagues.

5. Communication changes with context and distress

Partner strategies must account for variability. A young person who speaks fluently in one state may need writing, symbols, gesture or delayed conversation in another. More language, more questions and more people can further reduce access during pain, fear, shutdown or overload.

A 2026 scoping review of communication during autistic distress included eighteen articles; nine included firsthand autistic perspectives. Non-spoken methods were described in eleven studies. The review identified calm and supportive environments, communication aids, reduced demand and shared responsibility for repair as facilitators, while noting that partner misunderstanding and unavailable aids can worsen communication. It also cautioned that intellectual disability, AAC users and multiply marginalised autistic people remain underrepresented.

This evidence supports flexible modes and partner humility. It does not mean that every action has a known communicative intention. Behaviour may signal that something is wrong without revealing what, why or what response is safe. Partners should observe, offer access, check interpretations and investigate health or safeguarding concerns when indicated.

6. Implementation determines what was delivered

A minimum A017 implementation record names:

• the communication activity, barrier and context;
• the young person’s preferred modes and desired outcome;
• the partner or partner group whose behaviour will change;
• one or more observable partner behaviours;
• the training method: explanation, model, rehearsal, guided practice, feedback and follow-up;
• who provides coaching and how competence will be checked;
• how the strategy changes during distress, fatigue, pain or unfamiliar situations;
• how new partners and staff will be prepared;
• the intended communication outcome, possible adverse effects and review date.

Training should occur close enough to the real context for partners to practise the actual judgement required. A partner may demonstrate a strategy in a workshop yet revert to rapid questions in a busy corridor. Video feedback, direct observation or structured self-reflection can make the interaction visible, but recording requires appropriate consent, privacy and secure handling.

Fidelity should be proportionate. Counting every pause can make natural communication mechanical; never checking implementation makes an unsuccessful trial uninterpretable. Sample a small number of agreed interactions and combine observation with the young person’s report or accessible feedback.

7. Minimum monitoring

Measure both the partner behaviour and the communication result. Depending on the goal, record:

• partner implementation: use of the agreed mode, pace, wait, model, response or repair;
• communication access: whether the person could understand, express, refuse, choose, ask, comment or correct;
• quality and range: initiations, turns, message functions, novel messages and successful repair—not word count alone;
• independence: reduced need for prompts, guessing or a particular translator;
• participation: access to learning, decisions, relationships, healthcare, safety or ordinary routines;
• experience and cost: the young person’s sense of control, effort, frustration, fatigue and preference;
• generalisation: use with different partners, activities and settings;
• equity and safety: privacy, cultural and linguistic fit, access to relevant vocabulary, response to refusal and any safeguarding consequence.

An increase in adult prompts, questions or elicited responses is not automatically improvement. The young person may communicate less often but more effectively, use a less effortful mode, refuse more clearly or need fewer repairs. Define success around function and agency.

8. Cautions, safeguarding and equity

Communication partner practice can affect consent, healthcare, safeguarding and legal decisions. Consequential messages require careful attention to authorship, reliable access and context. Partners should not complete a message, steer a hand, hold a display in a way that cues a desired response or treat their interpretation as the person’s verified statement.

Facilitated Communication is a discredited, facilitator-dependent technique with evidence of facilitator authorship and harm. Rapid Prompting Method, including forms described as Spelling to Communicate, is not recommended by American Speech-Language-Hearing Association (ASHA) because of prompt dependency and lack of scientific validity; messages should not be assumed to be independently authored. These approaches are distinct from independent typing and from transparent partner-assisted scanning in which options are systematically presented and the person selects using a previously agreed, observable response.

Avoid partner strategies that:

• require eye contact, stillness, a particular tone or conventional body language as proof of listening;
• prioritise speech when another mode is more effective or less costly;
• make food, drink, toileting, safety, pain relief or regulation conditional on requesting correctly;
• repeatedly test skills the person has already demonstrated;
• interpret all distress behaviour as a known message while missing pain, illness, abuse or overload;
• turn modelling into physical control, relentless prompting or a demand to imitate;
• provide only requesting vocabulary and no route to refuse, comment, disclose, joke or say “something else”;
• infantilise language or materials because speech is limited;
• use one family member or assistant as the default voice for the person;
• expose private communication in public teaching or data collection;
• assume a strategy is culturally or linguistically neutral.

Partner-mediated work can shift substantial labour onto families or individual staff. Offer training at feasible times, include interpreters, recognise home languages, provide equipment and follow-up, and monitor burden. A caregiver’s ability to implement a programme is not a measure of commitment. Workforce plans should anticipate turnover rather than repeatedly leaving the person without trained partners.

When abuse, exploitation, pain or another urgent concern is possible, preserve the person’s safest available communication route, record exact observations and messages, and follow current safeguarding or clinical procedures. Curiosity about function must not delay protection.

9. What we can say

• Communication success depends partly on the knowledge, behaviour and responsiveness of communication partners.
• Structured partner instruction can change partner behaviour and improve communication outcomes in specific AAC and early social-communication contexts.
• Explanation, modelling, rehearsal, guided practice, performance feedback and follow-up are recurring training components in the evidence.
• Identifying preferred modes, allowing sufficient time, respecting non-spoken communication and repairing collaboratively are supported by guidance and recipient-experience evidence.
• Measuring partner fidelity and the young person’s functional outcome produces a more interpretable review than measuring either alone.
• Communication partner strategies can complement direct intervention, AAC, environmental adaptation and specialist assessment.

10. What we cannot say

• We cannot assign one effect size or evidence grade to all communication partner strategies.
• We cannot transfer outcomes from a manualised preschool or AAC programme to generic staff advice.
• We cannot assume that increased partner responsiveness will automatically produce wider language, wellbeing or participation gains.
• We cannot treat more speech, more prompted responses or fewer visible behaviours as universal evidence of better communication.
• We cannot know the intention behind an action without accessible checking and contextual assessment.
• We cannot assume that a strategy learned by one partner will generalise to other people or settings.
• We cannot use partner training as a substitute for communication-system access, direct teaching, health investigation, safeguarding or specialist assessment where these are needed.

11. Review, exit and escalation

At review, ask:

1. Did partners use the agreed behaviour in the real context?
2. Could the young person communicate the intended range of messages more successfully?
3. What did the young person communicate about ease, control and preference?
4. Did prompting, repetition, misunderstanding, distress or reliance on a translator change?
5. Did the strategy transfer across essential partners and settings?
6. Did it introduce pressure, privacy loss, cultural mismatch, dependency or increased burden?
7. Should the strategy continue, be refined, become universal practice or stop?

Escalate for speech and language therapy or multi-agency assessment when the person lacks a dependable way to communicate essential needs; hearing, vision, motor access, swallowing, pain or neurological change may be involved; communication fluctuates markedly; a high-stakes decision or disclosure depends on uncertain interpretation; an AAC system or access method requires assessment; prompt dependency or authorship is uncertain; or ordinary partner adjustments have not secured access.

A strategy can end when the barrier is resolved, the person no longer wants it, the behaviour has become stable universal practice, or review shows no meaningful benefit. Booster coaching may be more appropriate than indefinite formal intervention. Withdrawal should never remove the person’s established communication access.

12. Phoenix judgement

Communication partner strategies are a promising, high-value enabling practice family whose effectiveness depends on specification and coaching. The strongest direct evidence shows that partners can learn defined behaviours and that communication can improve in specific AAC and parent-mediated contexts. Guidance and first-person evidence strengthen the case for preferred modes, time, flexibility, respect and shared repair.

The evidence does not support an undifferentiated claim that “communication partner training works”. Outcomes vary by population, programme, partner, mode, context and measure. Change in partner fidelity is an important mechanism, not a substitute for a meaningful outcome for the young person.

A useful plan identifies the interaction barrier, the observable partner behaviour, the active training method, the young person’s desired communication outcome and the plan for generalisation. The governing test is not whether adults used the approved words. It is whether the young person gained more authentic, independent and safe communication power.

Shared evidence profile fields

For communication-partner work, identify whose behaviour is being taught, how it is practised and which communication situations are being supported. Advice, a shared record and coached partner instruction need separate descriptions.

The following fields make a specific evidence or implementation record comparable with other Atlas profiles. They do not supply missing study data or replace the source-specific judgements in this entry.

• Identity and version: Name the component or programme, its edition or protocol where relevant, and the purpose being evaluated.
• Source role: Separate direct comparative evidence, descriptive implementation findings, guidance, theoretical support and firsthand experience.
• Population and setting: Retain the studied age, communication/access characteristics and setting. State when an intended application lies outside them.
• Intended and actual delivery: Record the planned components and dose separately from what was received, by whom, and with what support or interruptions.
• Comparison and other support: Name the actual comparison and concurrent changes. If there is no comparison group or it is unreported, say so rather than supply an assumed usual-care condition.
• Outcome and reporter: Record the outcome, time point and reporter. Keep the young person’s account separate from proxy judgement, and access or participation separate from task performance.
• Fidelity and adaptation: Record whether the core components were delivered and describe adaptations; distinguish an adapted application from the protocol tested.
• Burden and unwanted effects: Record time, effort, practical access, cost or workload where known, alongside refusal, fatigue, distress, restriction and other unwanted consequences. Unreported burden is not evidence of no burden.

• NICE — Autism spectrum disorder in under 19s: support and management
• NICE — Babies, children and young people’s experience of healthcare
• RCSLT — Learning disabilities position paper
• RCSLT — Augmentative and alternative communication guidance
• ASHA — Augmentative and Alternative Communication practice portal
• Shire and Jones — Communication partners supporting children who use AAC
• Kent-Walsh and colleagues — Effects of communication partner instruction: meta-analysis
• Biggs and colleagues — Natural communication partners in aided AAC modelling interventions
• Oono and colleagues — Parent-mediated early intervention for young autistic children
• Edmunds and colleagues — Parent verbal responsiveness and child communication
• Deniz and colleagues — Parent-mediated play-based interventions
• Green and colleagues — Preschool Autism Communication Trial
• Pickles and colleagues — PACT long-term follow-up
• Oldenburg and colleagues — Communication during autistic distress
• ASHA — Facilitated Communication position statement
• ASHA — Rapid Prompting Method position statement

Narrow integration sources checked 11 September 2026

• NDCS — Deaf-friendly teaching: secondary schools: professional guidance for adult hearing-access tasks.
• Irizarry-Pérez and colleagues — 2024 family-experience study: qualitative access and feasibility context.

These working tags describe the approach’s focus. Conditional connections depend on the particular barrier, goal and application. Professional delivery roles remain recorded separately.

Direct focus

• 03 Communication & connection — The active intervention changes how partners notice, interpret, support and repair communication.
• 06 Agency, safety & participation — The draft explicitly works on communication access, refusal, choice, decision-making and meaningful participation through partner changes.

Conditional connections

• 02 Thinking, attention & action — Relevant when a defined partner adjustment reduces processing, memory or response-time demands.
• 05 Sensory, body & environment — Relevant when positioning or sensory access is a specified communication barrier.

These entries offer related reading for the situations described. A link expresses the specific connection below; it does not establish individual suitability or an effect of the approach.

• E012 Difficulty communicating needs — Read alongside this approach when partners need to recognise and respond to asking, refusal or other communication. Treat an interpretation of behaviour as a hypothesis to check, rather than an established intention.
• E068 Difficulty communicating when under pressure — Read alongside this approach when pressure changes the person’s available communication. Consider partner pace, waiting, accessible alternatives and opportunities to repair misunderstandings later.
• E060 Difficulty asking for help or signalling difficulty — Read alongside this approach when the response to a request, or the route for making it, prevents help-seeking. Communication-partner work addresses that component; recognition, trust and system access may also matter.