Communication requires the intent to convey a message to someone else, according to communication consultant Susan Stokes. That intent can be fostered in any nonverbal child. Parents of persistently nonverbal children often give up searching for interventions due to shame and social isolation, even though successful communication enhancement methods exist, states Portia Iverson, founder of Cure Autism Now. These methods work for any nonverbal child, with or without autism.
Parallel Action
Step 1
Sit beside your child without any attempt to interact. Allow your child to engage in whatever action is typical for him for one to three minutes, unless he acknowledges that you are there by any change in speed, rhythm, body positioning or sound.
Step 2
Assume a similar body position and engage in the same or similar action as your child for one to three minutes. For example, if your child is rocking, rock. If she is tapping on the table, tap on a pot lid with a wooden spoon. If she is making sounds, repeat similar sounds. This is known as parallel action. Continue until your child indicates that she is aware that you are there and changes her activity in any way in response to yours.
Step 3
Talk to your child about what you and he are doing, using "I" statements. For example, "I like tapping on different things to see how they sound. The table thumps, but this pot lid dings." Thump the table with your knuckles and strike the pot lid with a wooden spoon as you say it, or substitute whatever other objects get your child's attention. Wait 10 to 15 seconds without saying anything else, to give your child time to think about what is happening, process it and decide how to respond, advises clinical consultant Barbara T. Doyle of New Horizons for Learning.
Step 4
Place a pot lid and spoon or whatever other objects got your child's attention in your child's field of vision, on the table or floor next to him. Continue to strike your own pot lid for 10 to 15 seconds, using a consistent rhythm, speed and level of force each time. Stop and wait 10 to 15 seconds for any response from your child.
Step 5
Repeat any response your child makes, whether it is a change of body position, speed of motion or any other indicator. Use "I" statements again to comment on what is happening, such as "This feels like we're riding in a covered wagon in the Old West. I'm going to make the horses pull faster. Giddy up, horses." Make a whip-cracking motion as you say "Giddy up" and begin rocking faster. Continue rocking faster for 10 to 15 seconds. Wait 15 seconds for your child to respond.
Step 6
Tell your child "These horses are getting tired. They're slowing down." Slow down your rocking as you say it. Wait 15 seconds for your child to respond.
Step 7
Say "I think these horses are hungry and thirsty. We should give them a drink and feed them." Place something your child likes to eat and drink in her field of vision. Serve yourself the same food and drink. Tell your child "Mmmm. I really like this orange juice after a hard wagon ride. This peanut butter is very smooth," as you eat and drink. Wait 15 seconds for any response.
Step 8
Continue to engage in parallel actions, laughing or commenting as you or your child interact, for five to 15 minutes. Praise any independent actions that indicate your child's awareness that you are playing together by laughing, hugging your child or whatever makes your child respond in a positive fashion.
Interactive Play
Step 1
Lay out any items that got your child's attention while you were using the parallel action strategies already described. Wait 15 seconds for your child to indicate awareness of the items in any way. Wait another 15 seconds to see if your child touches or picks up any item and begins to interact with it.
Step 2
Pick up the item yourself if your child does not. Hold it in your child's field of vision and say "I like banging this pot lid with this spoon. I can bang fast or slow." Bang the pot lid quickly three times. Wait 15 seconds for your child to respond.
Step 3
Say "You can bang the lid if you like. Here's the spoon." Hand the spoon and lid to your child if she reaches for it. Bang it yourself before placing it in her field of vision if she does not take it when you offer it.
Step 4
Substitute other items each day for the original item that got your child's attention. Wait 15 seconds for your child to indicate that he noticed the change and wants the original item. Ask your child, "Would you like the pot lid and spoon? They are in the box beside you." Wait 15 seconds for your child to make any response. Praise your child if he turns toward the box, reaches for the object or gets the object himself.
Step 5
Photograph all the items that get your child's attention, especially any that he gets from the box himself. Load your printer with photo paper and print all the photos. Make a scrapbook with one photo on each page.
Photo Exchange
Step 1
Open the photo scrapbook you made of all the items that get your child's attention. Leaf through it while sitting in your child's field of vision.
Step 2
Name each item and say something about how you or your child interacted with it. For example, "Here is the apple we ate for lunch yesterday. It was crunchy and red. I want another apple. How about you?" Go to the refrigerator and get an apple if your child looks at the photo. Cut or slice it and place it on a plate in your child's field of vision but just past her reach.
Step 3
Ask your child "Do you want the apple? If you want the apple, point to the picture like this." Put your finger on the picture. Hand your child a slice of apple if he reaches toward the apple or the picture.
Step 4
Continue until your child will point to the apple or the picture to get a slice of apple. Substitute other items that your child likes to eat or drink, one at a time each week, until your child will point to an item when he wants it.
Step 5
Put a piece of hook and loop tape on the back of each picture. Place the pictures on Velcro strips on a poster board. Go over the pictures with your child every day, naming each one.
Step 6
Ask your child, "Do you want the" and show her the picture as you name the item. Tell her "If you want the apple, give me the apple picture." Immediately get her an apple if she does.
Step 7
Photograph other items in your home and activities from your child's daily routine. Go over each picture daily until your child can consistently choose the picture he wants to get the item or go to the activity.
Tips and Warnings
- More children with autism spectrum disorders remain nonverbal past age 5 than other IQ-matched groups of children, according to Catherine Lord, director of the University of Michigan Autism and Communication Disorders Center.
- Do not meet the child's wants and needs before he displays them, even when you are certain you know what they are, advises Susan Stokes. He will learn to communicate faster and more effectively when he must interact with others to get his wants and needs met.
Things You'll Need
- Any items in your house that help you get your child's attention
- Camera
- Photo paper
- Scrapbook supplies
- Hook and loop tape
- Poster board
References
- National Institute on Deafness and Other Communication Disorders: NIH Workshop on Nonverbal School-Aged Children with Autism
- Cooperative Educational Service Agency No. 7: Developing Expressive Communication Skills for Non-Verbal Children With Autism
- Pathfinders for Autism: Where are the Families with Nonverbal Autistic Children?
- New Horizons for Learning: Personal Style and Interaction Tips For Working with Individuals Affected by Autism Spectrum Disorders
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