Five papers comprising the monograph describe a nonoral communication program which evolved from the clinical experiences of speech pathologists and physical therapists with severely dysarthric, physically handicapped children in a hospital school. Explicated are such aspects of nonoral communication as oral speech dysfunction systems of nonoral communication, nonoral message production with a communication board, and noncommunicative uses of picture and word cards. The inception of the program and subsequent experimental programing are recounted in discussions of frames, language materials, therapy, and case studies. A project evaluation paper reports observations made by the clinical staff as well as modifications in evaluation procedures, communication board and frame design, and programing rationale/procedures, evolved between 1968 and 1973. Examined is the role of the occupational therapist in custom designing communication board frames as it relates to the assessment of physical skills, individual needs, and frame design. An extensive case report is included which illustrates the following areas of communication board programing with a 4-year-old child: speech and language skills prior to programing; program design rationale, content, and materials; presyntactical programing; syntactical programing; index system programing, and parent reports. Appendixes contain sample communication display materials used between 1964 and 1967 and between 1967 and 1973, and communication board display frames. (GW)