In a child with severe cerebral palsy and limited communication, which communication strategy is appropriate?

• A. Yes/No questions with picture communication
• B. Full spoken language instruction only
• C. Sign language only
• D. Ignore communication attempts

Answer: (A)

When a child with severe cerebral palsy has limited communication, the goal is to provide an accessible way to express needs and participate. Yes/no questions paired with picture communication lets the child respond with minimal movement—by pointing to a picture or using a simple switch—to indicate yes or no. Pictures offer stable, concrete symbols that don’t require speech or highly refined motor control, making communication reliable for both the child and caregivers. This supports functional communication, reduces frustration from being misunderstood, and can be expanded with more symbols or methods as abilities grow.

Relying only on spoken language ignores current abilities and may be ineffective; using sign language only may be impractical if fine motor control or learning demands are too high; ignoring communication attempts denies the child a chance to express needs.