5 things I learned about fostering communication in children with exceptionalities…

ccommunication

1) Be vigilante about positive reinforcement vs negative   reinforcement     

So often we focus on the treats  and stickers and checkmarks our children earn while working towards a new goal as the source of positive reinforcement. For some parents this even creates another conflict because they feel they are being forced into a “bribe” system, and while these goodies do work, not everyone is comfortable using them. The good news though, is that positive reinforcement comes in many forms and the best thing you can do is to learn to identify the opportunities. Sometimes, parents end up negatively reinforcing an attempt at communication because it has been overshadowed by an accompanying behavior. For example, when  a sensory-sensitive non-verbal child is throwing herself on the floor because someone is trying to make her wears shoes, DON’T focus on the tantrum behavior (that would be positively reinforcing it’s value) but instead DO focus on the communication attempt. Give it value. Tell them, “I heard you”. This is a moment to drop the shoe battle and engage the child. “Are those shoes uncomfortable? Thank you for telling me. Thank you. That was excellent”. Put the shoes down. You are not creating a monster who will never wear shoes again, your are developing a child who has now understood the value of communicating with you on a level that you understand.  You are developing a child who understands that there is a way to express the “whatever” they feel but lack the means to share. You have given her a tool. If you want to encourage communication, you must see the efforts. It is possible that one day she will be able to explain to you why certain shoes torment her while others don’t. Imagine if she had the ability to tell you now? She does. Behaviour is her only tool. It is still valuable communication.

2) Combine! Combine! Combine!

When my child was working to regain speech after a near-total speech loss at 18 months, we discovered two things which he seemed to respond to and used them in tandem. For him, if we could calm his body, it was much easier to engage his mind. After seeing his dramatic reaction to Occupational Therapy (OT) which was strongly centered around a sensory diet, and a difficulty attending for his Speech Language Pathologist, we were fortunate enough to be able to combine sessions with his OT and his SLP. This allowed the OT to assist him with sensory modulation. He was significantly more attentive and responsive to communication attempts once that step was under way (also a great opportunity to introduce the language he needs to explain his needs). Similarly, if you have a particular support worker (including a daycare worker/ECE) that has a terrific dynamic with your child, and your child is particularly struggling with his Social Skills group, or Speech therapist, try getting the beloved worker go them him instead. I have hired many support workers right out of the daycare staff and program staff from various places. Sometimes two great things together make a masterpiece!

3) Echolalia can be your friend!

If you have a child with echolalia, be very careful about “disciplining” this behavior. This is often the first step to functional echolalia, which can then lead to intentional speech. Let me offer these definitions: Echolalia is your child repeating the same phrase,  or repeated sounds/vocalizations. Functional echolalia is your son responding with Billy Crystals voice as Timon when you chastise him for leaving his Lego lying about, saying “Mom! I’m not a kid anymore!” It might not be the response you hoped for, but it is relevant to the moment and the conversation. Many a child has watched the same movie 1200 times and then began repeating the lines over and over. For my own child, there was at first the movement of tiny lips as he studied and watched their faces and recorded their voices in his super brain. After that came a period where everything he said came directly from a movie, and often his choices were not only relevant, but hysterical! Eventually, he just spoke. With his own words. If you can build positively on the little things and ignore disappointment – you will see, and hear the effects. Pay no mind to claims of “useless communication”. Think of it more like “different languages”. Your job is interpreter. It’s best to learn the other language before you try to translate.

4) His obsession, your clue

Many a well-meaning clinician has told me to “absolutely stop stimming behavior” and “put an end to fixations”. I have seen some of the larger gains in children in these two areas when the parents have learned to hear communication rather than see poor behavior and silence. Temple Grandin once said “those kids obsessed with trains – those are your future engineers”. If you want to encourage communication, start with something your child cares about. I am not only suggesting that you indulge his obsession but that you encourage it. Look at trains together online. For a child who hates to sit at the table, perhaps a train themed dinner or engineers cap will provide the redirection needed to keep things on track. While I do encourage the limiting of time playing video games and using the computer, our obsessed children deserve a little more leeway on this issue. When you’re trying to build a foundation, you have to accommodate for the landscape. Try not to connect punishment with positive tools. Ever. For example, “if you don’t do what I want, you can’t have the______ <object of obsession>_____. This can kill your ability to use it as a positive tool once you’ve created anxiety around it or fear that it may not happen. Combine the good stuff and try always to separate the negative. Stimming behavior like flapping, rocking or jumping up and down on the toes (“pogoing”) can often give important clues about sensory needs. Observe these behaviours closely before attempting to vanish them. When do they occur most? When do they occur least? What was the antecedent? These questions can help you understand why the behavior is happening, what purpose it serves (and believe me, it does) and if there is a more functional/appropriate way to achieve the desired stimulation (ie. Sensory tools, including weighted objects and oral chews). Sometimes something as simple as sunglasses or sound blockers can bring a quick end to stimming.

*On a sidenote, when it comes to escalated behaviours, redirection is my favourite tool. It minimizes the negative experience and focuses positively on something new. This is an excellent time to refer back to the trains!

5) Throw out the timelines and checklists.

Really, forget them. Don’t torture yourself at the Well Baby Clinics and drop-in centres as the other moms “ohhh” and “ahhh” over their little marvels. You’re child maybe be learning slower or he may be learning diffierently, but he could also be learning more. About my own mother it has often been said “She never spoke a word until she was three and a half years old and then she opened her mouth one day and just started talking”. (My grandmother would often finish with “and she’s never stopped”). A child who is managing other issues such as pain, sensory dysfunction, hearing loss or others is experiencing things differently than you. Rather than be frustrated with them, be patient. The greatest gift communication will give your child is the ability to self-advocate. Some children will have mastered primary math long before language. When you teach a child something at the moment their brains are developed enough and ready to receive it, they process it much quicker. For example, some people will spend countless hours, days, months teaching their children to master colours or shoe tying or reading when some of the same activities introduced six months later could bring instant success. Timelines mean nothing, but timing is everything!

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