I use this visual support as a cue for students who have impulse control deficits, social skills deficits, difficulty telling a cohesive narrative, etc. When students state something off-topic, interrupt, say something offensive or otherwise inappropriate, I ask them if what they said was something that should stay in their "thought bubble" or if it can go in their "talk bubble." I cut out the images, place them back to back, and laminate them so I can flip it over and ask the question along with each visual. The large ones are used for a student to have throughout their day or in a group setting. I use the small ones to provide staff with the visual and for myself to hole punch and put on the lanyard I wear with other visual supports.