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I use a combination of icons and photos with my student. We started with photos only, moved to very clear icons, and then to more abstract ones to represent more abstract concepts as he had the need for those more. Some of the icons are very unclear, even to adults, and often you need to pick one that's originally labeled something else, like in Boardmaker, and relabel it for your needs. You can also make your own drawings so that you can make it very clear or make xeroxes or paste a few drawings together to make a new one.

Here's a great example: At school, my student has recess, which includes snacktime and playtime on the school playground. In our version of Boardmaker, there is no icon that represents these things, nor is there a photo we could take that would be both. Plus I want him to have the pecs that will represent recess whereever it takes place. So we printed out one of a lunchbag and one of some playground equipment without labels and put them together as one pec with the word "RECESS" on the top. This way, he knows what it is from the two activities and knows that he'll need his snack bag and will be going to the playground.

BTW - my student is 6.5 years old. We used photos only until he was about 5, then started to use icons, and now even have sight words to replace some of those. When teaching the new form, make sure to pair them together and teach that the new one is the same as the old.
 
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