Early Intervention Strategies to Promote Communication Behaviors

Look what is this

Editor’s Note – This article was submitted by Louise Southern, M.Ed., BCBA, Training Specialist for the Autism Society of North Carolina.

When we are called upon to support young children with Autism Spectrum Disorder, we often find that a key area of focus is communication. Communication can mean many things, and it is not only characterized by what a child expresses – or tries to express – verbally. Communication is often composed of nonverbal behaviors such as gestures, facial expressions, body orientation, and even tantrums or other behavioral “displays” that we don’t want to see. These nonverbal communication behaviors, perhaps more so than what a child can actually say, moderate the quality and functionality of their communication.

Communication Exchange: Communication involves an exchange between two people. One person sends the message, but another person has to “receive” it. Without this exchange, how can the child’s communication be functional? Consider a child who can imitate what others say on command and yet does not use gestures or body orientation to communicate intent. The child might verbalize requests for what he wants but does not direct his communication to anyone.

Joint Attention: Joint attention occurs when two people share interest in an object or event at the same time, and there is understanding between the two people that they are interested in the same object or event. Now consider the child who sees a big dinosaur in a book but does not ever draw your attention by pointing to the dinosaur and then looking to you. And when you point to the big dinosaur in the book and exclaim “look at those scary teeth!” the child does not look at the dinosaur, nor does he then look to you with similar affect to share in this potentially social experience. Joint attention deficits in young children are some of the earliest indicators that a child might have Autism Spectrum Disorder.

Social Motivation: Down the road, consider how deficits in these areas would affect an individual’s performance in nearly all domains: social, educational, employment, etc. Thus, it is important to focus on the development of these nonverbal behaviors (e.g., gesturing, shifting attention to the other person) in young children, as they are foundations to communication and socialization. In many cases, the strategies we use to target communication in young children draw from developmental and behavior analytic approaches such as the Early Start Denver Model (ESDM) and Pivotal Response Treatment (PRT). Such approaches hinge on the understanding that the fundamental deficit of social motivation should be addressed through joint activity routines that build reciprocity and sustained engagement with another person.

Focusing on these early communication behaviors does not mean sitting a young child down at a table for extensive practice drills. Rather, these behaviors are most effectively and appropriately targeted in the context of naturalistic, highly motivating sensory and play-based routines that you expand over time.

A routine might start as:

  1. Build block tower, taking turns.
  2. You slowly drive your car towards the tower, as if you will crash it.
  3. Crash the car if the child expresses any sign of interest.
  4. Repeat routine, assessing motivation along the way.

Or as another example, a routine might start like this:

  1. Child is sifting mulch outside, so you do so as well.
  2. Lift hand up, say “1-2-3” and pour mulch onto the ground again.
  3. If child shows any signs of interest, try saying “1-2-3” and slowly pour mulch into the child’s hand.
  4. Repeat if the child shows any motivation to continue.

Start simple, and recognize that baby steps (such as a few more seconds of engagement with the child in each activity, a glance toward you or the activity, a reach, a faint smile) are still progress.

Below are a few basic guidelines when targeting communication behaviors within play and sensory-based routines:

  • Start with the child’s interests. What does he do in his free time, what materials does he use, how does he use them? If it’s a train set, start there. If it’s mulch or string, start there. If it’s jumping and spinning, start there. We cannot impose upon children what we think they should be playing with, if that is not where their current interests and skills lie. In order to teach the power of communication, the child has to be motivated to engage and to communicate something.
  • Arrange the environment to control access to any of these preferred toys or materials so that the child has to communicate with you – not necessarily through words – that he wants the item. Otherwise, if he can freely access the things he wants, what does he need you for?
  • If possible, break up the toy or item into parts, to allow more opportunities to target a nonverbal behavioral request such as a fleeting glance, watching, reaching, or pointing. For example, if the child is motivated to sift through Legos, don’t give him all of the pieces at once. Give a piece or two, then pause and look in anticipation. Immediately reinforce any gesture, look, or action that might mean “I want more” by giving the child more of the item.
  • Once the activity has started, imitate the child’s actions to capture his attention. Look for any sign of shared affect and engagement, even if it is fleeting.
  • Playfully add one action to the routine that might interest the child: swirling the string; fingers moving to tickle the child; dropping the figurine into the water – splash!; singing as the child jumps on the trampoline. Then after a moment or two, pause, wait, and look in anticipation to see whether the child expresses any motivation for you to continue or repeat the action. Reinforce any nonverbal communication behavior by immediately continuing the action with lots of enthusiasm. This is how we begin to shape communication behaviors in these motivating contexts.

ASNC’s Clinical and Training Department staff is composed of PhD and master’s-level licensed psychologists, Board Certified Behavior Analysts, and special education teachers. We provide workshops (e.g., Early Intervention Strategies for Parents and Professionals) and individualized intensive consultation using evidence-based practices to support children and adults across the spectrum in home, school, employment, and community-based contexts. For more information on our consultative services, contact Dr. Aleck Myers at amyers@autismsociety-nc.org.

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: