Vol. 3, No. 3, May/June 1995	Previous Issues Subscribe to AT Messenger Download PDF Viewer
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Children Learn About Communication by Communicating

Maureen T. Schweitzer, MA, CCC/SLP
Coordinator, Kent County ATRC

Speech and language development is a complex process. It becomes even more complex when a child does not use speech to communicate his/her needs. There are so many unanswered questions related to why some children are not able to use speech to communicate. Once we get beyond the why, it is important to know what options these children have. My experience with a three-year-old describes some options and considerations.

Liz has a diagnosis of global development delay, which means that she has delays of an unknown cause. She can walk and run; she can feed herself, and recently, she learned to put her coat on. Her hearing is normal, and she follows directions pretty well for a child her age. She attempts to say a lot of words, and usually, you hear the first sound of the word, but many times the other sounds do not come out. When she was 2-1/2 years old, her parents were concerned with her development. At that time, Liz had started to show her frustration with her inability to speak by grabbing her face, which left bruises. She started receiving speech-language therapy, and although she continued to have difficulty getting her mouth to do what she wanted it to do, she learned to use signs and gestures. She was more successful at imitating signs and gestures than imitating words.

The use of sounds and words along with signs continued to be encouraged. After 12 months, Liz was able to say 20 words, and she knew about 50 signs. She did not always use the signs, but she knew them, and there was a decrease in her self-abuse. There were still many times when she became frustrated, and she showed it. At that time, Liz started attending Easter Seals' integrated pre-school where she received occupational therapy, physical therapy, and speech pathology services. New signs were added to her repertoire, but signs were getting more difficult, requiring greater manual dexterity and coordination. Liz had difficulty saying and signing two words such as "more cookie" due to the motor planning requirements. It was clear that she needed another option to assist her in daily communication.

Pictures of various toys, foods, and shapes were introduced so that when Liz couldn't say the word or make the sign, she could point to a picture to communicate her desires. Liz had no difficulty using a picture to represent her requests. Pictures were used to request songs during Circletime. Otherwise, it would have been difficult for her to request "If You're Happy and You Know It." The pictures were part of an electronic communication device, which spoke the message "If You're Happy and You Know It" when Liz pushed on the picture. Liz has learned to use her picture communication system to say other things she couldn't say verbally or with gestures. She continues to use a lot of sounds and is using more signs without much encouragement. She now also uses the communication device for the more complex language activities, such as asking questions, counting, and saying the names of her friends in pre-school.

She continues to use a combination of sounds and signs at other times. There has not been a decrease in her efforts to use speech, but there has been a decrease in her frustration. She has learned to express anger without hurting herself. With the use of a combination of sounds, signs, and pictures, Liz can express so much more than she could six months ago. She has learned a lot about communication by communicating. In fact, she is much better at demonstrating how much she knows. Liz recognizes and spells her name and is learning the other letters of the alphabet using her signs and communication device. By the Fall, I hope that Liz will have her own communication device to take to her new school and to use at home. These communication options will enable her to express basic needs and desires, ask questions, provide information, and converse. Her use of a communication device is not an end. It is her means to an education, to medical and social opportunities, to self discovery, to independence, and to feelings of self-worth.

Liz will continue to receive therapy services. Her speech (vocabulary) continues to increase, but she vocalizes only single words which do not allow her to demonstrate what she knows. Liz will continue to use a multi-modal approach to communication. Her parents are very pleased with her progress and the fact that assistive technology was introduced at her young age.

If you have a young child and are concerned about his/her speech and language development, call a speech-language pathologist to help you. They are communication specialists! If you have any questions about communication devices, call your local ATRC for product information, demonstration, or loan. The Kent County ATRC is celebrating Better Speech and Hearing Month on May 24 by offering a workshop on "Augmentative Communication-Everything That Talks." Call (302)739-6885 for more information.