Opportunity to Communicate: A Crucial Aspect of Fostering Communication Development
Contributed by Beverly Vicker
Communication has long been recognized as an important skill for children to develop. For children who have limited skills, some basic elements are necessary for a child to develop an adequate communication system. The child has to have a need to communicate, a means by which he or she can communicate, opportunities to communicate, and supportive communication partners (Beukelman & Mirenda, 1998). Often the emphasis of a program is on the development of a means of communication whether it be oral speech, sign language, or some other form of augmentative communication. This article will only focus on one element, the need for opportunity to experience communicative exchanges, and to acquire and practice communication skills.
It is not easy to discuss the issue of opportunity because to increase opportunity requires more time investment from the adults in the child’s life and sometimes changing the comfort zone for the child. This always involves a balancing act between competing goals and recognition of surrounding circumstances. Key elements are illustrated in the following diagram. All of the elements are important so there needs to be adequate opportunities for all to occur each day.
Independence of the child.
Interactions by the child with others.
According to Hart and Risley (1999), there may be up to 338 utterances produced per hour by a typical child 24 months of age and potentially 5,000 utterances in an average day. Not all of the utterances are directed to others and not all are responded to by parents. But, even if a given child only engaged in 700 exchanges per day with an adult, that still represents considerable time during the course of a week, month, and year to potentially practice communication skills. One must ask, how many communicative exchanges take place during the typical day of a child with an autism spectrum disorder (ASD) who is learning to communicate? What proportion are adult initiated? How many take place at school? How many at home? How many, in either situation, are unique exchanges versus a routine exchange? (In highly routinized exchanges, children do not necessarily gain new skills in vocabulary, syntax, functional use ,and background knowledge.) If a skill is still new, how many exchanges or practice opportunities have existed to firmly establish the new skill or to promote generalization?
Seven hundred exchanges a day is actually a low figure for a typical child who has verbal skills. Goals for a child with special needs are often lower than an arbitrary 700 exchanges and qualitatively different. For verbal behavior training, an applied behavior analysis program, the goal is usually 500 responses a day. For users of typical augmentative communication systems, 500 utterances a day should be a reasonable target. The Picture Exchange Communication System suggests 80 as a minimum rate. Language and communication skill development can be compromised if a child has an adequate means of communication, but the frequency of use is very low.
Very few adults, if any, set out to deliberately compromise opportunities for learning language and communication. Sometimes compromise happens because parents are too invested in other goals. The use of a pacifier with children older than 18 months of age is a good example, and it is an illustration that is not restricted to children with ASD. When one is out in the community, one frequently sees children of various ages with pacifiers in their mouths. The pacifier can help with emotional regulation keeping the child calm and relaxed amid the sensory stimulation of the community. This represents a good goal BUT the question remains if this is the best way of achieving emotional regulation once the child is beyond 18 months of age. The use of a pacifier is not a problem from a communication perspective when a child is napping or sleeping at nighttime during the early years. The child is not missing out on interaction during this time period. During awake hours, however, some children seem zoned out with their sucking behavior and the parents often do not talk to the child because he or she is so content. So much language learning opportunities are wasted and the child is less likely to take the initiative with commenting or calling attention to something because of the device in his or her mouth. This article is not saying “Do not use a pacifier.” Rather it is saying, “Are you missing language/communication interaction opportunities with your child, particularly when out in the community? Can you provide alternative periods of having the pacifier in and out? Can you talk more to your child, even when it is in and he may need to nod or gesture?” Being in the community can be challenging for a child with ASD but if you can capture his or her attention with something for brief periods of time, the community can also be a memorable and interesting learning environment.
Missed opportunities can also occur at home. Again the objective is to have balance in the child’s life. Most parents use time while their child is occupied with TV or video viewing to get some necessary household chores done or to have a moment to one’s self. This is necessary BUT sitting alone with the TV or computer does not improve your child’s language or interaction skills. A parent would seem to need several strategies for the child who favors excessive viewing and limited interaction. The first strategy will take time and effort. Attempt to sit down with your child and intermittently interact about the content. If you’re lucky, you will be able to direct his or her attention to some aspect of what is happening by using a directional point. (“Oh, look, Tigger is jumping again. Boing-boing-boing”). If it is hard to direct his or her attention, you might want to build a well padded finger on the end of a dowel and use that to point to what you want your child to notice. You could ask him or her a simple question such as is ‘Is Pooh there too? Where is he?” and encourage your child to point. Keep the intrusions limited to a few the first time, and maybe this activity can grow into some nice interaction over time.
Some children are so “zoned out” on the sensory aspect of viewing video or TV that you will be viewed as an annoyance or distraction while they are waiting for their favorite scene in a video. Try several things to see if you can build this into an interactive situation. First, give your child a warning that you will be sitting next to him or her for awhile. You may need to do some sensory things such as rubbing his or her back to reduce the anxiety/annoyance of you being there. This can build up a positive value for your presence. You may want to mention something about the video or whatever after the event. Once your presence is perceived as an acceptable variation on the usual viewing situation, you can begin to make a comment or ask a question but not at the moment of his or her favorite part. Your speech pathologist can help you make up a topic board for a video and that may help facilitate a few exchanges. A parent can provide good modeling of how the communication support can be used. Look for opportunities to teach new vocabulary and to explain actions.
An alternative strategy is to use the schedule and timer, and limit the time for watching or playing video games or other self absorbing activities. Choose to involve your child in activities where there will be some interaction. Initially it will be important to really tap into your child’s interests to counter resistance. Pick something that he or she likes to do and finds satisfying. It may only be a 7-8 out of 10 on a scale of interest and satisfaction, but it has to be of sufficient value to compete with videos, TV, computer, or games. If your child has no other interests, then that is a red flag signal for you to start helping him or her to build interests that will involve him or her with other people. It may take time to broaden interests but there will be a payoff in terms of building better communication skills and social interest.
The last barrier to communication opportunities can be the equally important goal of independence. It is very important for children with autism spectrum disorders to not be cue or prompt dependent, to be able to take the initiative to meet their own needs and to be able to occupy themselves with something of personal interest. BUT, being independent most of the time, means that the child does not need someone to help satisfy his or her needs. By not needing someone, he or she has a legitimate reason to not have to interact. So, some opportunities to communicate and interact are lost by default. This means that parents and teachers will have to create new needs that can only be resolved by interacting with another person. The opportunities often need to be planned. As mentioned earlier, one is looking to put some balance into the life of the child with ASD because without adequate opportunities to communicate, the child will have less developed skills. The child will also develop habits that do not include interaction. Different strategies will be needed with the child who has adequate opportunity in school or at home, but who is reluctant or not interested in communicating.
Opportunities to communicate/interact can abound if the child has an adequate means of communication. If the child does not, then the various elements of creating need, providing a means, and providing an opportunity should occur in tandem. If communication partners do not know how to be supportive, then this element must be addressed as well. Opportunity to communicate is not an area that can be ignored within an intervention program.
Beukelman, D., & Miranda, P. (1998). Augmentative and alternative communication: Management of severe communication disorders in children and adults (2nd ed.). Baltimore, MD: Paul H. Brookes Publishing Company.
Hart, B. & Risley, T. (1999). The social world of children learning to talk. Baltimore, MD: Paul Brookes Publishing Co.
Vicker, B. (2006). Opportunity to communicate: A crucial aspect of fostering communication development. The Reporter, 11(2), 16-18.