Strategies for supporting individuals with communication disorders

From therapy to social change

Support for people with communication disorders extends beyond therapy - it’s about ensuring access, representation, and dignity.

We move from individual strategies to system-level thinking: how advocacy, technology, and inclusive design can change communication access for everyone.

communication as a human right

UN convention on the rights of persons with disabilities (CRPD), Article 21: affirms the right to freedom of expression and access to communication for people with disabilities.

ASHA echoes this in its code of ethics: professionals must advocate for equitable access to communications services

Communication vulnerability

People with speech, language, or cognitive disorders are at risk of exclusion-in healthcare, education, justice systems, and employment.

Ex: person with aphasia may understand consent discussions but lack a way to respond verbally; without support, their autonomy is denied.

SLPs as advocates

Beyond clinical skills, SLPs must advocate for communication rights at personal, institutional, and policy levels.

Frameworks for access

The ICF (international classification of functioning) model:

• Emphasizes participation and context, not just impairment

• Access barriers can be environmental (background noise, no captioning) or attitudinal (stigma, low expectations)

• Advocacy means modifying environments, not just clients.

Universal design for communication (UDC)

Universal Design for Communications is the practice of designing environments, materials, and systems that are accesible and usable by all people without needing specialized adaptation later.

Grounded in the same philosophy as Universal Design for Learning (UDL) in education and Universal Design in Architecture (ramps and elevators built into the design rather than added later)

In communication, it means ensuring that everyone can participate meaningfully/independently in information exchange and interaction.

Core principles of universal design for communication

Equitable use

Flexibility in use

Simple and intuitive use

Perceptible information

Tolerance for errors

Low physical effort

Size and space for approach and use

Equitable use

Communication systems should serve people with diverse abilities equally.

Ex: providing captioning for all videos-not just when someone requests it

Flexibility in use

Supports different communication preferences and abilities.

Ex: offering multiple ways to interact in class or therapy: speaking, writing, typing, or pointing to symbols

Simple and intuitive use

Communication materials should be easy to understand, regardless of the user’s experiences or literacy levels.

Ex: using plain language in consent forms, and icons in hospital signage

Perceptible information

Information is communicated effectively regardless of sensory ability.

Ex: pairing auditory information (spoken announcements) with visual text displays at airports or clinics

Tolerance for errors

Systems minimize risks of misunderstandings or harm

Ex: confirming comprehension through teach-back methods in medical discussions.

Low physical effort

Communication should not require undue physical strain.

Ex: touchscreens with large, easily activated icons for AAC users with motor limitations

Size and space for approach and use

Layouts should accommodate users of varying mobility or proximity.

Ex: face-to-face seating with adequate lighting for lip reading, or adjustable microphone placement.

Examples of UDC in clinical settings

Visual supports: large-print schedules, labeled drawers, icons.

Accessible signage: dual-language and symbol-based.

Flexible communications modes: speech, writing, gestures, AAC.

Plain language reports: avoid jargon; use clear summaries

Examples of UDC in educational settings

Closed captioning and transcripts.

Multi-modal instructions combining speech, visuals, and texts.

Inclusive participation: oral, written, or digital responses.

Accesible materials: high contrast visuals, readable fonts.

Examples of UDC in educational settings

Closed captioning and transcripts.

Multi-modal instructions combining speech, visuals, and texts.

Inclusive participation: oral, written, or digital responses.

Accesible materials: high contrast visuals, readable fonts.

Examples of UDC in technology and telepractice

Telehealth platforms compatible with screen readers and captioning

AI tools adaptive to atypical speech or accent variation

Accesible websites (WCAG compliant)

Hybrid apps combining voice, text, image, and gestures

Why universal design matters in SLP practice

Prevents exclusion before it happens

Normalizes differences and removes stigma

Promotes efficiency: easier to design inclusively form the start

Empowers autonomy and confidence

Aligns with ASHA ethics on equitable access

Advocacy in actions: levels and examples

• Individual: teach clients to request communication supports, role-play conversations, support AAC use in public.

• Institutional: Add interpreters, captioned materials, and inclusive signage.

• Community: Host awareness events, partner with media, lead screenings for hearing/speech.

• Professional: Engage in ASHA advocacy, report inequities, mentor diverse students.

• Policy/systemic: support coverage for hearing aids, early intervention, and bilingual access.

Technology and access

Assistive and adaptive technologies: AAC devices, AI speech recognition, translation tools.

Accessibility and digital divide: ensure funding, training, and equitable distribution.

SLP role: help clients select, customize, and maintain tools; advocate with insurers for coverage.

Combating stigmas and promoting linguistic equity

Stigma and prestige: challenge “standard” = superior

Multilingualism: value linguistic diversity and code-switching

Autism and aging: normalize communication differences as human variations.

Strategies to combine stigma/promote linguistic equity

Use person-first or identity-affirming language

Challenge linguistic bias and stereotypes

Promote diverse media representations of communication differences

Teaching and empowering clients to advocate

Practical tools:

• Develop communication passports outlining presences and needs

• Role-play self-advocacy situations

• Creates peer mentor programs

• Support family-centered advocacy across settings

The advocate’s mindset

Key message: communication support is not only therapeutic - it is ethical, political, and deeply human.