Q: My child is 2 years old and only says a few words, but knows several signs. He gets very frustrated and has tantrums when we do not know what he wants. How can we help him?
A: This is not an uncommon situation for parents of children who have difficulty communicating. It can be frustrating not only for the child, but for those involved in the child’s care, as
well. In order to alleviate the frustration, I recommend placing the focus on the message your child is trying to communicate rather than on the way they are communicating. In other words, the goal is to increase your child’s ability to communicate in whatever way is available to them rather than focusing on the words they use. Assign meaning and attend to all of your child’s natural communication behaviors. These natural communication behaviors do not require any additional equipment and are referred to as "unaided." Unaided communication includes:
• Facial expressions: smiling, pouting, sleepy expressions, etc…
• Proximity: moving close to something you want and away
from something you don’t want
• Eye gaze: looking at something you want
• Conventional gestures: lifting arms up to say, "pick me up," pointing, nodding/shaking head, curling fingers repeatedly to say, "Come here," etc…
• Sign language (A WORD of WARNING: If using signs, teach content words rather than "more" and "please." These signs become "catch alls" and you will eventually find yourself in the frustration cycle. Your child is signing "more" and you have no idea what they want more of. The frantic search is back on and you will find yourself pulling everything out to see if they want more music, cracker, juice, etc… Teach your child the sign for the actual item/activity. If your child wants music, teach the sign for music rather than the sign for more. This will help to improve their expressive and receptive vocabularies. Sign language dictionaries are available at local bookstores and
libraries as well as online.)
• Vocalizations
• Words and word approximations
It is important that you acknowledge your child’s vocalizations, facial expressions, gestures, and other nonverbal signals. Respond to these behaviors as if they are communicative, even if you aren’t sure it was intended. Your feedback will reinforce your child’s efforts to communicate with you.
You may also want to introduce some aided communication techniques. Aided communication strategies require additional equipment. This equipment can be low tech (objects, photographs), or high tech (voice output communication devices). Below are some
ideas to try:
• Offer your child choices by holding up two objects.
• Find pictures of things your child really enjoys and put them in a small photo album, or other type of book. This will become their very own communication book. They can flip through the pages to find the item that they want.
• Find pictures of food your child likes, place a magnet on the back and keep them on the fridge. Your child can go to the fridge and
select a picture when they are hungry.
The ultimate goal is to help your child learn to talk. However, it may take some time for their natural speech to develop. In the meantime it is important to find alternative ways for your child to communicate. This will help reduce the amount of frustration your child experiences. Although, some examples of aided communication were provided, it is strongly suggested that you contact a Speech Language Pathologist in your area with knowledge of Augmentative and Alternative Communication (AAC) strategies to formally assess your child’s abilities. They will be able to help you select the appropriate system for your child, set it up and train you and your child how to use it. To find a Speech Language Pathologist near you, visit the following link:
http://www.asha.org/findpro/. Then, click on find a professional. To find out more information related to AAC, you can visit the following link: http://aac.unl.edu:16080/yaack/.
Children communicate in a variety of ways. It is especially important to pay attention to all of these signals when your child is not able to
use words to communicate their wants and needs.
Katie Barsness, M.S., CCC-SLP
Speech Language Pathologist
Augmentative Communication Specialist
Riley Hospital for Children
(taken from the Down Syndrome Indiana newsletter)