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Post by momofautistic on Jun 7, 2004 0:17:33 GMT -5
Communication
COMMUNICATION IS, without a doubt, the most serious impairment that a person on the autism spectrum experiences. When a person—particularly a child—is unable to communicate, it is very difficult to understand and meet his or her needs. A child learns security and safety through having her needs met, so the lack of communication means more than not hearing those wonderful and exciting first words. Communication is the underpinning of our psychological makeup.
The Nonverbal Person
Communicating with a nonverbal child intimidates many people. If a child understands language, even if he is unable to speak, it is hard enough to communicate with a child. If a child doesn't understand that language, communication between that child and others is very difficult and emotionally trying for the family. However, what most people don't realize is that they are already very proficient in communicating with a nonverbal person.
And You Thought It Was Baby Talk!
When parents bring home their newborn, they begin communicating nonverbally. All the little cooing and babbling sounds that come from perfectly rational adults are the beginnings of communication without words. Tunes hummed to baby are another form of communication. It is through the tone and the rhythm of the voice that messages are sent. Although a baby does not have the ability to understand the complex messages literally, she begins to learn about communication from these sounds and their cadence.
Parents learn as well how to understand nonverbal communication. Parents learn to recognize when their baby cries whether it is hunger, discomfort, pain, or any number of things that are being communicated. Those first cries, and the subsequent response by a parent, are the first forms of reciprocal communication.
If only communication stayed that simple. As a child matures, his needs include much more than just hunger or comfort. He needs to convey emotions, complex needs, and desires, and it is very difficult without language. To keep things in perspective, remember that you have already established communication with your child. Yes, it was at a very young age and, yes, it isn't a fully efficient language. But you have the basics and you know more about nonverbal communication than you realize.
ESSENTIAL
Do you talk to your cat? Kitty comes into the kitchen meowing, and invariably someone will pick up the cat food and ask the cat if he is hungry. No one expects to hear the cat answer, but a method of communication has happened in that moment. Talking to a human being is vastly different from talking to a pet. However, there are some valuable lessons here for the parent of a child with autism—body language, tone of voice, and visual cues increase the stimuli of all of those behaviors and communicate a message very effectively.
Trust Yourself and Pull Out the Stops
Much of the success in communication is about trust. If you believe your child will not understand, can never understand, and doesn't want to understand, you will probably find that to be true.
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Post by momofautistic on Jun 7, 2004 0:19:06 GMT -5
But if you believe she can understand much more than anyone realizes and you continue to communicate with that belief, you will find that her abilities will increase.
Never assume that your words and sentences are not understood. Your child's receptive language may not be at 100 percent, but something, somewhere, will get through and that is all you need to build on. Talk to your child as you would any child. Don't talk down to him, and don't talk over his head. Work at getting eye contact so he can see your facial expressions. Stand in front of him so he can see your body language, even if he appears to be totally oblivious of it. Consider your tone of voice and use every visual clue you can think of.
As the light begins to dawn for your child, and she realizes language is a useful tool, she will begin to attempt to understand it. It is a long and hard road for both parent and child, without a doubt. As the foundation begins with very little, and seemingly unimportant, understanding of minor words, you will realize that more complex receptive language skills can and will develop. Trust yourself.
Lacking Conceptual Images
For people with normal speech development, it is very difficult to communicate without using concepts. Things are big or bigger, happy or joyous, under, over . . . the list is endless. The human mind is built on and works through the understanding of concepts. But for someone with autism, concepts are very difficult to deal with. Can effective communication happen without relying on the conceptual imagery everyone uses each day?
A Language of Concept
Language by its very nature is conceptual. We believe, because we have been taught and we have seen the result, that these words are truly representative of something. If you go into an ice cream shop and ask for a large cone, you have certain expectations that you believe the other person understands. Generally, people do understand, and if they don't, they may ask for additional information.
Concepts within language are an obstacle for children with autism. When a word is first learned, whether verbal or through another form of communication, the use of that word has a hard and fast rule: a dog is always a dog; a cat is always a cat. But red? That is very subjective. Ask someone to go buy you a red hat and you will learn how many shades of red there are. Concepts such as quiet, hungry, or tired are even harder to grasp. Only time and experience can teach these lessons. Speaking normally with your child and using visual clues will help the process along, but there is no definitive method to teach a concept.
Echolalia
As a child begins to learn speech, it is common to see what is known as echolalia in children with autism. Echolalia is the repeating of words without using those words with any meaning. For example, a child can have a shirt or toy held up to him and a parent might say, "Is this your shirt or your brother's?" The response may be "Brother's." This may not mean that your child has signed off on the property in question; he may simply be repeating the last word he heard. If you are in doubt, test by using the question again, but reversing the order of words. If he repeats a different word, you can be sure it is echolalia.
ESSENTIAL
When talking to your child, use universal signs to help him understand. Spread your arms to indicate "big." Mock shiver for "cold." Use clues for your child to help him link the word with the object or action. As linkages occur, language will begin to make sense and communication will be more effective.
Echolalia is also seen with a child who is involved in activity. The child may repeat words she has heard during the day or words that are common to her routine. "Everyone sit down," "it's lunchtime," or "here kitty, kitty" are examples of phrases that might (continued)
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Post by momofautistic on Jun 7, 2004 0:20:36 GMT -5
be said without meaning. Echolalia is frustrating to parents because they can see that the mechanics of language, such as the voice, are working fine, yet there is no spontaneous speech. When your child engages in echolalia in response to a question, try to guide her to the correct answer and gently correct her. If she is playing alone and you hear repeated phrases and words, ignore it. It is not helpful to try to stop a behavior that is harmless; she is unaware this is an inappropriate social behavior.
Receptive Speech
People who have normal speech abilities take the skill for granted. Speech is the exchanging of ideas from one mind to another in a meaningful way. Speech is what separates humankind from the animal world.
Receptive speech is the ability of the human mind to hear spoken language from another person and decipher it into a meaningful mental picture or thought pattern, which is understood and then used by the recipient. Speech is the vocal expression of language.
A Confusing World
When a person has a deficit in his receptive language skills, the entire world is a mystery. People with autism are often assumed to be like people with deafness. But the inability to relate to others shows the difference between the two conditions. People with deafness can't hear sound, but they can understand the language and all the conceptual images within the words and put those to use within their own minds. People with autism hear the words but they do not have the same meaning. They may understand a fair amount of communication in the framework of their own mental processes, or they may understand little. Either way, they are operating on a different wavelength.
During early intervention, you will have a good idea of how well your child's receptive speech is operating. Children who have learned the appropriate use of the words mommy, daddy, hungry, and the like are beginning to understand that these words have a use. They are learning to understand how that usage applies to them. A child such as this will understand "pick up your toys" and "don't touch that." If a child does not turn in response to hearing her own name, does not have the ability to name certain objects after seeing them, or disregards verbal commands, there is a receptive speech problem.
FACT
Don't think that a child is ignoring what is said to him if he shows no reaction or withdraws into his own world. You are not being ignored. It is much like being in a crowd and hearing people speak to each other—you know when it applies to you. To this child, the voice has no meaning and does not apply to him.
Improving Understanding
A speech therapist will most likely be working with your child if he lacks the ability to understand language. Other therapists will also dovetail their therapy with the speech therapist's exercises with the common goal of showing your child that language is useful. Children do not resist speech when they are autistic, as was commonly thought years ago. It is to their advantage to understand and use speech; they just can't. It is as if there is a gap between the ears and the brain, almost as though a piece of electrical equipment has shorted out.
You, too, will be working with your child at home. In everything you and your family do, you will be showing her that language is something she can participate in. She will learn with your help. If your child is totally or essentially nonverbal, go slowly. Big picture books are helpful, as are flashcards. Avoid teaching conceptual words. If you try to explain "big" versus "small" with examples, your child may become confused. A big dog? So, is the word dog or big what is being taught? Stick with nouns until receptive language skills begin and you have a foundation. Pronouns are also very difficult (continued)
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Post by momofautistic on Jun 7, 2004 0:22:00 GMT -5
to understand when receptive speech skills are poor. Use people's names or speak in the third person to help comprehension.
ESSENTIAL
Pronouns are conceptual and should not be used unless a child has advanced speaking abilities. Speaking in the third person will be less confusing and frustrating. It is hard for a child with autism to understand that others have their own thoughts, and it's even more confusing when pronouns are used.
Expressive Speech
Expressive speech is using words and language verbally to communicate a concept or thought. If a person has expressive speech, they have some degree of receptive speech. Children learn their expressive speech by imitation; by receiving receptively from their parents, they learn how to use language as a tool. The first words a baby says are actually a sign that receptive speech has been working effectively for quite some time.
As stated previously, it is to a child's advantage to use speech, so if a child does not, there is a reason. Encouraging a child to speak is good, but forcing him to talk is stressful and not wise. Many parents will say, "How do I encourage without forcing?" There is a fine line between the two, but after some time it will become second nature. Hold up a cookie or something your child loves to eat and say "cookie?" He will not repeat it right away, but eventually he will. When he does, give him the cookie and praise him. Some children respond well to applause; others do not like the noise. The phrase "good job" is soon recognized as praise. The important thing is not to withhold the cookie because he doesn't say the word. Remember, expressive and receptive speech are tied closely together and safety and security are learned through communication. Continue meeting his needs and wants as though he was speaking and he will begin to see the usefulness of language.
Many experts state that if a child is not speaking by the age of six, she is unlikely to speak at all. However, this is not true. Many parents will report that their child began speaking for no apparent reason at the age of puberty. Some children have startled their parents quite dramatically by being silent for over a decade and then suddenly communicating their first verbalization in a complete and appropriate sentence. Others will tentatively begin talking with a few words here and there before trying a phrase. It is possible that a child with autism will not speak at all, but don't give up. You may hear that voice yet.
Sign Language
Sign language is the preferred language for people who lack verbal communication ability. American Sign Language (ASL) is the third most commonly used language in the United States. Only English and Spanish are spoken more than sign language.
The beauty of sign language is that it is convenient, portable, doesn't require any special equipment, and is standard throughout the United States. The major disadvantage—and this is one that can and should be overcome—is that the language has to be learned by all family members, not just the child with autism.
American Sign Language
There are two major forms of sign language. The most widely known through the deaf community is ASL. ASL is a consistent language used to allow people with deafness to "hear" the same things the rest of the population can hear. Speeches, concerts, plays, and many other public events have an ASL interpreter present for translation. ASL is consistent all over the United States.
Many communities have sign language classes. If you decide to use sign language in your family, it is very helpful to have classes to teach you in an orderly way so that you can pass this along to your children and work with your autistic child with ease. There are also (continued)
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Post by momofautistic on Jun 7, 2004 0:24:02 GMT -5
many books, videotapes, and computer programs that can help. These are very handy for parents and siblings of the child learning sign language.
Exact English
The other sign language, usually preferred by the autistic community, is Exact English. Exact English is based on ASL but has some important differences that make this the preferred method. The learning curve is a little easier than ASL, but the difference is not significant. If you know ASL, you can work with Exact English very easily. Learning ASL will only make Exact English easier, so don't hesitate to get instruction on ASL. A book with the Exact English signs will show the differences and should be all the extra help, beyond learning ASL, that you might need.
FACT
Check on the Internet for books on sign language. Some excellent books have large drawings of each sign and have signs arranged in alphabetical order. This is a quick way to reference a sign if you have forgotten it. It is also a good way to learn new signs.
The primary difference between Exact English and ASL is the use of conceptual thinking. Keeping in mind that sign language was developed for a community that had full receptive speech, the motions and gestures of ASL were created to say as much as possible quickly and economically. Entire phrases are often one single sign, and many of these phrases include words that are conceptual in nature. "I love you," for example, can be said three different ways: spelling out the letters of each of the three words (eight signs), signing one sign per word (three signs), or by using one sign that represents the entire phrase. ASL uses one sign for the entire phrase whereas Exact English uses one sign per word. This is helpful for children with autism as they learn about conceptual ideas. Love is not something we can photograph or demonstrate; it is an idea that we understand, and it is an idea that takes a long time to understand for a child with autism.
Another advantage to Exact English for parents is the gradual learning of the signs. As a child learns a new sign, parents can also learn the same sign. The alphabet can easily be learned by the entire family and can be used to spell out words if a child is prone to understanding words specifically by reading. This is a way to bring words off the paper and into everyday usage.
It is very common for a child to learn a sign and then verbalize the word that the sign represents. However, this is not always the case, and the goal of sign language should not be for the child to achieve spoken language. But, if this is the case with your child, this will be an opportunity to develop more language skills. It is doubtful that your child will be able to leave signing behind altogether, but as verbalization accompanies the signs, your child's skills in receptive communication improve along with expressive speech.
Communication Boards
Many styles of communication boards are helpful for a person with autism. The options range from complex, computer-run programs that are used to communicate to systems as simple to operate as a set of flashcards. There are systems you can purchase and systems you can make at home. Each child will have his own needs, and the most important issue is to personalize the board to meet those needs.
Picture Exchange Communication System (PECS)
It is common for children on the autism spectrum who have limited or no verbal ability to learn communication with a communication board. This is a form of augmentative and alternative communication (AAC). The beauty of this tool is that the learning curve is very low, and it can be used immediately. They say that a picture is worth a thousand words, and without a doubt, this is true for this form of communication.
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Post by momofautistic on Jun 7, 2004 0:27:33 GMT -5
Also known as picture communication system (PCS), this is the most widely used form of communication board used for children and adults with autism. All that is necessary are photographs or drawings that represent people and things (nouns), actions (verbs), and concepts such as size and color (adjectives). This system is favored because of its ease of use. One downside is that as a person's vocabulary grows, more and more cards are added to the collection and they can become unwieldy. However, there are systems that organize cards into categories, which make utilization of many cards very easy. It can also be difficult for a child to learn concepts from cards; if a card has a blue circle, is he communicating the color or the shape?
Building a Communication Board
If you choose to use PECS, you can test it out very easily with your child. Take photographs, or cut pictures out of magazines, and laminate them. Home machines to laminate can be purchased for $20 to $30 and are always handy to have around. Laminate about ten to fifteen cards, each one just a few inches square. Attach the cards together with a loose-leaf ring (without the notebook—these rings can be purchased separately) and show them to your child. As she learns that pointing to the picture of the television tells you she wishes to watch a program, she will learn the value of these cards. Make the cards relevant to your child's life so they are uniquely her own. Put them in a fanny pack and have her wear it so she has constant access to the cards.
ESSENTIAL
Be certain when you create a system that you have copies and records of the cards that your child uses. If a card is lost or if you upgrade to a more sophisticated system, you will want to maintain the consistency of the same picture. Building this on a computer will make your life easier; create a file that has all of the pictures that are being used. Back it up on a floppy or CD, and put it somewhere safe.
If this is a comfortable method that works well for your child, there are more sophisticated systems available. There are many ways to use PECS and they will open your child's world in a remarkable way. You are limited only by your own creativity and how you develop it for your child's needs.
Other Communication Methods
One method of communication that is very effective for accuracy is the keyboard. Many people with autism who cannot speak are very efficient readers and writers. They may not be able to say that they are thirsty and need a drink of water, but they are able to type it out on a simple word-processing program. Even a simple text file on a desktop computer, a laptop, or handheld computer device will work. If your child seems to understand language (receptive speech) and reads, try typing a simple question. "What is your name?" is a good one to start with. He may look at you, unsure of what you want. Say the question while you point to the words on the screen and then point to the keyboard. If he understands how to communicate through writing, he will attempt to provide the answer. Coach him a bit as you begin. If your child can use this as a tool, you will know very quickly.
If you elect to use keyboard communication, consider a handheld computer device. They are portable and have small word-processing programs that can operate either with a small keyboard on the device or with handwriting-recognition programs using a stylus. There is an added benefit of having a calendar on the small computer; most people with autism instinctively understand calendars and clocks and will use them to maintain their schedule and routine. It is also possible to play games on a handheld computer, which can be a great deal of fun and a good distraction for times when a child might be bored.
A very controversial communication tool is the method of facilitated communication (FC). This technique operates by another person assisting a nonverbal person's efforts in communication. The support may be as simple as providing encouragement to boost the self-confidence of someone who is unable to speak. It can also involve steadying or guiding a hand to pictures or words if necessary; people with tremors, nerve damage, or poor muscle control may require some physical assistance. The point of contention with FC is whether a facilitator may influence what is being communicated. Opinions vary widely and parents who are considering this form of communication would be wise to research it thoroughly to reassure themselves on their choice.
ALERT!
Unfortunately, it is common for special education professionals to have only one communication system set up for children in their school district. A wise teacher or speech therapist will know that there are many nonverbal methods of communication and will work hard to find whatever it takes to establish effective communication. However, if you feel that the system that is being taught to your child is not the best system for him and your family, you have every right to have this changed. Talk with your child's teachers about other possibilities.
The most important thing any parent, caretaker, family member, teacher, or medical professional can remember about communication is that there is no one right way that works for every child. Children with autism are just like any other children; each is unique and will respond to different styles of learning and working. If one child works well with keyboard communication and another just can't figure it out, but is a whiz with PECS, it doesn't mean one child is more advanced than the other. It simply means they are two distinct personalities.
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Post by DFGADFG on Nov 2, 2007 1:45:33 GMT -5
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