Karla Pretorius on how to increase functional communication.
This is a topic of discussion for all parents. As parents, we always look for more appropriate ways for our children to relay their message. We would love a clear vocal request instead of a scream, a cry, a meltdown or a child running away from bath time, or a healthy meal. But first, before we look at how to increase functional communication, let us look at what communication actually entails.
What is communication?
It is actually quite simple – communication is just one person (the sender) sending a message to another person (the receiver). As long as the message reaches the receiver and the receiver understands the message (and responds to it), the communication works. For example – I am in the grocery store with my little one. He sees a biscuit and wants it. He screams. I give him the biscuit. He stops screaming. That was a very successful message conveyed right there, but it was definitely not the most socially appropriate or convenient way of communicating.
Every person needs a way to communicate effectively. It needs to be easy and it needs to be successful. If the way that we want our child to communicate is too tricky or requires too much effort, they will use a different way, such as screaming. If our child does not communicate in a way that others can understand yet, it is our job, as parents, to help them find a way that works for them. Verbal communication is not always the easiest way for our children to convey their message to us. The goal of this article is not to discuss various reasons for this difficulty, but rather to increase functional communication.
Contrary to popular belief when a second or third mode of communication is introduced to a child or adult, it does not decrease their motivation to communicate verbally. Our children will often feel less anxiety when they have multiple modes of communication available to them. Meaning that if you provide various ways for your child to request, other than requiring a verbal response, they will firstly be more likely to communicate their needs functionally and secondly less likely to engage in challenging behaviours, such as shouting or becoming aggressive due to the frustration they feel.
Effective ways to increase communication
We all communicate via gestures – we might nod our head if we agree to a sneaky snack midday or we might wink to our child if we catch them playing nicely with their sibling. We should encourage our children to also communicate via gestures as these are easily understood by any person regardless of their background and culture and also easily learned. When you go on a holiday to a country where your first language might not be understood, people will all understand a friendly wave. It is a universally accepted form of communication and an excellent backup plan should your child be in need of help from you or the lovely Portuguese neighbour. Here are some important gestures, which you can pair with movements your child can do and will understand:
- Hand up for “stop” (when they are tired and they need a quick break)
- Thumbs up for “good” (when you ask your child from a distance if he or she is doing okay in a possibly novel social setting)
- Hand flip towards the mouth (this can serve a need for a drink of water)
- Covering ears (when there are loud sounds and it is a good idea to exit this environment, if possible).
There are many other gestures I can include, but it becomes quite child-specific as well as developmentally and age-specific. It is important to look at what your child requires most frequently and look at their fine motor abilities and then pair a gesture with an item or action and practice this with them. Show your child that you will respect their way of communicating in these situations as you understand that they might feel a bit overwhelmed and verbal communication might not be possible at that moment. When a child feels comfortable communicating in more than one mode they will more than likely increase their verbal requests too. Throughout the years I have worked with children, I have seen an increase in communication when a child is calm, they feel respected to communicate in whichever mode they choose, and when there is less of a focus on verbal communication. It happens automatically, they start gesturing more, and then this may be paired with an increase in verbal responses.
Speaking about pairing
Pairing is a technique that is often only used for younger children that might still be pre-verbal. I feel there is not enough importance placed on this technique for our more verbal and also our older children. This strategy includes a parent, therapist, or friend pairing a sound, word, or phrase with a motivating activity. For example, if your child enjoys jumping or bouncing on a trampoline, you can pair the sounds “j,j,j” or “b,b,b” respectively. Keep the sounds to approximations you have heard your child say before and as appropriate to the word you are working towards as possible. If your child struggles with the sound “j” for “jump”, you can always try the sound “u” for “up”.
This strategy can be modified for our verbal and older children, where we pair a word or phrase to an activity. For example, let us take the same example of the trampoline. If your child is able to imitate some words, we can always pair “j,j, jumping” and then “j,j, jumping u,u, up” with the activity. The idea behind pairing sounds, words, or phrases is that we want our child to pair the motivating activity with the sounds and words and then use these in a request.
We often forget that many therapy strategies are also useful for children without a diagnosis and should be included when siblings join in the fun. Modelling behaviour from a sibling to your child with specific needs is another powerful tool that can elicit more spontaneous language. Keep activities fun, short, and interest-based to increase motivation from not only your child with specific needs but also his or her sibling, cousin, or friends. The more we normalize a bit of extra support, the more people will engage in this natural way of supporting people around them.
I want to include one more and probably my favourite tool in increasing spontaneous and functional communication. As a parent of an SEN child, you probably have been recommended by therapists to increase the number of visual support strategies you have in your home or during outings. The use of visual choice boards is an excellent tool that is highly underrated in most therapies and homes. It is a simple setup where you laminate a poster and have some Velcro strips on it. You then print out some of your child’s favourite activities, toys, people, and items. It is a good idea to start with a limited amount, such as two items that are preferred, and work on increasing the number of choices. You can then ask your child what they want – they have to go to the poster, choose one, pull it from the Velcro strip and hand it to you – this is where the communication occurs. The message from the sender has been received by the receiver and you can then either label the item or your child can do this too if he or she is verbal and willing.
Visual support boards
As soon as your child is able to distinguish between various items, you can create different visual choice boards for different areas in the house. You can have one for the kitchen that has all of their favourite healthy snacks on, one for the sensory room with all the fidget toys they love, one for the front door with some of the outings they can choose to go on over the weekend . Only have the items or activities that are available on the choice board and I encourage you to keep track of the increase in your child’s frequency of requesting. We have found that once our children understand that there are various items, activities, people, or places they can choose from, they are more likely to do so. We have also found that this is usually followed by a verbal follow-up.
Our goal should always be on increasing functional communication in a spontaneous manner and not in a rote, forced way. Our children will be encouraged to communicate with us when they know it is on their terms, in a way they choose, and which is focused on their interests.
There are other ways to increase communication, but I have found that these are the most powerful when you want to see a change in your child that is not only positive but also long-lasting. After all, we all communicate more openly, in more detail, and for longer periods of time, when we know the receiver wants to hear what we have to say, when we speak of our interests and when we actually receive the outcome we want without being forced to say it in a certain way. Similar to me writing this article to you – I feel heard and I thank you for that!
Karla Pretorius, M. Psych is a Research Psychologist and Co-founder of AIMS Global. She started working in the field of autism in 2002 and has played an instrumental role on an international level in advocating for autism awareness, acceptance, and understanding. Karla received a double Honors degree in the US and South Africa as well as completed her Master’s degree in Psychology through the University of Stellenbosch as a Research Psychologist. Karla, together with her colleague, Nanette Botha has presented in many countries, such as Denmark, Indonesia, Singapore, South Africa, and the US. They have collaborated with autism advocates and adults on the spectrum by providing a holistic support system that evolves as their understanding of autism does too. She is a major role player in the autism revolution. Karla currently resides in Portugal but travels all over the world to work with clients. Her passion for autism drives her to continue learning from her amazing clients, their parents, adults on the spectrum, and professionals in the field.