When the spoken word is not enough

16 Sep

Often parents will be concerned about their child’s development when he /she is not speaking  or is not understandable at age 3 yrs.  They want the child to be able to say words.  They are surprised to find out that saying words verbally can be only part of the problem.

A Child with autism often needs to develop intent or a purpose for communication.  Without purpose there isn’t a  reason to talk.   Caregivers believe they can help by talking for the child or telling them what to say.   Communication is reduced to  repeating back what is said to them. Caregivers with the best intentions respond to wants and needs without requiring the child to communicate to them.  The child’s development becomes stagnant  because it can’t go beyond this hurdle.

Children with speech that is not understandable also run into difficulties.  They become frustrated because they can’t get their needs met and are asked to say words over and over again.  By first grade their peers begin to notice and they may be teased.  It’s not unusual for children to exhibit behavior problems along with a speech and language delay.

When children are slow to develop understandable speech at a reasonable rate, communication boards or pictures can make a difference.  They can bridge the gap between the speaker and the listener and reduce the frustration associated with speaking.  They allow for communication which is really the main goal.  It encourages the child to continue to speak because he is understood.  Parents often think that the use of communication boards will inhibit the development of speech, but actually the opposite is true.  The pictured words are often the words the child learns to say first.  If you are lucky you may have a program named Boardmaker which allows you to design your own communication boards or books.  There are also a lot of sites that have downloads available.   It is possible to access a communication book on this site, Boardmaker templatesBoardmakershare.com is a site that allows you to download already made boards that people have shared.  If you have Boardmaker,  you can edit the boards after you download them.  Otherwise you can download them and use them as they were shared.  It is free and well worth the registration.

If a child doesn’t have intent to speak, pictures may be linked with a consequence so that the child has a purpose to communicate.  For instance they may exchange a picture of a snack in order to get that item.  This can be built upon until the child is actually forming sentences.  This promotes the development of meaningful language rather than imitative speech or reciting of nonsense phrases.  The Picture Exchange Communication System is an example of  using an exchange method.  It has the advantage of being low tech and not expensive.

Often pictures are used to make schedules and help with transitions for children with autism.   However, do not confuse their use with communication.   Schedules are helpful for letting a child know what to expect with their day and reduce stress.  They can also be used as a bargaining tool.  The child can select a preferred activity after completing a number of tasks.  They tell the child what is happening but do not allow the child to express himself.   A schedule is not meant for multiple communication exchanges. A child benefits from both a picture schedule and a communication method.


I am an ASHA certified Speech and Language Pathologist who has worked in the public schools 30 plus years.

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