We used to use Big Mack switches from AbleNet for spontaneous communication around our home. When pressed, they played a recorded message (which Claire's sister Jill recorded for us), and we placed them near the item she wants:
Attempts to have her tell us when she needs to have her diaper changed were unsuccessful. We also used the switches for special events, such as when we had holiday decorations out ("I want to see the candles.") and for Halloween ("Trick or Treat"). One year was the first time since her regression that she was able to trick-or-treat, because she had regained the skill of holding non-food and toy items (such as a backpack or Halloween bucket), and it finally occurred to me to let Claire use a switch. I don't think she understood what was happening, but she enjoyed pushing the switch.
Unfortunately, at some point, Claire decided that they were toys and started picking them up and carrying them around the house to make noise, so we don't use them anymore.
Claire has also used a simple communication technique to choose between two items, such as food items, activities or toys. We placed pictures on clips so that they are upright (and sturdy), such as Polaroid photos with a cardboard back glued to it. Then I placed my right hand over her right hand, curving my fingers over hers and leaving only her index finger free. She extended her index finger and moved my hand to the item she wanted. This is time-consuming and Claire has little patience for it, but it could be a very useful technique to children who are more stationary. See Claire's page for a photo and video clip of this technique.
Copyright © Deborah Schilling