Most parents of a child on the autism spectrum want their child to talk or talk better.

We feel closer to a child who talks to us, we know their life will be easier and talking is an obvious and welcome marker of growth and development.

The first step in understanding communication development is to clarify what we mean by ‘talking’. Do you mean speech or language?

Communication is made up of …

• Speech = talking clearly enough to be understood by the listener
• Receptive language = understanding the meaning of words and sentences.
• Expressive language = what is expressed, including vocabulary and grammatical construction.

Receptive language starts with context and gesture prompts, but soon your child needs to understand the words, ‘going in the car’ not because you picked up the car keys, or ‘get your shoes’ even when you don’t point to them.

Expressive language is delivered by speaking, a speech generating device, using visuals, gesture, or signing and has many functions including…

• Requesting - ‘cookie’ or reaching,
• Protesting & assenting - ‘No’, pushes object away, ‘mmm’,
• Naming or labelling - ‘doggie’, points
• Commenting - ‘Eat’ while indicating a dog
• Answering - ‘Horsie’ in response to a question
• Greeting - ‘Hi’, ‘bye- bye’, waving
• Expressing state or emotion - ‘Tired’
• Verbal accompaniment to action - ‘Uh-oh’
• Questioning - ‘What’s that?’ or points

‍You can see from these examples that even at the gesture and single word levels true functional communication can take place.

What can you do?

Parents may find it hard to keep stimulating language when they don’t get a rewarding response but it’s vital to continue, and it is essential to get help early.

At every level of language development there is much parents can do. It is also important to find assistance from a speech pathologist experienced in working with children with autism. For some families this might involve telehealth consultations instead of face to face. You may seek help only to be told that your child is not ready for therapy – find someone like a behaviour analyst, who will help establish the prerequisites, or a more experienced speech pathologist.

Where do you start?

You can be an expert on your child’s communication, as this will assist anyone helping you, and if you are on your own it’s vital in accurately targeting your teaching. Be an astute observer and be honest – don’t over estimate their skills!

Understanding the child's level of communication

• Does your child show some intention to communicate?
• How does she get her message across?
  Sounds – echolalia – single words – 2-3 words – longer sentences – gesture – pushing or pulling you- difficult behaviour more than 20% of occasions. Note all forms.
• How many different ways does he use communication?
  Tick off the functions listed above
• Does he follow simple instructions about familiar objects? e.g. get your shoes, when the shoes are usually in the same place (a context clue) or longer instructions without clues.

You now have a clearer picture of your child’s communication level and are ready to start. We are focusing on early development, children who may be using sounds, gestures, pushing and pulling, difficult behaviour or even a few single words, or who may not understand words.

First Steps

• Is she hearing? – find an audiologist who is experienced in testing children who may not understand instructions or who may be uncooperative.
• Can he attend to a person or object for a moment or two and show interest in objects?
• Does she attend to your voice?

Once you are sure that your child can hear you need to teach these other skills.

How to teach these prerequisites

• Attends to and shows interest in an object
  With no highly preferred distractions, present object in a way that will attract child’s attention and keep it for 1-2 minutes. Use their preferences as a guide to selecting objects.
  Do they like watching movement? then make the object dance, fall over, or jump.
  Do they like light pressure? then make the object tickle, move back and unpredictably tickle again, so they are watching with anticipation. Repeat frequently with variations

• Turn or attend to voice
  Associate yourself as the giver of all good things and always speak on approach, so they hear your voice and anticipate that fun person!

Next Steps

Teaching early language is building a strong association, through multiple repetitions when the child is attending, between the heard word and its meaning.

What to teach? First focus on the names of common objects that she will encounter many times daily, like apple, shoes, chair, door, ball There are many words we can say about the same item e.g. drink, cup, water, juice, thirsty, yummy, careful! – however use the same label each time, to build that link.

When to teach? Any time, don’t set aside a lesson time – grab the moment.

Where to teach? Anywhere and everywhere – in the car, in the bath, meal time, playtime!

How to teach? Maximise learning by…

• Creating quiet so the child can hear the word and make a correct link between what is heard and the object. Pause briefly after a spoken word before speaking again.
• Creating an uncluttered visual field so they can see what you are naming
• Not talking too much! Give them time too.
• Gaining their attention before speaking
• Speaking at the child’s level – initially single words or meaningful sounds(uh oh)
• Balancing screen and people time, including your own!
• Not expecting a verbal response.

REMEMBER THAT YOUR CHILD WON’T LEARN LANGUAGE IF YOU DON’T TALK TO HER.

Key teaching method

Children learn labels as they share an object with another by looking between the object and person. We add the word for the object or action in that moment.

• Direct attention to the target by holding it up or moving it.
• Label clearly using a single word
• Wait for, or prompt, the child to look at target and back to you, then repeat the word.
• Do not expect the child to repeat the word

Another word teaching method

Try ‘filling in the gap’, as in ‘ready, set, ….!

Use 1 or 2 rhymes with a lot of repetition (e.g.10 Little Monkeys)

Make this fun, join in, add actions or whatever he likes.

Use of screen is helpful here for the amount of repetition of the same song in the same way and to maintain attention.

Don’t start making gaps until the rhyme is very familiar, then pause before the final word in a couplet for child to fill in (10 little monkeys jumping on the ….!) If he doesn’t, you complete it. Then continue the rest of the song. Gradually add new songs.

Watch for more steps about language development in the future!

Liz Watson

Speech Pathologist

Watson Consulting

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