by Tanna Neufeld, MS, CCC-SLP (Speech-Language Pathologist); NWACS President
As a clinician supporting mainly young children with Autism Spectrum Disorders (ASD), I work daily with emerging communicators (i.e., communicators who do not yet have a reliable system of symbolic communication) who are difficult to engage in play interactions, let alone in modeling on AAC tools! I also provide frequent trainings to providers working in school and early intervention settings who often express great challenges in getting their emerging communicators to engage with AAC. Some of the challenges that I often hear include:
“He won’t look at pictures."
"She doesn’t know how to point."
"He just 'stims' when I give him [a device, PEC symbol].”
"She isn’t motivated by much.“
“His attention span is very limited.”
I most definitely struggle with ALL of these barriers -and more- when working on engagement skills alongside communication with AAC. It is very tempting to want to “wait until the child is ready for AAC” - however, we know from bodies of evidence (e.g., here, here, and here) that there are no pre-requisites for AAC candidacy and that a wait-and-see approach to AAC intervention just isn’t going to achieve best long-term communication and academic outcomes for our kids. Here are a few of my tried and true tricks to help you engage the most emerging of communicators in fun and interactive “conversations” that leave them coming back for more and provide you with a solid foundation for aided language modeling opportunities.
1. Make changes to your position (or the child’s)
The most meaningful interactions with an emerging communicator who is learning to engage occur in close proximity and face-to-face. Adjust where you interact with the communicator by sitting at or below his eye level and assuring you are face-to-face, rather than side-by-side. Being close, face-to-face, and at or below the child’s eye level assures that most (if not all) of the interesting action is happening around YOU, the communication partner. Some examples of achieving this position include: laying down on propped elbow when playing on the floor, sitting/kneeling next to a child’s table when the child is in a child’s chair at the table, and simply sitting across from the child at the table rather than next to her.
2. Follow the child’s lead, interests, and message
Let’s face it - many children at the earliest stages of communication development are quite self-centered. They want to play what they want to play and therefore, want to talk about what they want to talk about! I recommend leaving your agenda largely at the door and preparing to engage (from minute to minute sometimes) with what the child is interested in and what they are trying to communicate about that interest. How do you know what she is interested in? It is usually what she’s looking at! How do you know what she might want to “say” about this interest (so you can provide verbal and aided language modeling to include these words)? Usually what she is looking at it or doing! What the child is showing interest in, as well as his non-symbolic communication signals (e.g., facial expressions, gestures, behavior) are “his message” and are therefore the best place to start from when wondering what to say and what to model on your AAC supports. Following the child’s lead might mean doing the same thing way more times than you find interesting, or perhaps moving more rapidly than you’d like from one activity to the next - but that’s okay, this isn’t about you! Following the child’s lead may also mean that you have to create social games and play environments that offer a ton of opportunities to participate in a high interest activity. If your AAC user likes to watch things that light up or spin, have a lot of different ways available to do this. If she likes Sesame Street, how can you incorporate this theme into your session materials and activity plan? Part of following a child’s lead may also mean tempting the child to interact by imitating her sounds, movements, or words in a playful way, even if that child is engaging in what is perceived as “self-stimulatory” behavior. We know through research evidence on building imitation skills that often times, imitating what a child is doing gets them interested in you and eventually, doing what you do.
3. Create social play routines with a partner at the heart
Many of our emerging communicators struggle to balance the attention demands required to look at a partner, look at an interesting toy, and look at an AAC support. For some kids, it is very helpful to the interaction if we limit the “stuff” (e.g., the toys) and concentrate on the play routine, placing the partner (e.g., you, a parent, a peer, a sibling) at the center of it all. Using silly sounds as you move toys in big, animated ways grabs the attention of most kids and brings fun that leaves them wondering what will happen next. Using “people toys” (described in the "More Than Words" book, The Hanen Centre) is also a great way to build interactions as these toys often have great cause-effect properties and require a partner’s role. Examples of these include ball poppers, balloons not tied on the ends, bubbles, stomp rockets, and basically anything you can pretend to sneeze across the room! Songs, finger plays, and movement routines (e.g., spinning on an office chair and then stopping, swinging and then stopping, climbing onto a cube chair and then crashing onto a big pillow) are also great places to get a child “hooked” on the partner and to create a routine that will lend itself to more communication opportunities.
No matter what you bring to the table (or floor) with your emerging communicators, have fun and be animated - pairing emotion and sound to the things that you do - and it will be really hard for your kids not to think you are the best thing in the room (at least for a minute)! Then use what you learn with each success to approach the next minute, and the next, following the child’s lead each step of the way and emphasizing the interaction, with a little AAC modeling on the side.
What tricks do you use to get kids engaged?
References embedded above:
Romski, MaryAnn & Sevcik, Rose & Barton-Hulsey, Andrea & Whitmore, Ani. (2015). Early Intervention and AAC: What a Difference 30 Years Makes. Augmentative and alternative communication (Baltimore, Md. : 1985). 31. 1-22. 10.3109/07434618.2015.1064163.
AAC Myths Revealed - A Child can be Too Young for AAC (Tobii Dynavox)
"Do This" Doesn't Cut It: Helping children with autism learn to imitate by Lauren Lowry, Hanen SLP and Clinical Writer (Research in Your Daily Work article from The Hanen Centre)