Deciding what to teach a child first is, of course, an individual matter dependent upon characteristics of the child as well as the environments in which the child spends time. Oftentimes, though, the child’s age will determine who delivers communication instruction, as well as the type and location where it takes place.

Instruction typically takes place at an early intervention center and/or in the home, often with the therapist and family members present. (See Organizations supporting children under three.) Typically, the skills that are focused on are those associated with the next stage in the sequence of communication learning based on speech and language development in children without disabilities. (See Two approaches: Developmental and ecological.) Given the young age, this child will likely be an unintentional or early intentional communicator and, thus, learning pre- or early communication, social and cognitive skills. (See Assessing intentionality, and the understanding of means-end, causality, and symbols and The first goal: Intentional communication.)

The use of communicative behaviors that are self-developed and unconventional (e.g. vocalization, grabbing, or throwing) may be encouraged at this early stage to allow the child to focus entirely on comprehending the idea of communication as an intentional act that offers control over the environment and people. Later, when the child has mastered the concept of intentional communication, he or she can begin to learn more conventional modes of communication. (See Basic communicative functions, Conversational skills and Teaching sentence structure.)

A communication program for an infant or very young child is typically based on where the child currently is developmentally, and how to assist the child in reaching the next stage. However, determining what to teach a preschool- or school-aged child depends more on what the child’s communication needs are in relationship to the activities and environments in which he or she participates or is expected to participate.

At this stage, the child needs to be able to communicate a greater range of needs, desires and information at home, in school and in more community settings.

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Most children will be receiving special services through their local public school, and the thrust of the AAC program developed there will be to assist the child in educational activities. Nevertheless, it is important to recognize the necessity of social communication, as well as the value of designing interventions that are motivating to the child. (See Organizations supporting children three and older, When does a child need AAC?, and The ecological approach: Focusing on participation.)

In summary, a first communication intervention program for a preschool- or school-aged child should consist of goals which assist the child in achieving more meaningful participation in relevant environments using objects, activities and methods that are motivating, and beginning at a level that is challenging but still allows for immediate success.