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Teaching Verbal Skills

Posted by on Apr. 14, 2007 at 12:12 AM
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Hi!  I am Mom to a 9 year old boy with Autism.  He only has a few spoken words but I want to encourage you to think about verbal skills as communication skills.  So if your child can learn to sign or communicate wtih a speech generating augmentative device that is a verbal skill too.  I know the primary goal is usually speech.  However is it critical to give the child some reliable form of communication as soon as possible whle still working toward verbal communication.

Signed Exact English has been a great gift for my son  to use to communicatie his wants and needs and to demonstrate that he can read! This is such a complex issue and so many things to try.  One of the most important  rules we follow in our house is that "EVERY SOUND IS A WORD".  We encourage ANY vocalization (well, short of screaming) to communicate. My son's primary form of communication is Signed Exact English, but when he signs he must also vocalize with the sign.  He can't say the whole word "milk" but he can say "mk" we require that...(this is soy milk for him as he is on the GFCF diet too...he is  not even really supposed to be using the soy  milk but that is another topic).  Anyway, "music" as you can imagine right now sounds just about lilke "mk" too BUT he is learning the function of using his voice to comunicate and that it can help get him what he wants.  He can't say "computer" but he can say "com" with a  couple other sounds to simulate the other two syllables. While speech therapists may get too wrapped up in exact is more productive to use the "errorless learning" concept that rewards every attempt with positive reinforement then tries to model the correct pronunciation and require increasingly closer approximations to the word.  My son's "car", "Mom". "come" and "hi" are some of the best and so another tool we use is to take the sounds he has and emerging sounds and try to shape them into additional funcitonal words. 

We are now focusing on the individual sounds of "b" and "p". I have to actually touch my son's mouth to gently press the upper and lower lip together as the starting p oint for "b" or "p" and demonstrate them then ask him to imitate.  "p' we do almost as a whisper right now to drive home the  difference between the stronger b and the softer p.  Then we take the b and ask for functional words "bye"'s getting pretty good!  Yipee! He already had a "c" cor "k" sound so we are asking for "cup" also a nice approximation developing, and we  have a new puppy so we are asking for "pup". 

Listen to the sounds your child may make when they are playing...(my son makes more sounds spontaneously than when Apraxia issue.)  Your child will be more motivated to ask verbally for something they really want..."cookie" for son  tries pretty well to say "apple" too. Another tool can be just the opposite of this later technique and that is once you have identified any sounds t hey make that resemble individual speech sounds ask them for some thing really out there...David is asked for words like "zoo" and "they" because we are tr ying to get new sounds that might  come in the process of tring these really dificult ones.  I have been having him stick his toungue out between his teeth and do a raspberry to get the feel of placing his tongue toward the front of his mouth touching his  teeth...notice where your tongue has to be for the "th" or z" sound. 

Having your child imitate oral motor movements and playful sounds are very helpful...we like the Mighty  Mouth game that makes players do things like:

1. stick out the tongue in a point 2. stick out the tongue as if you were trying to touch your nose 3. stick out the tongue as if trying to touch your chin 4 lick  your lips as if trying to lick off peanut butter 4. pucker lips like a  kiss  5. do a fish mouth with rounded lips open like, an "O"  6. move tongue from side to side with mouth open 7. push tongue against inside of cheeck  8. move tongue up and down with  lips parted.  Watch to see if your c hild moves his/her head with the  up and  down or side to side movements or can keep thier head isolated.  You could make cards with these oral motor movements on them and play it like Simon Says.  I reward my son's attempts with tickling as he loves to be tickled...he also goes for high f ives and praise to keep motivated. 

Taking your index finger and tapping gently all around the lips can help provide some additional sensation to the mouth when working on speech sounds, as can various oral motor stim can find in catalogs like Beyond Play. 

Singing games even if they seem to young for your kids are also great speech activites as they stimulate both sides of the brian at once. Think of songs like Itsy Bitsy Spider, Bingo, Wheels on the Bus, and Head and Shoulders Knees and Toes..with the motions, singing and interaction these improve social skills as well. My son always responded well to music...when he was 2 and 3 it seemed like he only listened to me when I was singing.

Even if the kids are too young to read it is never to early to introduce them to words maybe with pictures too to help them understnad  language...picutes and words of things like coookie, car, apple, ball, dog, cat, etc. and picutes of family members...Mom, etc.  I STRONGLY suggest working tirelessly on building receptive language...if you need some ideas on how to do that you can talk to me in my chatterbox. Communication is critical!   This is what we spend about 90% of our instructional time on in one way or another.

Don't underestimate the importance of reading daily to your child...good old Dr. Seuss is GREAT for kids to internalize the sounds and rhythm of  language! 

by on Apr. 14, 2007 at 12:12 AM
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Replies (1-5):
by New Member on Apr. 25, 2007 at 8:48 AM
Thank you for all the good info. Please let me know of any other ideas and tricks. I am new to all this.
by Group Owner on Apr. 27, 2007 at 12:33 PM
Hi Welcome!  I opened this group and then sort of left it on the back burner waiting to see if anyone came-ha!  If you know others who are concerned about teaching verbal skills or other communicaiton skills such as sign language or augmentative communication please spread the word. 
by New Member on Jul. 15, 2007 at 7:50 PM

I read your post and it was very informative. My son is almost 6 and is non-verbal, he can repeat mostly everything you say but he never speaks independently.  In school he uses a picture exchange method.  I often question the effectiveness, and progress of this method, and I am assurred it's working.  Not being farmilliar with other methods I accept this assurance.  I am interested in learning about the methods you wrote about.  If can give me some info I will be greatful.

by Group Owner on Jul. 17, 2007 at 1:56 PM

Quoting kmzma:

I read your post and it was very informative. My son is almost 6 and is non-verbal, he can repeat mostly everything you say but he never speaks independently.  In school he uses a picture exchange method.  I often question the effectiveness, and progress of this method, and I am assurred it's working.  Not being farmilliar with other methods I accept this assurance.  I am interested in learning about the methods you wrote about.  If can give me some info I will be greatful.

Please let me know which of the methods is most interesting to you to start wtht.  Consider that we realize no method of communication seems as simple to we oral motor communicators as speech, but to our kids oral motor communication can be like asking them to do Calculus.  

 Every other form of communication seems limiting to we oral motor communicators.  Sign Language after-all is something the general public doesn't know and so unless an interpreter is present many people the individual encounters will not understand...for example my son's general education teachers are never required to learn Signed Exact English...he relies on the fact his family and aide understand.  BUT it may  not be the best method in the long run.  You will find I am playing devil's advocate a bit here trying to get you to determine what outcomes you want now and in the future for your child's communication.  Signed Exact English is still the most reliable form of expressive communication my son has to date, so I do believe it is a valuable tool and all you need is your body..nothing to tote along and the only limits to expressive communication is the user's knowledge of the signs and ability to reproduce them effectively enough to get their message across..their has to be a level of fine motor control and motor planning  to do this but not as much as required by handwriting.

A higher tech augmentative device can be heavy (the ones we tried weighed around 5 lbs...which initially sounds light but try carrying that around all day...especially if you are an elementary age child. This may  be an effective tool for those with strong visual memory and categorization skills. Pre-programmed buttons will open up new widows with lots of word choices to give the user an almost unlimited expressive communication option.  The Dynavox systems are really top of the line as far as I'm concerned.  These can be a means to an end..they can help bring about increased expressive communication and even increased verbal communication.

The lower tech boards with  overlays are limited to the number of squares in the provided overlay...these systems were too limited for my child.

Back to your current  picture based system.  I t hink as many of these individuals respond well to visual supports, the use of a picutre exchange system can be a vehicle for receptive and expressive communication that meets the needs of the user, but teaching functional communication has to be center to this process. ALL METHODS of communication are limited if the individual does not understand how to initiate spontaneous expressive communication.

A child learning to speak/communicate when they want to is a huge hurdle to overcome...I mentioned in anther of my responses today how my son for the longest time only was the responder never initiating communication. 

Can you give me some examples of how your child uses the picture exchange system in school? For example does he use it to ask to go to the restroom, to say he is hungry or thirst, to an swer questions, or to label objects.  How does your child participate in the curriculum at school? Is it also by using a picture communication system?  For example, if your child is 6 is he in Kindergarten or 1st grade, and working on learning sight words...will he pick up a printed card of the sight word when it is presented orally or does he just verbally echo it, or can he do something like circle it on a worksheet when it appears with other words? 

When you are at home if your child has n ot learned he can ask for w hat he needs start thinking about what he likes to do, eat, drink, etc.  Then make opportunities for him to ask for these motivating items/activities.  If your child has his pictures at home use them...if not you can make them from graphics on-line...I can help you find pictures you need.  Even if you are putting the card in his had and then reinforcing with the activity/objcet at first that is OK. If your child can already imitate the voiced words (as I interpreted from what you said about him repeating what people say) then you can/should require him to say the word that is in the picture card as well.  In our case we require a voiced approximation of the word with our son's sign.  We want him to know it is effective to use his voice.  Our son still has VERY  LIMITED verbal vocabulary with a HUGE receptive vocabulary and BIG sign vocabulary.  He has learned to communicate when he is motivated for something often to the point of annoying persistence. 

Teaching a child to answer YES/NO questions appropriately is a skill I would put at the top of my list oo.  Even if your child will only use a head nod for yes and a head shake for no.  If t hey can answer appropriately that will help others A LOT who are trying to meet their wants and needs.  We chose to opt for the head nods/hakes instead of a sign, or picture...everyone understands nodding or shaking your head...if accompanied by v oice all the better. 

Gosh..did I get to what you were asking for about the other methods?  Please redirect me if I missed the target entirely-LOL! 
by Member on Aug. 29, 2007 at 11:57 AM
HI! thank you for the info.   my son has a dynavox for communication.   He also has low vision so he is not able to use it a t full potential at this time - we can only set it at the "8 spaces per page" level at this time so that he is able to see the "bigger" spaces.     Even at that I have noticed when changing these pages - I think he is memorizing each page "where the keys are" and memorizing the "route to navigate" to that page -- rather than responding by sight so much.   
What my problem is -- the school system is not utilizing the device as they should.     My son is non-verbal.   I set up the device to say "hi", "bye", "please" , etc. and was planning that Andrew would use this to communicate with teacher, other students, etc.       They are not.    they said they do not want to discourage him from "trying to verbalize" - by becoming dependent on this device.     
They do utilize it for educating -- numbers,etc. - which is good.

How can I get them to utilize it????
I feel that may be do in part to the size of the dynavox ---- Andrew is not able to carry the device by himself - He would need the teacher or other to carry it for him --- thus when they move about the room for activities ---- (it doesn't seem real structured at his school) someone would have to carry the device for him to communicate on.

What about the palm pilots??????    Would those be more logical for him? He would be able to carry that himself.   Can the pictures be larger - and if they are would it be funtional -- having only a few pictures/page - due to the size of equipment?    
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