## 3 Methods  
### The Design Process of the Communication Menu  
The communication menu was developed in four stages:  
1. In the first stage, we conducted preliminary interviews with more than ten children with autism, parents, and teachers. The Ethics Committee of the China Medical University, Taiwan Ministry of Public Health, provided ethical approval for this study. All participants signed a consent form when explaining the designed questionnaire. We used core vocabulary graphics recording 100 sentences and then select ten questions from all sentences (Appendix A and Supplementary File S1), and then made more than ten communication boards according to the grammar (Table 1) for the study and related words gleaned from these interviews to design the requesting-help communication menu [35]. Some parents, class tutors, and language therapists met regularly to discuss the core vocabulary graphics. They compiled a core vocabulary of more than a thousand commonly used communication terms to be used in our communication graphics system. The design team collected the details of how children with ASD learn communication skills by pointing at paper-based picture cards. They used the concept of core vocabulary to create an interface with which participants can learn by repeatedly practicing specific sentence patterns [36; 37; 38; 39]. 2. In the second stage, researchers designed textbooks based on core vocabulary and the ISO copyright-free graphics library (available at [[https://isorepublic.com](https://isorepublic.com)]([https://isorepublic.com](https://isorepublic.com)); accessed on 1 October 2021) to redesign and select the most frequently used words with graphics to make sentences. For example, Table 1 lists subject, verb, object, adverb, or subject, verb, adjective, adverb, and other combinations of sentence elements. The requesting help module provided the main communicative content--the core vocabulary. Because of different needs, the requesting help module and its dozens of vocabularies were organized into ten categories, and the vocabularies were used as marginal vocabularies, so it could provide the use and expression of choice judgments. [40; 41]. Researchers used different colors to classify the different parts of speech (for example, yellow for subject words, orange for affirmative and negative words, green for verbs, and so on). They also used a structured layout design to guide participants in using lexical phrases in proper sequence [42; 43; 44]. 3. In the third stage, because the participants sometimes found the interface too complicated to easily use, we realized that we need to further study the differences in how children with ASD understand meaning. We hoped that this stage of intervention would help us to improve the participants' abilities to engage in further operational communication and to request help. Therefore, we adjusted the interface to use in formulating eight modules of requesting help recognition concepts. The operational communication content of requesting help was then developed. Scenarios were created (Appendix A Table A1 and Supplementary File S1). We then gave our prototype to parents and caregivers to judge its value and verify its usability for children with ASD [45; 46]. 4. In the fourth stage, the interface refinement and assessment stage, our system was installed onto a tablet device for the three children (the end users) to test. The designers, special education instructors, and speech therapists assessed the effectiveness of the refined interface. The interface showed a table of the parts of speech, subjects, verbs, objects, nouns, adjectives, adverbs, and conjunctions. Our participants could select images based on the parts of speech in the table. Because many children with ASD find it difficult to create coherent sentences and engage in articulate conversations, previous researchers have created communication assistance methods and devices to allow them to practice and improve their abilities to converse with other people.