The Role of Tangible Symbols in Enhancing Communication among Children with Multiple Disabilities an Integrative Review

Abstract

Abstract

Children with multiple disabilities have challenges in communication due to combined sensory, motor, and cognitive impairments that affect their ability to use traditional language or symbol systems. These challenges often result in limited participation in social and educational environments, leading to isolation and delayed development. Augmentative and Alternative Communication (AAC) systems are essential in addressing these barriers, providing accessible pathways for interaction and expression. Among AAC strategies, tangible symbols—three-dimensional or tactile representations of objects, people, or concepts—offer unique advantages for children with multiple disabilities. This integrative review synthesizes key research findings from 1989 to 2024, analyzing empirical and theoretical studies on tangible symbols and their impact on receptive, expressive, and social communication. The review explores their applications in diverse educational and clinical contexts, integration with AAC systems such as the Picture Exchange Communication System (PECS), and their role in literacy and cognitive development. Findings reveal that tangible symbols foster intentional communication, promote inclusion, and serve as a developmental bridge toward abstract language use. However, issues such as lack of standardized implementation, limited teacher training, and inconsistent follow-up restrict their widespread adoption. The review concludes that tangible symbols represent a practical, low-cost, and evidence-supported AAC tool that can significantly enhance communicative competence and independence among children with multiple disabilities when used systematically and collaboratively across settings.

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