Activity: Treat Sounds Like Words and Repeat Your Child’s Sounds
One of the most effective strategies you can use is to respond to your child’s sounds as if they were words: by answering your child, by imitating your child’s sounds, or by saying something that sounds like what your child said. If your child is vocalizing to himself, go up to him and imitate the sounds. Get in a good position for attention (see Chapter 4), repeat the sounds your child is making, and then pause. Your child may vocalize again. If so, respond again. Then, see how many times you and your child can go back and forth. This is a little conversation, and it shows that your child can control his voice, can choose to turn it on and off, and is aware of taking turns with voice. If your child stops vocalizing, that’s okay! It doesn’t mean that you’ve done anything wrong or that your child doesn’t like it. Maybe it’s really hard for your child to choose to turn on his voice right now. Maybe it is a new experience and your child has to think about it a little. Maybe he is surprised! You’ve done the right thing; keep doing it. With enough experience, your child will probably start to vocalize back when you repeat his sounds. Persistence will pay off.
Step 2. Develop Vocal Games with Your Child’s Sounds
Once you and your child can vocalize back and forth easily when your child starts to vocalize, try starting the vocal game yourself, before your child makes a sound.
Activity: Use an Everyday Activity as an Opportunity to Make One
of the Sounds Your Child Typically Makes
Try this activity while you are face to face and you have good attention—in the high chair, at the changing table, on your lap, on the bed. Look at your child, make a sound you know your child can repeat back and forth, and wait expectantly for your child to “answer” you. If she does, answer back and carry out your mini-conversation. Practice starting these with the various sounds you and your child use to play turn-taking sound games. When your child can sustain the back-and-forth interaction with you when she starts it, and when she can “answer” you with the various sounds she has when you start the “conversation,” you and your child have taken a giant step toward speech.
If your child does not answer you when you start the vocal play, don’t worry. At some point, she probably will. Continue to imitate your child and build these little back-and-forth exchanges from your child’s vocalizations, and continue to try to start them several times a day. Your child will very likely follow your lead in the near future.
Twenty-month-old Sabrina was a quiet little girl who rarely sat still and had little interest in objects. Her vocalizations were infrequent and occurred when she was moving around the room. Her mother, Christie, consistently imitated her, but Sabrina was not yet responding. Christie also sang to Sabrina many times a day, with animated face, voice, and gestures, and she found that Sabrina particularly liked “Twinkle, Twinkle, Little Star.” When Christie started to sing it, Sabrina would stop, turn, and come close to her to watch and listen.
A few weeks after Christie started to use the techniques in this book, she heard Sabrina making song-like vocalizations. These sounded a bit like “Twinkle,” so Christie sang back what she had heard. Sabrina turned and approached her mother. Then Christie stopped the song, and Sabrina started to “sing” again. They went back and forth several times in a row.
Christie took this as a cue to augment the song repertoire and started to sing during many of her dressing and changing routines—just little made-up songs as she went along. Within a week or two she started to hear “words” inside Sabrina’s songs; her daughter was learning speech sounds inside the music. When Sabrina started a song, Christie continued it. She found that if she started a favorite song and then stopped at the end of the line without finishing it, Sabrina would fill in the missing word. Sabrina’s consonants and vowels, and her word-like utterances, were increasing steadily inside the song bits, and Christie started to hear these new sounds when Sabrina was vocalizing to herself as well.
They had had so much practice going back and forth in songs that Sabrina now began to respond when Christie imitated her vocalizations. She repeated them, and the two could go back and forth with sounds as well as songs. Sabrina now had enough sounds that Christie could begin to embed them into their play routines. Sabrina loved feeding one of her baby dolls and watching bubbles. Christie could use Sabrina’s “ba-ba” sound inside both of these routines, for bottles and for bubbles. And when she got one of these routines going, Sabrina did imitate the “ba-ba” sound, several times a day. In a few weeks, Sabrina had moved from no consonants or imitation to many episodes every day of back-and-forth vocalizing and singing, and Sabrina was now ready and able to start to imitate some word approximations inside the routines that Christie chose, using the sounds Sabrina had already mastered.
Step 3. Increase Opportunities for Listening and Responding
to Sounds Made by Others
Another technique to use with a child who is just beginning to develop control over her sounds is to increase the range of sounds you provide by using nonspeech sounds, songs, and chants.
Rationale. Animal noises, car noises, and other types of sound effects made during play routines are important steps toward speech, even though they are not speech sounds. Activities involving songs and sensory social routines generally involve words used in ritualized, playful ways that will engage your child.
Activity: Increase the Number of Times Your Child Hears
Nonspeech Sounds
When you are playing with toys with your child, weave sound effects into your social exchanges with the toys.
Here are some activity ideas:
Say “Ringggg” dramatically when you put the phone up to your ear.
Make engine noises (“vroom-vroom”) when you play with trains, cars, and planes, and also when you do books or puzzles about vehicles.
Make animal noises for toy animals and pictures of animals in books and puzzles.
Make silly noises like tongue clicks, raspberries, lip pops, and other crazy fun sounds you can think of during diaper changes, mealtimes, toy play, and sensory social routines.
Watch your child’s reactions, and repeat those effects that catch your child’s interest and attention. Make each sound and patiently wait for your child’s turn to imitate or make a sound back. Whether or not your child responds, take another turn. The predictability of your sounds will help your child learn to make them.
Activity: Increase the Number of Times Your Child Hears Words
These kinds of activities generally involve words or sounds used in playful ways that are built into chants, play routines, or songs. Here you can use all those “baby games” that combine words and gestures, like peekaboo, chase/“I’m gonna get you,” bumblebee, “Round and Round the Garden,” and “This Little Piggy.” We also include songs with action, like nursery rhymes—“This Is the Way the Ladies Ride,” “The Noble Duke of York/Grand Old Duke of York,” “London Bridge,” and “Ring-around-the-Rosy.” Bubble routines that involve “pop and poke,” as well as routines with balls, jumping, swings, and slides that involve “Ready, set, go!” and “One, two, three!”, provide opportunities for words to enter your child’s ears in rhythmic and predictable ways. When your child is involved in any rhythmic activity like jumping, swinging, or banging, add the words “jump, jump, jump” (or “up and back” for swinging, or “whee” when the swing comes toward you) in rhythm with your child’s activity.
Children seem particularly attracted to these kinds of rhythmic social sound and action routines, and these are often the first words they say. Try to build up lots of fun sensory social routines every day with these kinds of sounds, words, and songs. Hearing all these sounds will help your child build up more and more sounds and learn much more about the social aspects of sounds and the meanings of some words.
Summary of Steps 1–3
Thus far in this chapter we have been talking about helping your child develop the sounds that she will need for s
peech production, and helping your child use those sounds in back-and-forth imitation games. See if you agree with most of the statements in the following checklist. If so, you are now armed with important skills for helping your child learn to speak and use language. These are skills you will use throughout your child’s first language-learning stage—building on the sounds your child can already produce, offering new sounds and words in interesting contexts, and helping your child expand sounds in meaningful activities. If you don’t feel secure in these skills, turn back to the start of the chapter and ask your child’s speech–language therapist to observe your interactions and give you some feedback or coaching with these techniques. Eventually this style of talking with your child will become so natural that you will not even think about it. Maybe it already is!
Activity Checklist: Am I Helping My Child Develop New Sounds?
____ I know the sounds my child makes regularly, both vowels and consonants.
____ I typically imitate my child when he or she is vocalizing, and I try to be positioned for eye contact.
____ I know how to pause and wait for my child to take a turn after I make a sound.
____ I know how to develop some back-and-forth sound games with my child.
____ I use lots of sound effects, single words, song routines, and “baby games” that combine action and simple words or sounds with my child.
____ I routinely pause when I am playing games with sounds or words, and wait for my child to look, gesture, or vocalize (take a turn) before I continue.
Step 4. Talk to Your Child in a Way That Promotes
Language Development
Rationale. How parents talk to their children has a big influence on their children’s language development, and this is also true for children with autism. Parents who talk frequently to their children (face to face, using simple language) about what the children are doing, seeing, and experiencing; who label their children’s actions and objects; and who narrate activities as they are carried out help their children talk more and develop larger vocabularies. Parents who use speech mostly to give their children instructions or corrections limit their children’s opportunities for language learning. You want to be sure you are talking to your child throughout the day during both play and nonplay activities, and that whenever possible, you have your child’s attention when you are talking.
Talk about what? The easiest thing to do is simply to talk about what your child is doing. “You want the ball?” “Here’s the ball.” “That’s right—roll on the ball!” Follow your child’s focus of attention. You know that what your child is attending to is what your child is thinking about. Put words to it: “There’s the bed.” “You want on the bed?” “Up on the bed!” “Time to sleep.” Put the words in your child’s ear that you want to come out of your child’s mouth. Name the object your child is looking at. Name the action your child is using with the object. If your child is looking at what you are doing, describe it. If your child is looking at you, say something. Act as your child’s narrator or translator; name what your child is looking at, playing with, touching, or using.
How complex should your language be? For children who are not talking yet, you want to keep your sentences really short and to the point. Limit your language to simple words and short phrases to capture the key nouns and actions of your child’s movements.
Activity: Make Your Language Just a Little More Complex Than
Your Child’s
In general, you want your language to be just a little more complex than your child’s. If your child doesn’t talk yet, or if your child is just beginning to use words, then these one- to three-word phrases are just about right.
Here are some ideas:
Name people:
“There’s Mama!”
“Hi, Daddy!”
“Grandma’s here. Hi, Grandma!”
Label objects:
“It’s a ball. See the ball.”
“That’s a doggie.”
“That’s the light.”
Label actions:
“Bang, bang, bang the drum.”
“Jump, jump, jump” (on the bed).
“Splash, splash” (water in the bathtub).
“Pour the water” (from cup to cup in the kitchen sink).
“Water on” (as your child turns the faucet on). “Water off” (as she turns it off).
You can think of a simple vocabulary of the words you want your child to learn, and then use those words frequently (many times a day) until your child learns them. Provide words for the objects and actions your child encounters in daily life. Everything needs a name—sensory social routines, foods, toys, people, and pets—and actions are important to highlight as well as names of things. There is no need to focus on colors, counting, or letters for children who are just beginning to talk. Those will come later. In the beginning, focus on names, labels for objects, and actions of the objects and activities that engage your child.
Sixteen-month-old Manuel’s parents do an excellent job of narrating his activities. They use a mixture of Spanish and English, just as they speak with others in their family. It is quite important to their family to raise bilingual children, since the grandparents speak only Spanish. Manuel’s brother also has autism and speaks both languages well, so the parents are confident that Manuel will also learn both. Here is what Manuel’s father says as Manuel is playing with a ball maze on the coffee table.
Manuel goes to the coffee table and begins to put a ball in one of the holes that is part of the toy on the table. His father, Ramon, goes over to the coffee table and sits on the floor across from Manuel (he is now at eye level and close). Ramon places a ball—“Pelota aqui [Ball here]”—as he points. Manuel hammers the ball; Ramon accompanies with him “Boom, boom, boom.” Then he asks for the ball—“Dammi a Papa? Pelota? Gracias [Give to Papa? Ball? Thank you]”—as he reaches out his hand and Manuel gives it. Manuel pushes several balls into their holes. “Push, push,” says Ramon.
Then Ramon picks up the hammer and a ball. He offers both to Manuel, while saying, “Te quieres, Manuel? Quieres pello or pelota?” Manuel reaches for the ball. “Pelota? Si? [Ball? Yes?]” As Manuel takes it, Ramon says, “Si, la pelota. [Yes, the ball.]” Manuel reaches for the hammer, and Ramon says, “Quieres pello. Aqui e pello.” Then, as Manuel hammers the ball, “Bang, bang la pelota.” Then he asks for it: “Dammi a Papa” [Give to Papa], aqui [here],” as he points to his hand. He says, “Thank you,” as Manuel gives it to him. “Papa’s turn,” Ramon says as he hammers: “One, two, three!” Then he says, “Manuel’s turn,” as he hands it over to Manuel. Manuel bangs the hammer: “Bang, bang, bang.” Ramon offers a ball—“Manuel, pelota?” He gives Manuel all three balls, and as Manuel puts them in the holes he counts: “Uno, dos, tres; tres pelotas [three balls].”
In this narration, we see all the features we have discussed. Ramon, the father, uses simple words and phrases to describe all of Manuel’s actions and the objects that he is looking at. He takes turns with his son and uses simple language to accompany his own actions. His language is repetitive, and his sentences are generally one or two words long, just right for a child who is not yet speaking. He uses sound effects (such as “Bang, bang”), ritualized phrases (“One, two, three”), and simple gestures (such as extending his hand) when he makes a request of his son. He helps Manuel follows his simple verbal instructions, and he uses a happy, positive voice throughout.
Ramon also joins Manuel in an activity that Manuel has chosen, and he positions himself so that he can easily follow Manuel’s actions and gaze so he can label just what Manuel is focused on at that moment. This is what we mean by “narrating your child’s activity” at just the right level for this child. In this episode Manuel vocalizes only three times (we have not described these here). However, within 1 month, Manuel is imitating many of these words and is initiating some of them as well: “One, two, three,” “thank you,” “ball,” “please,” “mas [more],” “agua [water
],” and several other words in both languages. At 18 months he is well on his way to becoming a verbal child, and at 22 months he speaks in short Spanish and English phrases, has well over 50 words, and understands his parents’ simple speech in both languages.
Step 5. Add Sounds to Gestures
Rationale. We have been talking about how to help your child do three things: (1) develop more sounds and words; (2) develop the ability to “turn on” his voice; and (3) make words or sounds back and forth with you and others in vocal play—“mini-conversations.” For children who can do these three things, the next step is adding gestures to their sounds, to increase their nonverbal communications. We talked about how to build up your child’s gestures and body language in Chapter 7. Now it’s time to put sounds to those gestures.
To help your child learn to put word approximations or sounds to gestures, you will need to model the skill very consistently. The procedure should follow these steps:
1. Choose a gesture and a word or word-like sound that your child uses frequently, and model them together.
2. Add sounds or simple words to accompany all your child’s gestures.
3. If your child is making sounds but not words with her gestures, add word approximations—nouns or verbs—to the simple sounds.
Here are some ideas for carrying out this sequence:
Choose a gesture and word or word-like sound to target. Pick a sound your child can already produce. Now choose a gesture your child already uses frequently that the sound could easily be paired with. Let’s say, for example, that your child has learned to consistently reach or point to an object to request it, and that your child makes many requests by pointing every day (because you are offering many choices every day—good for you!). Now think about what sound or word your child uses that could be paired with a point. Does your child say “da”? Is “da” something your child can repeat after you? If so, it’s a great choice for pairing with a point—it’s close to the word “that.” What about “ah”? Can your child repeat “ah”? It also sounds a little like “that.”
An Early Start for Your Child with Autism: Using Everyday Activities to Help Kids Connect, Communicate, and Learn Page 35