Communication is the beginning of all interaction. It doesn’t have to be verbal, in fact, the
majority of communication relies on body language rather than words. But communication is one of the common
challenges that a child with autism and their family faces. Sometimes it’s like they’re trapped in their
own world, one where you don’t exist.
That can be very frustrating and saddening for you as a parent. You want to build a bridge to draw them out
of that world and back into yours.
Before you can do anything else with your child, you need
to have them interacting with you. Even
throwing a tantrum is an interaction.
The child has noticed you and while he or she is not happy, they are
aware and interacting. When my son first
began speech therapy, he was very much trapped in a world all his own. The speech therapist practically stood on her
head and turned cartwheels trying to get him to notice and interact with
her. Her persistence paid off but it
took almost a year of therapy before he became reliably verbal.
Using Your Child’s Interests:
When you’re trying to get your child to interact with
you, sometimes it helps to crawl partway into their world. There are lots of autism therapies which are
based on getting down on the floor with the child and inserting the therapist
into whatever activity the child is doing.
If your child is obsessively lining up cars, then you can start adding
cars to the line. Even if your child
becomes upset, remember that a tantrum is an interaction. Use the opportunity to encourage them to ask
for what they want, either with a picture or words. Generally it is best to try and teach when
the child is not upset, but if a tantrum is the only opportunity you have, then
use it.
Use your child’s interests to force them to communicate
with you. If they like being on a swing,
encourage them to ask for a push. Or
teach them to wait by counting to three before pushing. It takes a certain amount of creativity in
the moment, but you can combine playing with teaching. It’s more about using a child’s natural
motivation rather than sitting down and trying to motivate them in a more
artificial environment. If you’re
playing with cars, you can hold out the car until the child looks at you or
makes an appropriate request.
Eye Contact:
Looking at people and making eye contact is a very basic
communication skill and one that a lot of children with autism have trouble
with. By encouraging your child to look
at you during interactions, you can make it part of their natural
response. It can be a first step in
teaching your child to interact. You can
use noise, bright colours, whatever you think your child might respond to. Many children with autism respond better to
objects, so holding up a desired toy in front of your face can be a good place
to start. When the child looks at the
object, make a big deal and give it to him or her immediately. Gradually, you can move the object out of the
direct line of sight.
I used to stick brightly coloured stickers or plastic
poker chips to my forehead before sitting down to play with my son. When he looked at me, he thought I looked
funny. Usually he would reach up and
take off the sticker (or whatever else I was using). I would wait a few minutes and then stick
something else on. Eventually he started
looking at me more often in order to see what I had stuck to my forehead this
time. The habit persisted and his eye
contact is fairly good at this point.
Non Verbal Techniques – PECS:
There are ways to reach even non-verbal children. If your child isn’t speaking then he or she
is likely much more visually oriented.
Using pictures instead of words tends to work much better for these
children. In some cases, using the
pictures can help prompt the child to become more verbal. PECS
(Picture Exchange Communication System) is the common method for visual
communication. Small pictures are used
to communicate, often adhered to a short strip of Velcro. The child carries a binder or container with
the pictures and then pulls them out and sticks them to the conversation strip
to show people what he or she wants.
Several of the tablets are now offering a version of the PECS software.
Teaching your child to use PECS requires the help of another adult to
act as a hand-over-hand guide.
Initially, you would want to pick a picture of something highly
motivating to your child. Food is the
most common choice but it can be anything motivating. You place the picture in front of the child
and show them you have the reward. The
assistant then uses their hands to guide the child’s hand to touch the picture. As soon as the child touches the picture
(within 1-3 seconds), the child gets the reward. A little while later, you repeat the
process. You don’t want to work on it
too long at any one time, otherwise your child will get frustrated. It’s usually best to set a timer and when the
timer is done, the session is done, no matter how well or poorly it’s going.
Gradually the assistant will move to prompting the child
to touch the picture, then use hand-over-hand to get the child to hand the
picture to the parent. Then they can
just prompt the child to give the picture to the parent. It’s important that the parent doesn’t prompt
or use hand-over-hand because the child needs to understand that this is a way
to get someone else’s attention in order to get what he or she wants. Once the child has grasped the basic concept,
then you can expand the number of pictures, teaching them to choose from
between more than one option. It’s best
to teach this using something you know they really like and something they
really don’t. That way the assistant can
use hand-over-hand or prompting to encourage the child to pick the preferred
item. If both items are preferred, the
prompter isn’t going to know which one the child actually wants and that
doesn’t help the child to learn to communicate his or her actual desires.
Verbal Encouragement Techniques:
If your child does use vocalizations then you can
encourage them to become more verbal by imitating the sounds that they
make. If the child grunts, you
grunt. If they babble nonsense, try to
repeat it exactly the way they said it.
That helps the child to clue in that people pay attention to the noises
he or she makes and encourages them to pay attention to the sounds that other
people are making. Our speech therapist
said that she only drew the line at repeating a farting noise that the child made.
To
help them to distinguish sounds and words, you can exaggerate your voice, using
singsong or very dramatic techniques.
When you listen or watch children’s programming, the actors are very
animated, bouncing around, waving their arms and exaggerating their
voices. This makes it easier for the
child to pick out the individual sounds rather than having everything blur
together into the background. Watching
children’s shows can give you some good ideas on how to get your child’s
attention. Low budget shows can be
particularly useful because they have to rely on getting the child’s attention
with the actor rather than fancy special effects. It’s also important to use simple, clear
language. Use one or two word sentences
to communicate. Rather than ask “Do you
want milk?”, just ask “Milk?” so that your child isn’t struggling to pick out
the crucial word.
Another
way to encourage verbal skills is to fill in the blank. Repeat a phrase that the child knows well,
from a TV show or book or nursery rhyme, but leave out the last word. The natural inclination is to fill it in. Eg: Jack and Jill went up the _____. I’m willing to bet that even as you were
reading it, your mind said “hill” rather than leaving it blank. I’ve even had adults automatically fill in
the blank when using this technique with my son. I had a friend over who was sitting with my
son and I at bedtime while we read “Brown Bear, Brown Bear”, one of his
favourites. I read “Brown Bear, Brown
Bear, what do you-” and stopped for my son to fill in the last word. My friend immediately chimed in “See!” and we
both had to laugh. If your child isn’t
filling in the blank, you should do it and then prompt them to imitate
you. You can use this technique with
videos and TV as well. By pausing a
favourite show or clip, the child can be encouraged to finish off the line or
scene.
“Plus-One” Technique:
If your child is more verbal, you can encourage them to
expand the words they do use by using a “plus-one” technique. That’s where you add one more word to the
sentences that your child uses and encourage him or her to imitate you. So if your child asks “Cookie?” then you
encourage them to say “Want cookie.” As
soon as they do, give them what they’ve asked for (within 1-3 seconds). If you really want to encourage their verbal
skills, don’t worry about healthy eating or meal schedules. There will be plenty of time to get those
things back on track once your child’s verbal skills are more firmly
established. You can keep building on
the sentence until you’ve got something that’s appropriate and grammatically
correct.
Eg: Child
says: Goal:
Cookie? Want
cookie.Want cookie. I want cookie.
I want cookie. I want a cookie.
I want a cookie. I want a cookie, please.
The goal is to get your child to ask for things clearly
and appropriately so that anyone can understand him or her. It opens up a whole new world for the
child. Realizing that you can ask for
what you want makes the world into a much less frustrating and scary place. If you’re finding yourself getting
frustrated, imagine how frightening it would be to be in a world where you
never understood what was happening to you or how to ask other people for
things you wanted or needed. That can be
how your child is feeling if he or she can’t communicate.
Scripting:
A more advanced communication technique is called
scripting. That’s where you write out
what your child should say. Obviously,
the child has to have a fairly firm ability to communicate already and the
ability to read, although it can be done with verbal prompts. This is more about teaching the child
appropriate language to use in various situations.
We’ve been trying to get our son to greet people
appropriately when he’s out and about in the world. He’s very good at telling people “Good-bye”,
especially if he’s eager to leave. But
he doesn’t seem to like saying “Hello” when he arrives. Our speech therapist recommended writing out
“Good Morning” on a card and showing it to him to encourage him to say it. It’s worked very well, getting him into the
habit of saying “Good Morning” to the teachers and children when he goes to
school. We’re starting to fade out the
prompt, only using the card if he doesn’t automatically respond to a greeting.
You can create scripts for any number of situations. This may seem artificial, but we do use
scripts in everyday life. When you meet
someone, unless you’re very close friends, your conversation will likely go
like this:
Person 1: Hello.
Person 2: Hello.
How are you?Person 1: I’m fine. How are you?
Person 2: I’m fine.
That’s a script and it’s one we’re all familiar
with. By writing out your child’s half
of the conversation, you can make it easier for him or her to concentrate on
the interaction rather than the words.
Some people with autism have been known to have difficulty retrieving
the appropriate words, the same way we all do sometimes when we have a word
just on the tip of our tongue. By using
a script, that frees up more of the person’s concentration to focus on the
actual conversation.
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