Our second installment of a 4-part series focusing on communication in children with Autism Spectrum Disorder (ASD) focuses on the emerging verbal stage of development.
Children on the autism spectrum who are in the “Emerging Verbal” stage of language acquisition are just beginning to acquire single words and some 2-3 word phrases and are using them to communicate with the people around them. Their vocabulary is still quite limited, but they are beginning to use words functionally, i.e., for specific social purposes. They have acquired what is called “intentional communication” and are beginning to communicate for a variety of functions including requests, comments, asking questions, greetings or a number of other communicative functions. (Part 1 of the series: Pre-Intentional/Pre-Verbal)
Children at this level may or may not be consistently combining their words with eye contact, but they are clearly directing their word(s) to another person and are expecting some type of response or reaction. Young children with an autism spectrum disorder who are just beginning to use words are often relatively good at labeling things, such as names of foods, shapes, animals, colors, and letters, but are less likely than typically developing children to use their emerging vocabulary in a social context.
Children with ASD often have difficulty with the nonverbal aspects of communication including decreased use of gestures to compensate for verbal difficulties and decreased or inconsistent use of eye contact and facial expressions. This is a critical time to teach the child with autism the “magic” of communication and how using their words can bring them not just things, but interactions with others that provide pleasure, excitement, and emotional connections to others.
Strategies to Support Continued Language Development at this Stage
Children at this stage need continued encouragement to use their words for a variety of purposes and should be given multiple opportunities throughout the day to put their words to use in more ways than simply labeling things they see. The idea is to generate opportunities in a variety of settings for a variety of purposes, with a variety of people. Here are some suggestions about how to accomplish this:
- Find creative ways to structure the environment so your child will be in a setting where one of his words could be useful for a specific function, such as requesting an action or object. For example, if he knows the names of a number of colors, provide an opportunity where he can specify the color of a toy or item of clothing he wants. If he says “blue,” model the phrase “want blue” or “blue car,” and then give him the blue car. Then find another context or setting in which to use the word blue, perhaps for an M&M, crayon or a hat.
- Put items your child is likely to want into containers he cannot open by himself, so he will need to come to you for help, and you can then model the word “open,” which is a request for an action. Once he has acquired the word “open,” find opportunities to use that word in a variety of contexts, such as opening the car door, the front door of the house, the refrigerator, and the kitchen cabinet. Have your child use the word with different family members. Set up a series of containers that he can ask you to open (“open box,” “open jar,” “open bag”) to find a surprise in each one.
- Target question-asking by setting up situations that will evoke a question. For example, put a small toy or edible in a bag and shake it, then model the question, “What’s that?” or “What’s in there?”
- Target requests for social routines your child enjoys, such as tickling, chasing or hiding. Start by engaging in the enjoyable action, label it as you are engaging in it with the child (e.g., “tickle, tickle”) several times, then stop and wait for the child to say “tickle,” and then tickle him again.
- Social commenting can be encouraged by using the child’s interests and modeling showing of objects and pointing out objects that your child finds interesting. If your child attends school, find out what themes will be presented and try to use at home (e.g. songs, books, etc.). For example, if the theme at school is “animals”, read the book “Brown Bear, Brown Bear” at home, look at pictures of animals on Google images or in picture books. Pictures of preferred animals can be hung around the home to provide opportunities for showing to share interest and social commenting.
- Target calling an adult to obtain their attention. Have one parent (dad) hide under a blanket while the other parent (mom) stands a few feet away with the child and models calling the parent under the blanket (“Daddy!”). Then daddy pops out from under the blanket and runs over to the child and tickles him or throws him up in the air.
The Focus of Speech-Language Therapy at this Stage
The focus of speech-language therapy and home practice at this stage should be to develop a truly functional vocabulary for the child that can be used for multiple purposes in multiple settings, with multiple people.
Simply adding more words to a child’s vocabulary through use of flash cards or drills does not lead to functional communication.
Better that a child has a vocabulary of 20 words that he can use in various settings for various purposes with a number of different people than that he have 100 words he uses primarily to label things. Children who learn more communicative functions in social contexts are acquiring the skills they need to move into the next stages of language development: Verbal and Highly Verbal/Social Pragmatic stages, which will be covered in the blogs to come.
Part 1 in Series: Pre-intentional/Pre-verbal
Part 3 in Series: Verbal
Part 4 in Series: Highly Verbal
Do-Watch-Listen-Say: Social and Communication Intervention for Children with Autism, by Kathlen Ann Quill
An Early Start for Your Child with Autism: Using Everyday Activities to Help Kids Connect, Communicate and Learn, by Sally Rogers et al.
More Than Words: A Parents Guide to Building Interaction and Language Skills for Children with Autism Spectrum Disorders or Social Communication Difficulties, by Fern Sussman (available at www.hanen.org)
It Takes Two to Talk, by Jan Pepper & Elaine Weitzman
Beyond Baby Talk, by Kenn Apel & Julie Masterson
Early Intervention Games, by Barbara Sher
Relationship Development Intervention with Young Children: Social and Emotional Development Activities for Asperger Syndrome, Autism, PDD and NLD, by Steven Gutstein