Methods of Communication

EC Handout #2
Valley CoPA (Community of Practice in Autism) – January 2008 from the RAISE Infant Program

There are different opinions about what strategy or strategies to use to help children learn to communicate. There is not yet good research to tell us which approach is best but we do know that every child is different and there is no “one size fits all” strategy. Sometimes one method is tried and, after a period of time, the team, including the family, will decide that it is not effective and another method will be chosen. Sometimes a decision will be made to combine approaches and other times a decision will be made to try one approach at a time. Each approach is challenging in its own way to implement and, no matter what, it will take time to see success. We do know that children learn the best and fastest when adults are consistent in their teaching – no matter what they are teaching. So we encourage you to choose an approach and try to implement it consistently.

Some general advice no matter what approach is chosen:

  1. teach specific words whenever possible. DO NOT TEACH “more” and “please” and other words that are very general until the child has acquired many specific words. Some children learn a word like “more” and then will use it universally and so the word becomes meaningless. Example: a child walks into the kitchen and signs or says “more.” The parent wonders “more what?” So teach the child the specific word (cracker, apple, juice, swing, tickle, up, etc.).
  2. know that if it were easy for your child to communicate, he or she would already be doing it. Your child is telling you by his/her communication delay that this is very hard! Therefore, it is going to take time and hard work on your part to get communication going. In most cases, there is no quick fix but, with hard work and consistency, there is always progress!
  3. make sure everyone in the child’s world uses the same approach. If one person expects a child to sign to get a drink and another person expects the same child to talk for a drink and yet another person will give the child a drink whenever he/she whines or fusses, the child is getting many different messages and it will take a long, long time for the child to develop an effective way to communicate with everyone in his/her world.
  4. expect good things from your child. Believe your child has the ability to communicate beyond whining, grunting, pulling and pointing and it will be so!
  5. let us know how we can help you.

Here are some of the pros and cons of the three main strategies:

Verbal/Talking (an effective method to teach talking is the “pivotal response approach” by the Koegels):

Some of the Pros:

  1. almost everyone in our culture understands and uses words
  2. for many families, having their child use their voice to talk is of the highest priority and this is where they want to focus their energy
  3. a child always has his voice with him (unlike picture cards)
  4. always uses immediate reinforcers. For example, if a child wants a book, the book becomes the reinforcer for the correct response and the child should get it immediately
  5. fits easily into daily routines
  6. a child is reinforced for “trying,” not just for a correct response

Some of the Cons:

  1. words can be challenging for some children to say. Some children will not be able to talk but we don’t know who these children will be when they are in early intervention (“early intervention” refers to birth to three programs). It is only when a person gets quite a bit older do families and teachers and therapists begin to realize that the person may not ever talk.
  2. no one can make a child talk. However, we can take their hands and try to make them sign or we can make them exchange a picture card.
  3. when this strategy (pivotal response) to encourage talking is first implemented (the strategy involves the parent withholding a favorite item or activity until the child vocalizes), children typically “test” the strategy by increasing their crying/whining/tantrumming to see if the parent will give in. This is a natural and temporary response but this can be very stressful to parents.

Sign Language (Mark Sundberg and James Partington have done a lot of work with this approach):

Some of the Pros:

  1. adults can usually shape their child’s hands into the shape of a sign. This allows the child to always give the correct answer/response (“errorless learning”)
  2. a child always has his/her hands (unlike the picture card method – it is hard to always have the pictures with the child at all the times he/she wants to communicate)
  3. this method includes pairing the sign with the spoken word. For some children, signing is a bridge to spoken language and the hope is that the child will figure out that talking is easier than signing and the signs will drop out as the words increase.

Some of the Cons:

  1. some children greatly resist having their hand shaped
  2. some children do not have the fine motor skills to sign well and may become dependent on the adult shaping their hands into the signs
  3. some children do not readily imitate so have a challenging time learning new signs
  4. some children do not watch others very much and so may not watch when others sign to him/her
  5. many people in our culture do not know sign language and so the child does not have a way to communicate with those people. However, this is not a factor for very young children because they are always in the care of adults. It is assumed that the adults providing the care (parents, teachers, sitters, etc.) will know the signs the child knows.
  6. every once in a while there is a parent or other primary caregiver who does not learn the signs the child is learning and this makes it very challenging for the child.

Picture (the official picture exchange method is called PECS by Bondy and Frost):

Some of the Pros:

  1. pictures are generally universally understood (unlike signs)
  2. the picture exchange method also results in “errorless learning” (like sign language) because the picture exchange is always completed (even if the adult has to guide the child, hand over hand, to get the exchange done)
  3. pictures can be looked at again and again. Words and signs are said/made and then are “gone” and the child must then remember them. Because pictures are permanent, the child does not have to remember – the child can look at each picture again and again. Many children are visual learners and the picture method builds on that strength.
  4. the method includes pairing the picture with the word. The expectation is that the child will learn the word and realize that it is easier to say the word than exchange the card and so talking will increase.

Some of the Cons:

  1. to teach the system correctly, there needs to be two adults in the early stages to facilitate the exchange of a picture for the desired item or activity. Having two adults always available can be challenging.
  2. the child must have the picture cards with him/her at all times
  3. it takes some time to make the cards