Talking To Children – Where Do We Start?
People talk when they get together. Have you ever wondered why? We acknowledge each other, we greet, we share our thoughts, impressions, hopes. We want others to understand us, be aware of us, like or respect us and sometimes we may even want others to know why we are frustrated and unhappy. We also respond to others, agree or disagree with their comments, share our emotional reactions. It is our desire to make social contact with others, to reach out and be part of a social group that has led to the development of language.
A sad fact about Autism is that having achieved speech and language with effort that often costs the family heavily, some will reduce their attempts to talk to the bare minimum by the time they are adult, responding with basic gesture, single words and grunts.
Why is this so, and where have we gone wrong in the teaching? Why do they not enjoy interactions like the rest of us do? The answer is that we have not broken through the barrier to socialization that ASD puts up. Eventually, even the best teaching will not achieve the desired result, if we do not first establish a social function for language. The importance of social willingness to communicate is rightly emphasised by the new diagnostic criteria for ASD as defined my DSM5. We no longer look at speech and language delays but at how the child shows a desire to communicate, or to what extent that is absent.
Let us look then at the nonverbal part of communication, the part that really matters with our children, and how we can improve their awareness of it by the way we communicate with them.
Firstly what can our tone and facial expression convey in conversation. Here are some non-verbal messages you should recognise just by looking at the person talking: “you are important and powerful, you are intelligent, you are stupid or intellectually impaired, you are loved and treasured, you are an inconvenience and a nuisance, you are interesting or you are very boring” to start with a few. Just what message would you like to send to your child to make communication more interesting and attractive? We will get to that a little later.
To start with, let us look at the very early communications between adult and baby, and see where they may have broken down. We tend to think that babies copy us, but actually we copy babies and so let them know that we understand how they feel. We start with fixating on baby’s eyes and so when baby manages to glance our way, initially by chance, we catch this, eye contact is made and we make a little fuss. Actually baby also finds this rewarding and pleasurable as demonstrated by MRIs, and it is probably the lack of this chemical response in the baby’s brain that is the first sign of the Autism to be.
We actually show empathy with a sad consoling face when baby cries, with lots of smiles and laughter when baby smiles or gurgles. If you are not convinced, try to spoon feed a baby with your mouth shut. We seem to be hard wired to echo baby’s expressions and before long – possibly around 6 weeks, baby fixates on our smile and tries hard to smile back, and soon after will try tongue movements in imitation. In behavioural terms we have gained stimulus control of mouth movements. Most parents of children with ASD report smiling, if a little later, suggesting that the start possibly was established by most, even if not with the usual ease.
Next, the baby, aware of adult eye gaze, follows this and notes where we are looking. What we then say is associated with the object we are looking at and so first nouns are learnt. I noticed in talking to parents that names are learnt before nouns and nouns may not appear, suggesting that many more obvious pairings may be needed. We know now that ASD makes associations difficult to establish so learning will be slower and the relationship may not happen if the baby has not achieved joint attention. Joint attention is when both baby and adult are looking at the same thing. We can direct baby’s attention with our glance, by ‘pointing ‘ with our eyes, and we need to note where the baby is looking. At that point we also need to make sure that the baby knows that that we have noticed this. Achieving joint attention becomes a primary aim of communication and many more pairings may be needed for associations to occur before language can begin.
What happens to parents whose baby is not responsive but appears quite content and happy, and simply shows no interested in where and what other people are looking at? The parent will works on establishing nonverbal communication, but eventually if there is no response, begin to slow down. Parents need to realize that the child does not note the input and its meaningfulness. The child is not rejecting their communications. Unfortunately it is only human nature to give up. What is needed is more input, and exaggerating input, not less, to make the message clear.
The message we want to give the toddler is “I am aware of you and what you are interested in; I think you are important, I love you, I will encourage and help you and I will make our interaction fun for both of us.” How do we get this message across when we also know that Autism makes it difficult for many to ‘read’ or even recognize faces? Mostly by being in their space and in their face with lots of exaggerated expressions on our faces continuing to mimic their reactions to show that we empathise, and by providing lots of entertaining items we can both share to further develop joint attention. We must not allow toddlers with ASD to drift into their own world and find their own sources of entertainment or self-stimulation which will serve to further shut us out.
As the toddler grows older and words may not have achieved much meaning, it is important to shape our gestures and our voice tone, as well as staying with routines which will make predicting easier for our toddler. Use lots of natural gesture and body language. Gestures need to include a lot of directing of attention to maintain the joint attention which builds communication. Body language and facial expression needs to support the message. You may have noticed how early typical toddlers start using body language, when they stamp a foot and wave you off indicating a negative when you offer something undesirable. Our toddlers need to be made aware of gesture too.
Voice tone is a very basic form of expressing a message, and precedes speech. It is a major way in which we convey attitude and emotion. Be aware of the messages you are sending nonverbally, and make sure they are the ones you want to send. We speak differently to toddlers and children and children who are spoken down to are often quite resentful of being treated as toddlers. There was a study a while ago comparing the way teachers of typically developing children and teachers in the special education stream talk to children of different intellectual levels. Both sets of teachers talked to the special children in a way one would speak to much younger children, but the special teachers made this even more so. Special teachers also tended to talk down to the typical children. As the child grows older we need to talk in a way that conveys respect as an equal if we want to gain the child’s confidence and a desire to participate in conversation. Watch the tonality; it must not be high pitched and overly varied. You may need to be a little slower if your child’s auditory processing requires this, but you must not be too loud. Instead keep sentences short and use words you know are recognized. Simplifying the language structure should not include a demeaning, or belittling, secondary message.
Also watch the content of your messages. Are they mostly ‘mands‘– that is demands, commands and reprimands. Too often parents, especially parents of children with behavioural issues end up only giving messages with little positivity to their tone. Even when making requests you need to keep a calm voice and model polite behaviour, something which is not always easy in a stressful situation. The more we restrict language to a one way flow of instructions, the more difficult will it be for the child to see communication as positive.
Another error is to turn a communication into a teaching and testing opportunity with a sequence of questions. Questions are a necessary part of conversation, showing an interest the conversation partner and drawing out information to share and to comment on. However, whereas one or two questions are an integral part of the structure of conversation, three questions constitute interrogation and the target faced with the need to answer will not feel an equal conversation partner and will feel stressed.
We need to talk to our children, even when they are not likely to talk back. They will be aware of the nonverbal interaction. We need to respond to their nonverbal messages and put them into words, using exclamations and encouragers to indicate we understand. By doing this we will be modelling the two way flow of conversation and the sharing of thoughts, and we also will be maintaining the child’s social attention. It is important to talk in an inclusive way, in a way that engages the child’s interest with appropriate comments and topics, and in a way which shows them that we respect them and their thoughts.
Once a child starts using words, extend the early truncated sentences into the child’s intended meaning by including them in sentences. If you know your child and have been watching the nonverbal messages you are likely to know what is being intended with the single word or with the string of jargon others will not understand. Paraphrase this into simple sentences, scaffold the comments to where they are conversational, and respond to them. However, remember that this is prompting and it must not be overdone. A child with poor articulation may be very much aware that the articulation is not good enough and will not try to make comments knowing that you will make them for him/her. On the other hand if they do try and are not understood or are overly corrected, the desire to communicate soon disappears.
Your child will also need to learn language. This means we will need to teach a vocabulary of needed words, teach sentence construction, grammar and shape appropriate articulation. That is another task completely, and obviously very important. However, without first achieving and maintaining a desire to communicate based on joint attention, shared feelings and enjoyment of the interaction, the social aspect of communication will not develop. One can actually teach the child to talk without achieving communication.
