A personalized communication wallet.

This article was accepted for puhlication i\!/arch 10, 1992 f;.lapting activities and equipment so that they are age appropriate for clients is a challenge. In school systems and day training centers, as nonverbal students with significant cognitive limitations become older, their methods of communication must be adapted into appropriate and acceptable modes. This was the case with three male adolescent students. One student, who was autistic and whose IQ was within the 20-35 range, had a communication key ring made up of Mayer-]ohnson picture symbols (similar to stick figures in action) attached to his pants by a slinky cord. He sometimes used the key ring as a stimulatory toy, rather than a communication device, by twirling it. In addition, he often left the key ring hanging from his pants, which resulted in its becoming dirty and mutilated. Two students with mental disabilities whose IQs were in the 35-55 range (one with right hemiplegia) used gestures, pointing, grabbing, and, at times, other maladaptive behavior to communicate their basic needs and wants, such as pulling their pants down in public to indicate a need to urinate. Through occupational therapy assessment and intervention, it was determined that a personalized communication wallet could be designed to address these maladaptive behaViors. The design of the wallet required consideration of limitations in vision (one student was registered with the Commission of the Blind), fine and gross motor skiJls necessary for manipulation of the wallet, and social skills The wallet became a concrete personalized communication tool that allowed for clearer communication in school and in community settings, such as fast food restaurants and museums.