Children with difficulty developing verbal speech are often in need of aides or devices to help them understand and use language. For these children, schools often use programs like PECS (Picture Exchange Communication System) to help grow language and comprehension, along with visual strategies and signs. Some children have problems maintaining attention when they have to manipulate the pictures in PECS or motor plan for signing, so other supports are brought in. Many devices have symbols and/or voice output when touched or typed. Regardless of the system chosen, the direction for, and purpose of, it should be clear and followed by the school and home team.
All and any systems used should be both a therapy tool and a communication support. When used correctly and consistently the child will come to understand the relationship between an item, word or icon and the outcome they generate by choosing it. This creates a living experience for them that connects the meaning of a communication act (pushing the button, making the sign, finding the picture) with accessing their needs. A positive outcome increases their motivation to continue using the system or process. The only time a system should be used as a communication substitute is when an individual is physiologically unable to produce voice and/or speech.
Over the years I have seen many unusual and surprising outcomes in clinical cases. After working with one child for a year with little success in developing verbal/vocal speech, his parents started him in a tutoring program for signing. After two weeks of intensive support from the tutor, he began signing and talking up a storm! This system opened his ability to speak. Another child demonstrated such high internal distraction and verbal apraxia that a device was ordered and accessed as a communication tool. After six months of consistent and daily use he began speaking and communicating verbally! The device opened the path towards verbal/vocal speech. One young adult was diagnosed with Selective Mutism, a condition where there is no obvious reason for lack of speech. A small device was implemented to help him produce quick responses and make simple requests. These instances helped him feel better about communicating and interacting with people in general and he felt more optimistic about working on his communication with a therapist. In all these cases the chosen system was both a support for communication and a therapy tool.
We all learn in different ways. Some of us need to learn something in many ways and mediums in order to fully benefit from the learning. You know your child or young adult. By working closely with teachers and therapists you trust, you will find the system that holds the key to their door of comprehension. Once your child “gets” the system and the advantage of language, they will move forward on their own with your support.
Sharon Hensel-Cohen, MSCCC, Director of Nicky’s World, is a licensed Speech/Language Pathologist in private practice. [email protected]
