Communication for children with Autism Spectrum Disorder (ASD) does not come easily. There is a varying degree of how much speech a child has, from non-verbal to having speech but rarely speaking spontaneously or speaking a lot without keeping in context of the conversation. They may not make comments, ask questions and they find it difficult to use appropriate language.
As parents are usually eager to help their child to speak, they would ask questions to tempt them to talk (e.g. "What is it?" "How many dolls do you have?" "Do you want the noodles?"). It is also common for parents to insist on making their child to speak (e.g. repeatedly asking them to say the word "cat"). Interactions like these are setting up the child to only respond rather than be the initiator of conversation. Hence, a good way to approach this is with a technique we use in ABA therapy called "Communication Temptation" (CT).
So what is communication temptation?
Just as the term suggests, Communication Temptation (CT) is when the environment is set up so that the child has opportunities to initiate speech and it also improves and encourages spontaneous speech in a fun and functional way. A child is more likely to communicate when they have reasons to do so. It gives the child the appropriate language for situations they may encounter in their daily lives.
Types of communication
Communication itself has a few components and they are:
1. Requesting: "I want to eat the chocolate."
2. Question asking: "Where is the glue? / What is it?"
3. Commenting: "There is something on your face/Look! It's a plane!"
4. Directing: "Pour the water into the cup"
5. Reporting: "I played hide and seek with Adam yesterday."
6. Assertiveness: "Hey that's mine!/Stop it!"
Among all those above, teaching requesting is often the simplest to start off with. Here are a few steps you can do to teach your child a specific target.
1. Deciding on a target
Using your child's favorite toy or food makes for a good target to start with. Your child may request for "ball" if his/her favorite toy is the ball. If your child has speech but tends to only speck in single words, you may expand their language "I want the ball" and then to "I want to play with the ball." You can even get your child to ask "Can I play with the ball please?" if they are capable of asking questions. Remember, choosing a target is based on how motivated your child is to request for it so that the chances are higher for them to speak spontaneously.
2. Setting up the environment
This is where you set up the 'temptation.' Start by choosing an activity that your child enjoys. For example if your child likes to play with a basketball, you might want to start bouncing the ball or basketball with the other sibling(s) in front of your child. When your child reaches over to grab the ball, you may pull your hand back a little and teach them to say "ball/I want the ball/Can I have the ball please?" before allowing them to take it / giving it to them.
Remember, the target has to be motivating for the child to request or speak for it to be spontaneous - if not, they may be only dependent on your help/verbal prompt.
3. Use the power of communication
Initially you need to check if your child knows the targeted word. If they do not, then you would need to model the correct phrase to say in order for the child to learn to associated the word to the item. Hence, the timing of giving them the item once they have said the targeted word is crucial for the association of the sound of the word to the actual item.
You may start with giving them a few rounds of free access to the item and when you feel ready to increase the requirement you may want the child to imitate the sound of the targeted word. Once the child reaches out to grab the item, hold their hand and model the correct phrase for them. Pause and wait for the child to imitate that sound and re-articulate the targeted word before immediately providing them access to the item.
-You are playing ball with the child
-Child is reaching out to grab the ball
-You hold back the item and say "ball."
-Wait for the child to say "ball."
-Immediately give access to the ball
Here are a few things to note:
1. It is okay if the child does not imitate the word accurately as we are working on him speaking spontaneously first.
2. We do not correct the child if they have difficulty saying the target word as it might demotivate them to speak spontaneously.
3. Re-articulation is important as it lets them know what is the sound or word that we want them to speak.
4. Fading off the prompt
If your child shows that he understands the concept of "word = I get what I want", you may consider thinking of withholding your prompt and wait to see if your child would say the word independently.
5. Practice, practice and practice
With more repetition, your child will be able to make the association faster and learn more efficiently. Create opportunities to practice whenever it is play time, or include it in activities. At least 10-20 minutes a day of practice would be good practice for your child.
Once your child is able to spontaneously request from you independently, the child needs to practice the skill with other people as well as with other items. This means you can get other family members/teachers to practice with your child or move on to other items or even in different settings.
Happy practicing! :)