So, what are the important steps in building functional communication?
1. Building Communicative Intent: Intent can begin with looking at a wanted object, pointing, making a sound, etc. It means communicating or “showing” a want or need. Every human being has highly preferred items (food, game or toy, certain people or animal, swinging, etc.) that can be used to target communication. Knowing that a child loves chips or gummy bears, or to play with his or her favorite toy gives us a starting point for communication. Those would be the first words we would teach repetitively, with pictures, words, and the object itself.
Getting a nonverbal child to request a wanted item for the first time by pointing to a picture, vocalizing the beginning sound, or making some form of gesture toward the object is a feeling that can match no other! Sometimes, we can approach this from a different perspective ~ avoiding an unwanted activity. For instance, if given the choice to a) do work; or b) play with favorite toy, most children will certainly make an effort to make their choice known! This has been called “friendly sabotage” and it means just what it sounds like ~ harmless trickery to get someone to do something we want them to do!
2. Teach the Vocabulary through pictures and words (also signs if desired): Here is the part that I see gets missed many times in our quest to teach functional communication. We print up a bunch of picture symbols, put them into a communication book, and we expect the child to know the meaning of the symbols because the picture makes sense – to us! Better yet, we load our favorite new Assistive Technology app onto an iPad and expect that we will be having a wonderful conversation with our pre-verbal child by dinnertime. My favorite analogy for this is handing a dictionary to an adult and expecting them to know and understand every word in it. Each symbol must be taught, used functionally, and become part of a child’s repertoire of vocabulary before it will be a word they utilize to communicate something to us. Begin with no more than 6 picture icons and build slowly from there. This is the KEY to building a child’s vocabulary, whether verbal or nonverbal!
3. Teach requesting by making a choice: This is one of the first ways we can tap into communication – choice making. Do you want the pretzels or the broccoli? (Wanted item vs. unwanted item). Then we can move to two preferred items – Do you want the pretzels or the fruit snacks? Usually we can use food for this step but toys or other preferred items can be used as well.
4. Begin generalizing across settings: If you started choice making at snack time, begin doing this at all meals. If you are at the grocery store or Grandma’s house, offer choices there as well. Start looking at picture books that have pictures of these foods that you can point out and label. Point to the real objects wherever you see them.
5. Show icons on pages or schedules: Once this picture and word system has been used for a while, you can begin building into familiar activities, such as a daily routine or schedule. Breaking down a routine, such as brushing teeth and labeling each part of the process (sink, faucet, water, toothbrush, toothpaste, rinse, etc.) can all be put on a page as a “sequence of events”. Putting a schedule of the day on the fridge that shows what the child’s morning routine or will look like (eat breakfast, brush teeth, get dressed, go to school). Another simple page or board to make is first/then with picture icons (ex: first – dinner, then – dessert).
6. All caregivers should be on board: At home, at school, with anyone that your child spends a good amount of their time with. All should be modeling use of language in the same way – repetition and high-exposure to new vocabulary is the foundation of building communication.
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