When a child does not speak, or has limited or inconsistent use of speech, they may be described by medical and educational professionals as “nonverbal” or “non-speaking”. Non-speaking children compose 30% of all children diagnosed with autism. Many nonverbal autistic children communicate without speech by using nonverbal methods of communication, such as gestures, facial expressions, sounds, and behaviors. When communicating with an autistic child or any child struggling to develop speech and language, it is important to consider how to adjust your style to better support their individual needs. All autistic children are different, but these general guidelines can be a good starting point for you to become a supportive and responsive communication partner.
Follow The Child’s Communication Lead
Children in general are more likely to interact and communicate with people that they know and trust. Children with autism are no exception to this fact and therefore, it is important that you allow the child to lead the way in your conversation. Before launching into questions or sharing your own ideas, take a moment to observe the child to make sure that they are ready and interested in communicating. For example, if a child is showing signs that they may be dysregulated or anxious about your presence, you may overwhelm them further by talking. Similarly, if a regulated child is playing with dinosaurs and you approach with questions about what they did at school today, your attempts to connect and communicate may fall flat because the topic is not related to what the child is engaged in at the moment. By observing the ways in which a nonverbal child with autism is already communicating, you have a window into how best to use your language to connect with them and to teach them new skills. To break the ice, talk about what the child is looking at and what they are doing at the moment. If the child is attempting to communicate with nonverbal strategies, stick with them and offer support to help them achieve their goal or solve the problem at hand. When communication breakdowns occur, as they will, empathize with the child and offer reassurance that you will do your best to understand their ideas. Following the child’s lead in conversation means that you are observant and responsive, you are quiet after your turn in the conversation to give the child time to process and respond, and you allow the child to set the topic.
Use Visual Language Support
All children who struggle to speak benefit from the use of augmentative and alternative communication (AAC) tools and strategies. AAC includes things like sign language, communication boards, and communication devices, which can all be used as means of expression when speech is unreliable. These tools not only support a non-speaking child’s ability to express their ideas, but also serve as a valuable tool to help a child understand what others are communicating to them. When you speak to a child using AAC, you model the way AAC can be used to communicate and offer support for children to comprehend new words. An example of using AAC to communicate with a nonverbal autistic child might look something like telling the child it is time to eat snack using your spoken language (e.g., “It’s time to eat a snack.”) and pressing the word “eat“ on the AAC device as you say it in your sentence.
Another way to offer visual support for language as you communicate with nonverbal autistic children is to use gestures- like pointing and showing-when you provide instructions, offer choices, or ask questions. By gesturing as you speak, you help your young communication partner know what information is most relevant while simultaneously showing them how to use gestures and other forms of nonverbal communication to express their own ideas. If a child uses individual gestures or movements to indicate certain things already, you might also integrate these into your spoken communication when appropriate. Visual emphasis through pointing, showing, moving and other methods should be placed on keywords, not full sentences. For example, if giving instructions about putting shoes on, you might speak the direction (“Put on your shoes so we can go.”) and point to the keywords in the direction as you speak (e.g., point to shoes as you say shoes, point to the door as you say go).
A third way to support a nonverbal child in learning the language around their routines to better follow your communication is to use visual schedules. Visual schedules are not intended to be a means of communication for the child, but can serve as a valuable support to help children understand what to expect when gaps in their understanding of language may be present. Visual schedules are also a helpful reminder to adult partners to keep routines and language as structured as possible. Structured and predictable words and phrases help to ease transitions and support learning for children who struggle with language. An example of using a visual schedule to communicate with a nonverbal autistic child might look something like talking through the steps of the morning routine as you show the pictures of each step on the schedule (e.g., “First you need to get dressed, and then we can eat breakfast.”).
Pace Your Speech
It is not easy to know exactly how well a child understands your communication when they may struggle to respond in clear ways. To maximize comprehension, it is generally helpful to use well-paced speech that emphasizes keywords. Slow your speaking rate while maintaining a natural rhythm. Place emphasis on the words that seem most important to your message by offering visual support and changing your tone of voice. It may also be helpful to offer repetition when needed, and to rephrase your communication if it seems that a child is not following your original attempt. For some children with language processing differences, it may be helpful to shorten your language and to use repetitive and predictable language around certain activities and routines. Be mindful to give all children enough time to respond to your communication, which may mean waiting quietly for several seconds before repeating or rephrasing.
Limit Questions
Although questions are necessary at times, it is helpful to limit questions and use more statements when interacting with children. Questions place high pressure on children and may be difficult to understand because they often lack context. Questions are often a go-to strategy for adult partners when they are unclear of what a child is trying to communicate. Instead of using this approach, consider asking the child to clarify their message by adding other methods of communication. For example, you might say “Show me” or “take me there” to remind the child that they can help you understand by using these repair techniques. When questions are necessary, be sure to offer as much visual support as possible and to pause after your question to give the child enough time to process and respond.
Offer Choices, and a Way Out
It can be difficult to fully understand what a non speaking child wants or needs. In addition to observing their behaviors to gain insight into what they may be communicating, offering choices can be helpful. It is important to provide visual support with choices whenever possible, and to offer an option that allows the child to indicate that neither of the choices is accurate. You can achieve this “way out” by using a picture, sign, or verbal prompt that indicates “none of these” or “something else”. Including a way out might sound something like “Do you want apples, cheese, or something else (while showing each item as you say it and then using the sign for “different” to indicate “something else”). If a child has a way of indicating yes and no, you might also scan through choices with them and ask them to indicate yes or no for each one.
Wait Quietly More Than You Talk
When a child is not speaking, it is common for adult partners to do most of the talking. However, it is important to wait quietly to encourage the child to interact and communicate. When taking turns in communication, make a statement or ask a question, and then pause quietly to allow the child time to think about your language and respond in their way. This expectant waiting also gives you time to observe the child so that you can continue to follow their communication lead. Counting to 5 or more in your head is a helpful way to keep yourself from chiming in too quickly. As you wait for the child to initiate or respond in their own way, remain attentive to them and interested in the activity at hand so that you don’t miss your opportunity to respond to their ideas.
Provide Feedback
As you become more familiar with a child’s methods of nonverbal communication, you can offer the child feedback on what you notice and what you think it means. This is a helpful way to connect meaning to the child’s behaviors, and to model language that can be used to add to their intended message over time. Providing feedback also helps the child understand what your assumptions are so that they have the chance to correct you if you're inaccurate. Offering a child feedback on the nonverbal communication methods that you see them using might look something like telling a child who is smiling after you spin them around in the air “I see your smile! I think you like spinning with me!”. Notice the words in italics- those are keywords in a feedback phrase like this one and can be emphasized with modeling ong AAC, gesturing, or using changes in your vocal tone to make them stand out.
No matter which of these strategies you find most helpful when communicating with a non-speaking autistic child close to you, it is important to keep communicating! Each conversation is a wonderful chance to connect and to learn from one another. Non-speaking children need us to speak to them often, and to observe and listen to how they are communicating with us so that we can build our competence as communication partners.
If you want to learn more about how to support the communication development of a child in your life who struggles to speak, consider starting an online parent coaching program with us!
Originally posted on the Goally blog