Strategies and activities to promote communication development in non-verbal or minimally verbal children with autism

Communication challenges are a hallmark of autism spectrum disorder (ASD) and present hurdles that can hinder social interactions, academic progress, and daily routines. However, within these challenges lie opportunities for growth, understanding, and empowerment. We will dive into what these challenges may look like, and effective strategies used to unlock the potential for communication in children with autism.

Timeline of Communication in Typically Developing Children

Communication begins in infancy, where a cry might signal hunger, comfort, and social interaction. Infants can also identify important sounds in their environment, notably the voice of their caregiver. As they grow, babies begin to distinguish between speech sounds, laying the foundation for language comprehension (National Institute on Deafness and Other Communication Disorders, 2022). 

Birth – 3 months

• React to loud sounds
• Recognize familiar voices
• Begin to smile

4 months – 6 months

• Track sounds with their eyes
• Respond to changes in vocal tone
• Notice light and sound toys

7 months – 1 year

• Enjoy interactive play (peek-a-boo, pat-a-cake)
• Respond to spoken cues
• Understand words for common items
• Communicate with gestures and various babbles

1 year – 2 years

• Identify body parts and follow simple commands/questions
• Enjoy stories, songs, and pointing to pictures in books
• Start using simple phrases and questions

2 years – 3 years

• Have words for most objects
• Use two or three-word phrases
• Speech becomes more clear/consonant sounds can be heard

3 years – 4 years 

• Responds to questions
• Talk about various activities
• Use sentences with 4 or more words

4 years – 5 years 

• Comprehend stories
• Communicate effectively
• Use correct grammar

Communication Barriers in Children with Autism

How well a child with ASD communicates may depend on how they’re growing and learning socially. 

Children with ASD may find it challenging to talk and understand what others say to them. They might struggle to use gestures, make eye contact, and/or use appropriate facial expressions. Some may not talk much or at all, while others may have a large vocabulary and want to talk nonstop. Their words might not make sense and they might not understand the body language or tone of someone’s voice. This can make it harder for them to connect with others, especially kids their age. 

Understanding these challenges can help parents and caregivers support their child’s communication and social skills as they grow (National Institute on Deafness and Other Communication Disorders, 2020).

Strategies in ABA that Increase Communication Skills-Naturalistic Developmental Behavioral Interventions NDBI

Naturalistic developmental behavioral intervention (NDBI) is a therapeutic approach that occurs in real-life settings and focuses on teaching skills within the context of everyday activities and interactions. This approach aims to promote learning through natural environments and situations rather than artificial or contrived settings.

NDBIs often involve teaching communication, social, and adaptive skills in settings such as home, school, or the community. These interventions typically incorporate principles of Applied Behavior Analysis (ABA) but emphasize teaching skills in a more natural and socially relevant manner (Bruinsma et al., 2019).

Specific NDBI Strategies We Can Use to Foster Communication

 (Bruinsma et al., 2019, pp. 240-253)

1. Embedding Communication Learning Trials

Embedding learning trials is a strategy that involves setting up learning situations where the child gets to communicate in a natural way, such as during activities the child likes or has an interest in. During these learning situations, the adult pays attention to what the child likes, gets the child’s attention, and ensures the activity is fun. Then, they give the child a chance to communicate by showing or saying something that encourages the child to respond. If the child responds, the adult praises or helps them if they make a mistake. This approach helps the child learn to communicate in different situations, not just when adults ask them to.

2. Narrating and Modeling

Adults should speak to children often during everyday activities and play to help them learn new words. For example, when picking a child up, the parent may say “up” or “tickle” when playing with their tummy. Even if the child isn’t talking yet, hearing these words can help them learn. Try using simple words and phrases first and then add more words as the child learns. For example, when playing with trains, a parent might start by saying “train” and then add more words like “go train!” or “the train is going fast!” Talking to children during play helps them learn to talk and understand words, even if they don’t start talking right away.

3. Recasting and Using the One-Up Rule

Recasting is a technique that can be used when children are learning to talk during everyday activities. This technique means repeating what the child says but making it sound better or adding more words. For example, if a child says “buh-buh” for bubbles, the adult might say “Bubbles!” while blowing bubbles, helping the child learn new words and how to put them together. The adult can also repeat what the child says and add one extra word to their phrase. This reinforcement helps the child learn to talk in longer sentences over time without feeling overwhelmed. Adults should use the correct grammar when doing this to help the child learn better.

4. Shared Control Strategies

In therapies that help children communicate, like Project ImPACT or PRT, it’s important for adults to let the child take the lead sometimes and then take turns themselves. This strategy helps create situations where the adult has control over the outcome or object that the child might find rewarding. An adult’s turn can be contrived as an opportunity to teach by using the things the child likes as natural rewards. For example, if a child wants a toy out of reach, they may be motivated to ask the adult for help. Again, this approach helps the child learn to communicate while having fun. These shared control strategies can happen during many different activities. It’s all about making learning fun and letting the child lead the way sometimes.

5. Using Motivational Strategies

Different strategies can be used to keep children motivated, such as noncontingent reinforcement (NCR) or shaping. During NCR, an adult can give the child something they like without asking them to do anything first. NCR can be done to get the child interested in an activity or to keep them motivated to communicate. For example, the adult might play with the child a little bit or give them a few pieces of a toy to start with. Then, they wait for the child to communicate before giving them more. Another way is to “shape” or reinforce the child’s attempts at communication, even if it isn’t perfect, praising the child for trying or attempting to say a word or phrase. Shaping can help the child stay motivated to keep trying and improve their communication skills over time.

6. Imitating the Child

Imitating what your child does or says is another helpful way to encourage communication. This technique may involve imitating their actions, sounds, or expressions. If your baby isn’t talking yet, you can mimic their actions with toys or use song routines like the Itsy-Bitsy Spider, helping them learn how to imitate and communicate. You can also use sensory or social routines, which are activities that involve touch, movement, or other senses, to encourage imitation. For example, you can copy your child’s actions and then add something new to see if they copy you back. This helps your child learn new skills and can be a fun way to interact together.

7. Reciprocal Conversation

Children learn to interact with others through playful, back-and-forth exchanges called reciprocal communication, even before they start talking. Adults can respond to the child’s attempts to communicate, whether it’s through gestures, sounds, or words. For example, if a child plays peekaboo with a blanket, the adult joins in by lifting the blanket and saying the child’s name. Then, they wait for the child to react before continuing the game. This interaction helps build the foundation for later conversations and communication skills.

Alternative Communication Methods

It is important to keep track of your child’s progress in therapy. If your child is not making enough progress with their speech after a few months of therapy, the therapist might suggest trying other ways to help your child communicate. Teaching sign language or a picture card system (like PECS) can bridge possible communication barriers. A speech language pathologist (SLP) may know more about different communication devices and can help find the best fit for your child (Bruinsma et al., 2019, pp. 252).

References:

Bruinsma, Y., Minjarez, M., Schreibman, L., & Stahmer, A. (2019). Naturalistic Developmental Behavioral Interventions for Autism Spectrum Disorder. Paul H. Brookes Publishing Co.

National Institute on Deafness and Other Communication Disorders. (2020, April 13). Autism Spectrum Disorder: Communication Problems in Children. NIDCD. https://www.nidcd.nih.gov/health/autism-spectrum-disorder-communication-problems-children

National Institute on Deafness and Other Communication Disorders. (2022, October 13). Speech and language developmental milestones. NIDCD. https://www.nidcd.nih.gov/health/speech-and-language

 

 

 

Teressa Hughes first became interested in ABA after working as a behavioral technician (BT) at a school in Louisiana. Under the guidance of an incredible mentor, she learned how to be an integral part of a child’s growth journey, which deepened her interest in the field. Sharing in children’s achievements and victories, no matter how small, means the world to her!

Teressa is particularly fascinated by the science behind ABA, focusing her attention on data collection and visual analysis. She is also becoming more involved in parent training, empowering caregivers with strategies to optimize their child’s therapy program. Her next goal is to become a lead registered behavior technician (RBT) while pursuing her Master’s degree in ABA with a focus on autism spectrum disorder at Ball State University.