Before Speech: What Children Need and How You Can Help

James D. MacDonald Ph.D

During my 40 years in clinical and research work with children with autism, I have observed that speech is the single biggest thing parents seek and push for in their children. This rush to words without the necessary foundation not only impedes the development of communication, it also undermines the powerful role of parents in preparing for speech.

Three major problems in autism relate directly to developing and socially using speech. First are the problems in interacting with people through social play, imitation, turn taking and having partners who fit his world. Our children often do not interact much. This is critical since the more a child is allowed to interact, the more he will learn to speak. Second, when children do have some speech, they often use it in rote, self-directed or otherwise non-social ways. They may have language, but they do not communicate effectively. And third, autism can involve socially unacceptable behaviors that show that the child is not socially modeling others effectively. All three issues show that helping a child become less autistic means helping him be more interactive in relationships.

To be useful in relationships and daily learning. Speech must be communicative, that is, social, intentional and reciprocal. To communicate, a child needs to interact frequently with others.

COMMON PROBLEMS INTERFERING WITH PREPARING FOR SPEECH

Children with autism too often do not play socially with people, imitate or model others, or take turns in reciprocal ways. They do not interact regularly with others and thus miss many opportunities for learning about relationships. Other problems commonly found in many child-adult relationships are as follows:

· Child interacts to meet needs more than to socialize.

· Child rarely initiates contact with people.

· Child rarely responds to others.

· Child connects only briefly with people.

· Child interacts in ineffective ways.

· Child makes sounds to himself more than to others.

· Child rarely takes turns or engages reciprocally.

· Adults dominate the conversation and the activity.

· Adults initiate interactions and activities too difficult and beyond the reach of the child.

· Adults expect child to talk before he interacts and communicates.

· Adults use instructions and directions to communicate and these modes of communication do not require thoughtful responses from the child.

· Adults often interact in serious and anxious ways with little room for playfulness.

WHAT DO CHILDREN NEED TO DO BEFORE SPEECH?

It is critical for children to have meaningful interactions with their caregivers. These interactions lead to the development of speech and meaningful language. The following can be treated as child specific goals.

· Playing with people in any physical or vocal ways he can do. It is true that play with possible people is the essential work of a child, especially when the child is self-engaged and slow to interact.

· Imitating and modeling is an early way for a child to show social awareness and to begin incorporating others into his cognitive world.

· Turn taking and interacting in reciprocal ways helps the child to both become communicative and to practice his emergent communications.

· Communicating deliberately with any actions or sounds. Any actions and sounds should be seen as important developmental steps and definitely not as mistakes.

· Communicating with traditional speech sounds and combinations of sounds more like those of his partners.

WHAT CAN PARENTS AND OTHERS DO TO HELP A CHILD PREPARE FOR SPEECH?

In typical development, infant and toddlers learn to be social and interactive in a non-verbal way, long before they become verbal. The following five strategies help children first become interactive, then non-verbally communicative and then socially talkative. Be aware that the ultimate goal is ‘social talking’ and not just having a vocabulary.

STRATEGY 1: BALANCE

Balancing means that you do only as much as the child is doing or saying. You also wait silently for him to take his turn and you make turn taking a primary way of interacting. Why is this important? The child needs time to do new things. If you fill that time, he learns that interacting means watching and listening to others but not socially participating. He can become passive and believe that he cannot do many things he can do. Remember, the more he interacts the more he learns. Waiting for his turn also teaches the child the self-control he needs for socially appropriate behavior.

Try to balance your interactions with your child in the following specific ways:

· Interact more like ping-pong than darts.

· Wait for the child to initiate an interaction, then respond.

· If the child does not initiate even after waiting, you may initiate, then WAIT silently for your child’s turn

· Accept any actions, sounds and words as a turn.

· Act and talk only about as much as the child does.

· Keep an easy give and take flow in interactions.

· If the child dominates the play, take your turn.

· When the child stops interacting, keep him for one or two turns, then let them leave.

STRATEGY 2: MATCHING – ACT LIKE YOUR CHILD PLUS – ONE

Your child’s language comes from you. Consequently, you need to communicate in ways that he can and take an occasional next step. You will act in ways that he can act, and talk in ways that he can talk. This also means that speech will come from his actions and communications, as you two interact. Every action can be a word someday. Think about this carefully. Actions become communications when you respond to them. Then any communication can become a word when you immediately give the child the word for it.

Ask yourself: am I doing what my child can try to do? If the answer is “no” then match more closely with your child, and he will interact more. For example, if the child is using single words, match him by using single and two-word phrases. If the child is using two-word phrases, match by using phrases and simple sentences. Think of matching as a staircase. If your child is on Step 2, you need to be interacting with him on Steps 2 and 3, and occasionally on Step 4.

Try the following ways of matching:

· Play in the way your child can play.

· Do actions and movements he can do.

· Make sounds he can make.

· Talk in ways he can do.

· Show him a feasible next step.

· In general, be a “possible “partner.

· Do not match behavior you do not want more of.

· Expect behaviors your child can do.

· Avoid expecting or demanding the impossible.

STRATEGY 3: BE RESPONSIVE

Being responsive before speech means that we accept whatever a child does as meaningful to him. We also realize that we can help him develop speech more when we respond to what he is doing and not to what we want him to do. It is critical to understand that a child has the meanings for language long before he talks. He has them in every action and communication without words.

Many act as though communication begins with words. It definitely does not. It begins with any action, sound or event that the child attends to. Consequently, to prepare for speech we must first ensure that the child is interacting and communicating non-verbally on a regular basis.

An example may help. Judy is almost 4 years old. She is just beginning to talk, and her family wants her to talk regularly. She is playing with a doll and rocking the doll in as she does when she puts her to bed. She is covering the doll with a blanket, rocking her and making soothing sounds. Her parents enter the room. The father goes to Judy and asks:

“Where are her eyes?”

“What is this?”

“What does she walk on?”

Judy responds to a couple of questions, then reaches for the doll backs and keeps playing alone. There is no communication.

Now, the mother enters and watches the girl first silently to see what the girl is experiencing. Then slowly she says “dolly” then waits and Judy points and says “do-ee”. Then the adult says “Rock” while doing the rocking action, then waits and girl rocks the doll more and says “ah ah”. Then the adult says ”night-night” and Judy makes the shush gesture and says “NIE NIE”.

What happened here is that one parent (in this case, the mother) responded to the meanings the event had for the child and the child responded while the other parent (the father) tried to get Judy in the adult’s world and his agenda and the girl did not have to interact.

Try to be responsive in the following ways:

· Accept child’s actions as meaningful steps to words.

· Physically join into your child’s activities.

· Respond “as if” your child was communicating with you.

· Understand that the more you respond, the more your child will learn.

· Respond to his actions and non-verbal communications.

· Discover what an action or experience means to a child and put a word to it.

· Respond without judgement or criticism.

· Respond with a cue for the next developmental step.

· Respond to positive rather than negative behaviors.

STRATEGY 4: SHARE CONTROL

Communication is a two-way street. It requires each person in a relationship to have some control and to yield control to others. Whether the child is non-verbal or has lots of language, sharing control of the interaction is an important skill to teach.

Adults can help sharing control by doing the following:

· Make it obvious that your child has clear effects on you.

· Don’t dominate the interaction.

· Help your child lead by waiting silently for him to do so.

· Change your behavior until your child participates.

· Take the lead about half the time and follow your child’s lead about half the time.

· Prevent child from interrupting your actions or words.

STRATEGY 5: BE PLAYFUL AND EMOTIONALLY ATTACHED

Granted it is difficult to build emotional attachment with a child who is distant and non-responsive as many autistic children are, it is difficult but is both necessary and possible. The way is to build a relationship in the child’s world, however resistant he may be. Almost every child wants to play and be free to explore. Your job is to find when the time is for your child. A good start is to believe, as research and common-sense shows, that children learn and communicate more in a playful environment than a directive and controlling one.

Try to play in the following ways:

· Discover and increase mutually enjoyable ways.

· Make sure your child has success interacting, by employing goals/activities within child’s reach.

· Make interactions relaxed and less stressful.

· Accept what the child is doing and join the activity.

· Be animated and attention getting.

· Imitate your child’s actions and communications.

· Be more interesting than the child’s distractions.

· Play in the way your child plays.

By practicing the 5 strategies – balance, matching, being responsive, sharing control, and being emotionally playful, parents and other caregivers can prepare children for speech much more by being a reachable play partner than a directive teacher. These strategies are not just to be used before a child develops speech. They help the child become socially and truly communicate, as the child progresses from phrases to sentences to conversations. It is critically important to practice these principles even with highly verbal children. Through these techniques, the child will learn to enjoy people, develop meaningful interactions, and build long lasting relationships.

About the Author

Dr. James MacDonald has worked with over 1000 families, teaching them to be their children’s most effective communication partners and has trained over 1500 therapists and teachers to work with language delayed children. “Dr, Jim” was a professor of Speech and Language pathology and Developmental Disabilities at the Ohio State University from 1971 – 1995. He directed the Parent Child Communication Clinic at the Nisonger Center during those years. In 1995, he took early retirement to devote his time to building parent-based programs and to direct the Communicating Partners Center.

In addition to teaching and clinical work, he directed federally funded research grants for 18 years with a focus on developing clinical approaches for pre-verbal and early verbal children. From the beginning, his overriding goal was to empower parents to be their children’s primary social and communicative teachers in the home. He has written over 50 professional papers, several books, and a series of training tapes. He also publishes the national newsletter, COMMUNICATING PARTNERS, which provides updated guidelines for parents and professional concerned about their children’s communication development. Visit www.communicatingpartners.com for more info.