Unlocking potential: Total Communication at Meath School increases the communication abilities of children with speech and language challenges

Total Communication is a cutting-edge approach used by staff at our Meath School. It combines signing, VOCAs (Voice Output Communication Aids) and active learning to help the primary age children there who have complex speech and language challenges. 

What happens in Total Communication? 

All staff at Meath use signing throughout the school day with the children, whatever they are doing. Each child with severe speech difficulties or limited expressive language additionally has a VOCA as an extra way to communicate: VOCAs ‘speak’ aloud words chosen by the child.  

The children are taught signs themselves, and how to use the VOCAs is modelled and practised. This is alongside active learning in lessons – for instance: everybody – staff and children – using props and costumes to act out the class story in literature. 

Is Total Communication effective? 

Yes! Meath has recently undertaken research to explore if Total Communication is effective. In the research design that we used, three children, each in a different class within the school, took part in class story lessons.  

We first measured the children’s ability to recount various events from the stories and the length of their utterances — the chains of language the children used — following lessons without Total Communication. We then measured the same abilities after lessons that incorporated Total Communication.  

The results were compelling. Each child showed a statistically significant improvement in the communication abilities we measured. As a group, the enhancements observed when using Total Communication were so pronounced that there was less than a 1 in 1000 chance that these results occurred by chance. 

Additionally, the children employed a variety of methods to express themselves, including using signs while speaking, utilising their voice output communication aids (VOCAs) for some words, or combining all three – speech, signing, and VOCAs – together. 

Who can Total Communication help?  

Research literature shows that the elements of Total Communication – signing, voice output communication aids and active learning — are effective for many children, not just those facing severe speech and language challenges. 

However, studies have not yet investigated the benefits of integrating these elements together into Total Communication for other children. We are eager to conduct more research to explore how this integration could help additional children. 

It is exciting to have evidence from the Meath research that demonstrates how teachers and speech and language therapists can collaborate using signing, VOCAs, and active learning to enhance children’s communication. 

The research has just been published in the peer reviewed journal ‘Child Language Teaching and Therapy’ and you can read the full paper here (reading the Abstract at the beginning, and the Conclusions gives a good overview): 

Luckins, J., Tongue, G. and Clegg, J., 2025. Is the Total Communication approach effective for children with complex speech, language and communication needs? Child Language Teaching and Therapy, p.02656590251315598: https://journals.sagepub.com/doi/10.1177/02656590251315598 

Want to find out more about other evidenced interventions to support children’s speech, language and communication skills? Check out our What Works? database.