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The Non-Verbal Child

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    The Non-Verbal Child

    What to do when your special needs child is nonverbal?

    We have four children, ages 6, 4, 3 and 1. Our four year-old has autism and is nonverbal. He has been so far unable to use any type of communication system, such as PECS or sign language. We struggle to communicate with him and just manage to satisfy his basic needs and wants through trial and error, as well as allowing him free access to different items so that he can choose for himself.

    Only our 6 year-old is receiving formal schooling right now. Starting next year, we'll be switching him to the MP curriculum. Part of the reason (beyond the fact that I think it's absolutely wonderful) is that it's more "open and go." I need less planning time in order to work with all of the kids.

    I've been excitedly following the special needs curriculum thread, but I'm a little disheartened because I just can't see our four year-old doing any of the work. I purchased your book, Cheryl, and was very inspired. What I've done so far is invest in quite a few CDs and educational DVDs that we listen to and watch in the car as we drive back and forth to therapy. I know that all of the kids enjoy them very much, but I can't figure out how to determine whether our SN child is achieving any understanding.

    Advice? Commiseration? Anything is appreciated.

    #2
    Michelle,

    Thank you for your support and for your post. You ask a very good question. You are certainly not alone in your concern for a non-verbal child's education.

    You can take comfort in knowing that you already help him by focusing on good language input in these ways: therapy sessions, CD's on trips to and from therapy, and a language-rich home with a homeschooling mom and three siblings! However, I understand and appreciate why you want to do even more for him.

    If you do not mind elaborating, does your son receive other therapies beyond language therapy? Are you satisfied with his current speech and language therapist?

    Has anyone tested his intelligence, perhaps with a nonverbal scale? Even if the results change over time, a knowledge of his current general level of cognitive functioning would be helpful for us, as we “meet” your son and try to help.


    For embedded advice, please see a thread entitled “little ones...” currently located on page 2 of our Struggling Student Forum. In this thread, as in others, CelticaDea offers helpful insights within her posts. For example, in her own family she observed that when a child does not possess normal expressive language, sometimes we neglect teaching other “normal” milestones or expectations, such as manners; yet even for the nonverbal child these must be taught, if only in a basic way.


    As we await your answers, rest assured that truth, goodness, and beauty will be important even for a nonverbal child, simply because he is human. The components we plan to include in the upcoming special-needs packages – poetry, manners, prayers, and elegantly illustrated children's books – may benefit your son's receptive language, even while he struggles to develop expressive language.

    If you can share a few more details, perhaps we can be more helpful. Others may have suggestions for you. Please elaborate if time permits.

    Thanks again -

    Cheryl


    Simply Classical: A Beautiful Education for Any Child

    Cheryl Swope, M.Ed., with Foreword by Dr. Gene Edward Veith
    www.memoriapress.com, www.cherylswope.com

    Comment


      #3
      Thank you for your response, Cheryl.

      He currently receives ABA therapy for 12 hours per week. They work on communication, social skills, and eliminating problem behaviors. We have not had a good formal assessment yet, but we are on a wait list to get him in to a neurodevelopmental pediatrics clinic in March. I'm hoping that he'll have a whole battery of tests then and that we'll have a better working understanding of what his strengths and weaknesses are.

      He's a tough one because he is so hard to read. He enjoys being around all of us, but limits his interaction to physical play. He loves to flip through picture books, but will close them up immediately and walk away if we try to sit next to him and read. The one "academic" activity that he consistently enjoys is sitting with me while I click through the colors and letters on Starfall for him. I know he has picked up his colors from there and some letters, but he doesn't "perform." If I ask him to point to blue, he'll shake his head and point to red because he wants to see red, not blue.

      We get little flashes from him sometimes. For weeks, I worked with him on writing letters hand-over-hand on a Magna Doodle. One day, he walked over to me with it and he made a perfect 'C.' He knew it too! He had a big smile on his face. But that was a year ago and he's never done it since.

      We do have to remind ourselves to treat him like a four-almost-five year-old. It's hard to remember because he doesn't talk. My rule of thumb is that if I expect our three year-old and one year-old to do something, I should at least attempt to have him do the same. Sometimes that works, but sometimes not. He sort of drifts through his day and doesn't seem to have the same internal motivators that the other kids do when it comes to things like self-care.

      He is a sweet and happy child, though. Very affectionate to my husband and me. I just want him to have a beautiful life. I know we'll know more once he's been assessed, but I feel almost like I need permission to NOT focus on academics, if that's what it comes down to. If he's never going to have the capability of reading or writing, I don't want to frustrate him by continuing to push. At the same time, I don't want to short-change him and underestimate him! It's just so hard when he doesn't talk.

      Comment


        #4
        Dear Michelle,

        My daughter and I were resting and catching up at home today from a 24-hour overnight EEG. Even though I am only now responding, you have been on my mind all day.


        Thank you for your answers and clarifications.

        This is especially encouraging:

        "He is a sweet and happy child, though. Very affectionate to my husband and me."

        With any special-needs child, the missing skills and abilities can become our focus. In fact, your son's own lack of verbal language reminds us how powerfully words impact our own communications! However, your son's communication in any form -- even nonverbal -- offers hope, especially because of the affection shown.

        See this statement excerpted from a study published this year by the American Academy of Pediatrics http://pediatrics.aappublications.or...t/131/4/e1128: “'We found that nonverbal intelligence was the strongest predictor of phrase speech, while social interest and engagement were as robust, if not greater, when predicting the age that children attained phrase speech and fluent speech,'” said Ericka L. Wodka, Ph.D., a neuropsychologist in Kennedy Krieger’s Center for Autism and Related Disorders and lead study author.

        If your son is evaluated in March, you can ask about this. You can request specifically that the examiners assess his nonverbal communication skills.



        You write:
        He currently receives ABA therapy for 12 hours per week. They work on communication, social skills, and eliminating problem behaviors.


        When you stated in your first post that your son received therapy, I assumed Speech and Language Therapy rather than Adaptive Behavior Analysis (ABA) training. If your son has not yet received an evaluation by a speech and language therapist, this might be something to pursue. You might be able to obtain such an evaluation quickly, even as you wait for your visit to the pediatrics clinic. You can use the suggestions from the assessment chapters of Simply Classical to prepare for the evaluation. You might consider doing the same with an occupational therapy evaluation, especially for any sensory issues, as good occupational therapy can help reduce any sensory-related obstacles to teaching him.



        You also note:

        We have not had a good formal assessment yet, but we are on a wait list to get him in to a neurodevelopmental pediatrics clinic in March. I'm hoping that he'll have a whole battery of tests then and that we'll have a better working understanding of what his strengths and weaknesses are. He's a tough one because he is so hard to read.

        And you write:
        I know we'll know more once he's been assessed, but I feel almost like I need permission to NOT focus on academics, if that's what it comes down to. If he's never going to have the capability of reading or writing, I don't want to frustrate him by continuing to push. At the same time, I don't want to short-change him and underestimate him!

        Yes, the evaluation could be very helpful for this! In the meantime, you can give yourself "permission" to adapt your expectations until you have more information. You can even engage your son in some of the same activities as with your three-year-old or one-year-old. If you have an iPad, you could also try the new Speakall! app developed at Purdue and modeled after the Picture Exchange Communication System (PECS). A description:

        While in PECS the graphic symbol card is put on a “sentence strip” for static display of the symbol(s) and subsequent provision of the desired items, the SpeakAll! app displays a “sentence strip that does the speaking”: whenever a graphic symbol is dragged onto the sentence strip area, the iPad will speak out the symbol referent in the form of pre-recorded speech.



        Another technique possibly worth exploring is Auditory-Motor Mapping Therapy for nonverbal children. "Google" this and see what you think. On this forum of course we cannot recommend any specific treatments or offer any specific diagnoses, but these ideas appeared multiple times in searches and seemed as if they might be worth exploring through your son's own doctors or therapists.



        As you wait for evaluations, see also Seven Ways to Help Your Nonverbal Child, from AutismSpeaks, adapted for use here and originally posted by Autism Speaks Chief Science Officer Geri Dawson, PhD, and Autism Speaks Assistant Director for Dissemination Science Lauren Elder.

        When I read these, I especially appreciated #3 and #4. Even if these strategies do not produce verbal language, you can document the effectiveness and responses from each strategy before your evaluation, as this will provide the evaluators with more information about your son. Some of these might even elicit improved nonverbal communication:

        1. Encourage play and social interaction.
        Interactive play provides enjoyable opportunities for you and your child to communicate. Try a variety of games to find those your child enjoys. Examples include singing, reciting nursery rhymes and gentle roughhousing. During your interactions, position yourself in front of your child and close to eye level – so it’s easier for your child to see and hear you.

        2. Imitate your child.
        Mimicking your child’s sounds and play behaviors will encourage more vocalizing and interaction. It also encourages your child to copy you and take turns. Make sure you imitate how your child is playing – so long as it’s a positive behavior. For example, when your child rolls a car, you roll a car. If he or she crashes the car, you crash yours too. But don't throw your car!

        3. Focus on nonverbal communication.
        Gestures and eye contact can build a foundation for language. Encourage your child by modeling and responding these behaviors. Exaggerate your gestures. Use both your body and your voice when communicating – for example, by extending your hand to point when you say “look” and nodding your head when you say “yes.” Use gestures that are easy for your child to imitate. Examples include clapping, opening hands, reaching out arms, etc. Respond to your child’s gestures: When she looks at or points to a toy, hand it to her or take the cue for you to play with it. Similarly, point to a toy you want before picking it up.

        4. Leave “space” for your child to talk.
        It’s natural to feel the urge to fill in language when a child doesn’t immediately respond. But it’s so important to give your child lots of opportunities to communicate, even if he isn’t talking. When you ask a question or see that your child wants something, pause for several seconds while looking at him expectantly. Watch for any sound or body movement and respond promptly. The promptness of your response helps your child feel the power of communication.

        5. Simplify your language.
        Doing so helps your child follow what you’re saying. It also makes it easier for her to imitate your speech. If your child is completely nonverbal, try speaking mostly in single words. (If she’s playing with a ball, you say “ball” or “roll.”)

        6. Follow your child’s interests.
        Rather than interrupting your child’s focus, follow along with words. ...[N]arrate what your child is doing. If he’s playing with a shape sorter, you might say the word “in” when he puts a shape in its slot. You might say “shape” when he holds up the shape and “dump shapes” when he dumps them out to start over. By talking about what engages your child, you’ll help him learn the associated vocabulary.

        7. Consider assistive devices and visual supports.
        Assistive technologies and visual supports can do more than take the place of speech. They can foster its development. Examples include devices and apps with pictures that your child touches to produce words. On a simpler level, visual supports can include pictures and groups of pictures that your child can use to indicate requests and thoughts. For more guidance on using visual supports, see Autism Speaks ATN/AIR-P Visual Supports Tool Kit.

        The authors continue, "Your child’s therapists are uniquely qualified to help you select and use these and other strategies for encouraging language development. Tell the therapist about your successes as well as any difficulties you’re having. By working with your child’s intervention team, you can help provide the support your child needs to find his or her unique 'voice.'"



        Finally, you write:

        I just want him to have a beautiful life.

        We do too! Our forum followers have been very quiet this winter, but I believe that everyone reading is cheering for you and for your son. Do not give up yet. You are only in the beginning of this journey with your son. For many of us, the beginning is the hardest part. "Learning" your son takes time, but your upcoming evaluation(s) may provide some information to help you very soon.

        Our special-needs curriculum packages will begin with skills at the 2- to 3-year-old mental age level, so eventually we may even be able to help.



        This has been a long post, but I know how isolating everything can feel at the beginning and just wanted to fill in some gaps from my first response.

        A final note -- as we prepare for Christmas we often read from Luke. Your son reminded me of the passage our family recently read. Elizabeth's baby John leaped in the womb at the presence of the Lord. John had no language, but he heard the Word and was granted faith.

        As your son hears the prayers, songs and readings of the Christmas season, may he be granted mercy, comfort, and joy, even if he cannot express himself in words.

        Blessings to you --

        Cheryl

        Simply Classical: A Beautiful Education for Any Child
        Cheryl Swope, M.Ed., with Foreword by Dr. Gene Edward Veith
        memoriapress.com, cherylswope.com

        Comment


          #5
          Thank you so much! You've given me a lot to read and research. I truly appreciate your taking the time to provide all of this information for me. Thank you, thank you!

          Comment


            #6
            I know this is an older thread, but I wanted to give a sort of update or hope for a non-verbal child. My youngest has verbal apraxia and had been non-verbal. She's received lots of therapy and can now speak. Other people can sometimes understand her in context and if she speaks a bit slower. People who are used to her can certainly do better than outsiders. Even I still need her to point at times.

            A comment that one of her speech therapists (SLP) has said often is how impressive her vocabulary is especially considering the time she spent not saying anything at all that she had to make up for in developing language concepts. Sometimes the SLP doesn't think she translated my daughter correctly because she's not expecting the word she used.

            Just because they can't use all of language you are teaching them yet, you may end up surprised at how much they were learning. One day they may even get it back out for you to hear.

            Comment


              #7
              Originally posted by CelticaDea View Post
              A comment that one of her speech therapists (SLP) has said often is how impressive her vocabulary is especially considering the time she spent not saying anything at all that she had to make up for in developing language concepts. Sometimes the SLP doesn't think she translated my daughter correctly because she's not expecting the word she used.

              Just because they can't use all of language you are teaching them yet, you may end up surprised at how much they were learning. One day they may even get it back out for you to hear.

              This brought tears! Thank you for the update. Amazing.


              "This feeling began to agitate me with a vexing, forward-reaching sense of a lack that should be filled. My thoughts would often rise and beat up like birds against the wind; and I persisted in using my lips and voice...."

              Helen Keller, The Story of My Life, 77.


              Cheryl


              Simply Classical: A Beautiful Education for Any Child
              Cheryl Swope, M.Ed., with Foreword by Dr. Gene Edward Veith

              Comment


                #8
                Argh! I had a huge post typed out, but lost it. I just wanted to say thank you to CelticaDea for your post; it gives me hope. I also wanted to update and say we had a great appointment with developmental pediatrics. We're pushing for increased therapy hours (all will depend on our military insurance coverage that is about to go through a major upheaval this summer) and are on a waiting list for speech therapy. He should get in for an evaluation some time next month. Our doctor said that Oliver was showing many signs of language readiness and he was especially heartened by his receptive language skills and overall mellow temperament.

                I mentioned your book, Cheryl, to our doctor and he was very interested in it and in your recommendations and methods. He is the top neurodevelopmental pediatrician for the Navy and just a wonderful doctor all around. I also loaned my copy of your book to our ABA center so they can get a better understanding of the type of education we want for our son.

                Comment


                  #9
                  non-verbal

                  Here are a couple of the best things I did during the early years of my son's therapy.
                  (Background: Diagnosed with severe autism at age 2-1/2. He is currently somewhere in the mid-functioning range. Verbal, although his speech will never be completely natural. It is more like he has sentence formulas that he follows, and every new word requires a lot of practice. He has some good self-care skills, but will never be able to live alone, have a real job, etc...)
                  We used to post the homework that the SLP and OT gave us on the refrigerator, so we all knew what we were working on.
                  We learned to build up and break down what we said. In the very beginning that was: "Block. B-ock. Bl-ock. Blo CK. Now Finn says BLOCK." (It took him a long time to understand the concept of "you" and "me," and really all pronouns. Things had to be super concrete.) Later it was building up and breaking down sentences: "Do you want to go in the car? In the car. Let's go in the car."
                  Using ASL in addition to spoken words helped to reinforce concepts. All the teachers at his early intervention program were using it, especially for things like no, stop, play, sleep, eat, cookie, and lots of songs. I figured out the signs for books like Goodnight Moon, Time for Bed, etc... and would sign along while I read the books. He learned a few signs that he used consistently before his speech caught up. The other special needs parents and I would all joke that every kid in the school could sign "more."
                  We bought those Baby Einstein flash cards that had nice large print with the name of the picture. None of my typically developing children would have been interested in them. But my son would spread them out on the floor and look at them for hours, just puzzling it out. I would tell him the names of the pictures. One day when he was four, I started covering the pictures and he would read the word. It's apparently not unusual for autistic children to learn to read by memorizing the appearance of each word. So we put labels on everything. And really, who doesn't love to use their label maker?
                  Blessings,
                  Jude

                  dd 17
                  ds 14 (special needs)
                  ds 11
                  ds 9
                  dd 7
                  ds 4
                  dd 2

                  Comment


                    #10
                    Thank you, Jude!

                    He uses a few signs consistently (yes, "more" is one of them!). This week, he has shown more interest in using his Proloquo app on the iPad. Just today he was able to request water, cereal, and to play outside successfully. I'm hoping that his willingness to use his iPad is indicative of a greater interest in communication as a whole.

                    I had tried labeling things around the house, but the game became pulling off all the tags. I will search for those Baby Einstein cards, though, and add them to the Amazon cart.

                    Comment


                      #11
                      games

                      My neurotypical kids have made a game out of pulling down wallpaper. Because you know, if there is one tiny corner where it has started to peel, they are going to have to see how far they can advance it. So really, removing labels looks like a pretty good game in comparison.
                      My first child was one of those annoying, eager to please, gifted kids that did everything early. The kind that makes the other parents worry if maybe their children are behind. Then God, who definitely has a sense of humor, sent me Finn to show me what a silly ass I had been. Nothing teaches humility like eighteen months of trying to break your toddler from playing in his poop.
                      Your post reminded me that I have got to get a replacement charger for the iPad. Why do they make those charger cords so poorly? I have had to replace the cord for my Macbook twice.
                      Blessings,
                      Jude

                      dd 17
                      ds 14 (special needs)
                      ds 11
                      ds 9
                      dd 7
                      ds 4
                      dd 2

                      Comment

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