A reminder that there is so much more to communication than speech—your child may be speaking to you in his/her own unique way.
For over 35 years, I’ve engaged with children on the autism spectrum, children who were labeled nonverbal. As a speech and language therapist, I am here to tell you, they all communicated to me.
Joey and Gerald covered their ears to tell me things were too loud in the classroom. Mary ran out the classroom when she didn’t want to do something or was surprised by an unexpected change. Andrew jumped up and down to tell me he was really excited to go for a walk. Jordan rocked back and forth to tell me he was anxious and unsure of what was going to happen next. Leslie took me by the hand to tell me she wanted something to drink. David pointed outside the window when he wanted to tell me the clouds were moving in. The two Lisas flapped their hands to let me know they were eager to go swimming.
That all happened back in the 1970s and 80s, but believe me, all those nonverbal communications were intentions, intentions not to be ignored. Today, we have nonverbal children signing, drawing, giving us pictures, writing, typing, and using a computer, iPad, or an array of assistive technology devices, all with the intention of communicating with us.
What we need to learn is how to see, acknowledge, and expand all those initial and developing nonverbal communications. We need to determine what other systems (aligning with childrens’ strengths and communication styles) we can develop.
It could be a single system or a combined system of communication. We might implement one in the beginning and find that a child needs a different system. We might start with one platform and find that another aligns better. We should never get stuck and we should always be evaluating the effectiveness of the communication systems in place.
What can parents do in the beginning?
Acknowledge each and every communication intention from children: what they look at, what they point to, sounds they make, where they lead you, and then EXPAND on those intentions.
Stop thinking and doing everything for nonvocal or nonverbal children, including communicating.
Guide them (in their own experiences), coach them (to help build skills), and mentor them (to teach).
Create opportunities to communicate. Don’t have everything ready when working with them. Have them help you discover what is missing and communicate that to you. This takes patience, sitting on your hands, and waiting for them to process and see you expect them to communicate in some way.
Use successive approximations: the process of honoring small steps towards acquiring an important skill, lesson, activity, idea, or concept.
Teaching requesting through successive approximations
How do we indicate that we want something? Do we look at it, point at it, reach for it, grab it, or ask for it? It all depends on our level of communication. So identify where children are in their ability to communicate.
Where is your particular child? How is he or she requesting? Are you honoring his or her level? If his/her level is looking or reaching, say: “I see you looking at (____) you must want that, okay!”
If a child is grabbing something, say: “Oh, you would like that, but we don’t grab; you could point, tap me and sign, or say ‘I want that’”. It is important to acknowledge any attempt at communicating, and then shape it to a closer and closer approximation of the acceptable request.
You may be able to motivate communication by utilizing a favorite person, object, toy, or activity to engage the child. Use a picture of the person, object, toy, or activity and have the child point to or give you that high interest picture. Then use pictures to stimulate requesting or naming.
Label feelings and build on them
Next, you could label the child’s feelings. For example, he/she reaches for food and you say: “I see you are hungry”. You can label sad, thirsty, mad as you observe execution of the feeling. You can program the child’s iPad or Go Talk with feeling words, and then after labeling consistently over time, you can then ask him/her to share emotions by finding the feeling icon on his/her assistive device.
Build communication through play
Join your child’s play activities and expand on them. Try games that require turn-taking or collaborative play. For example, divide a puzzle’s pieces in half and take turns putting the pieces together. It may be hard to direct your child into play. He or she may have restricted interests, but remember, it could be stressful to only play what you want to play.
So, watch carefully and observe the behavior of your child. This could be running up and down in a room or outside, it could be pushing a toy or object across the floor for close observation, it could be lining up toys, or it might be throwing something over and over again.
Yes, watch closely and see if there is any opportunity to connect and enter your child’s world of curiosity, even if it is for a few seconds. Try positioning yourself so he/she can easily look at you and involve you. As soon as he/she looks up at you, vocalizes, or says a word, acknowledge it by repeating it. This says: “I hear you.”.
Build communication through imitation
Another strategy for parents of nonverbal children is imitation. The good thing about imitation is that it can go both ways, just like a conversation!
You start off by imitating how your son or daughter sounds and plays to encourage more of such behavior. Imitation games are as simple as they sound: if your child stacks a Lego on his/her tower, you stack a Lego on yours. If your child knocks the tower over, you knock yours over too! Most items found in any toy box―balls, Legos, cars, dolls, action figures, or books―give parents an opportunity to engage in games that involve role playing.
Then comes assistive technology
We need to ask ourselves, are the systems easily accessible? Can the person access them when in a crisis? Can the individual even hold the device or use the system without hand-over-hand support and repeated prompting? Do the systems support the strengths of the child, teen, or adult? Is the person motivated to use the system? Does he/she have effective fine motor skills? At what level is his/her memory hindering use of the system? Does the system expand as the person makes room for more and more communications?
I believe finding the right system starts with good observation skills, acknowledging what the current communication system is, and then completing thorough assessments to identify best modalities and, of course, continuous evaluations to check the ongoing benefit of the system.
There are many types of assistive devices that are designed to help nonverbal children and adults communicate, both those who are capable of talking and those who are completely nonverbal (nonvocal). These devices are not just meant to take the place of speech; they are designed to be a foundation for communication as well.
Visual supports also help children make requests and share needs by touching pictures electronically producing words. There are many types of devices available, as well as apps that can be downloaded directly to your phone or tablet.
Parents play a key role in working with their school district or private speech and language therapist to determine which types of assistive communication technology could address their son or daughter’s nonverbal communication needs.
Practical tips to help parents get started:
Step 1. Identify the best team. Speech therapists and Assistive Technology specialists are key. What is the best way for your son or daughter to access technology? What kind of language system is needed? What systems or devices match strengths?
Step 2: Are low-tech (boards, books, pictures), medium-tech (fixed display devices) or high-tech (speech-generating dynamic display systems) methods needed?
Step 3: Follow the pathway to secure funding. If you are working with the school district, request an assessment in writing. Then get the results presented at the IEP (individual education plan) meeting and incorporated into the IEP. Make sure appropriate goals are written, progress reports completed, and training of all staff is prioritized. There are steps for working with private insurance. Check in with your provider.
Step 4: Make sure you are collaborating with everyone on your son or daughter’s IEP. Make sure everyone is using the system consistently and evaluating its effectiveness. Remember, to ensure that devices become successful communication tools, you must motivate and encourage your son or daughter to use them. They must travel everywhere with your child (home, backyard, kitchen, bathroom, school, community, grandparents’ home, etc.). The device must continue to be easily accessible and grow with your child’s communication skills.
Everyone communicates. Remember that. Start where your child is. Join him or her. Play with him or her. Use imitation. Try pictures, signs, writing and of course assistive technology.
Resources:
Autism Tool Kit Visual Supports: ATN/AIR-P Visual Supports and Autism | Autism Speaks
Technology and the Treatment of Autism: Technology and the Treatment of Children with Autism Spectrum Disorder (Autism and Child Psychopathology Series): 9783319371757: Medicine & Health Science Books @ Amazon.com
Assistive Technologies for Diverse Abilities: Assistive Technologies for People with Diverse Abilities (Autism and Child Psychopathology Series): 9781489980281: Medicine & Health Science Books @ Amazon.com
Apps for Autism Amazon.com: Top 60 Recommended Apps for Autism: Preschool through Adult (Technology for Autism Series Book 1) eBook: Hodgdon, Linda: Books
Make the Connection: Make the Connection: A Practical Guide to Parents and Practitioners for Teaching the Nonverbal Child to Communicate – with AAC: Berkowitz SLP, Susan: 9781945533013: Amazon.com: Books
American Sign Language :American Sign Language for Kids: 101 Easy Signs for Nonverbal Communication: Barlow, Rochelle: 9781641526012: Amazon.com: Books
Visual Supports for People with Autism: Visual Supports for People With Autism: A Guide for Parents and Professionals (Topics in Autism): Marlene J. Cohen, Peter F. Gerhardt: 9781606132159: Amazon.com: Books
Listening with the Heart: Listening with the Heart: A Guide for Understanding Non-verbal Communication in the Autistic Child, for Parents, Teachers, and Professionals: Becker, Liz: 9781092771092: Amazon.com: Books
This article was featured in Issue 127 – Nonverbal Communication
