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Without Words: Nonverbal Communication

 By Marty Stone, Specialist

When I became pregnant with my son, I started to wonder what his first words would be. I dreamed of the day when he would say "I love you, mom."    I am still waiting for that day. My son is 12 years old. He has autism and other medical conditions that prevent him from verbalizing his wants and needs. Although he cannot verbalize, he communicates with an electronic device, low tech methods of communication, some sign language, and gestures.  This method of communication is referred to as augmentative and alternative communication or AAC.

When a child cannot communicate, they often exhibit challenging behaviors to express their frustrations. An AAC communication system such as sign language, PECS, or speech generating devices can help reduce meltdowns by giving the child a voice.

Sign language is often used for children who are not talking. Sign language can introduce the concept of cause and effect related to communication. One of the biggest limitations with sign language is that few people know the language.  I have found it helpful to take pictures of common signs that my child uses to distribute to new therapists, family, and friends.

PECS or picture exchange communication system is sometimes introduced in early childhood programs. PECS is a modified behavior analysis program to encourage communication. Boardmaker is the most common program used with PECS. Since Boardmaker is expensive, a teacher or a therapist will sometimes offer to print sheets to use at home.  For children who can adapt between different picture systems, Google Images and hand drawn symbols can be used.  The images are often laminated and attached to a binder or sheet using Velcro. The system can be expanded for visual supports and creating schedules. The Indiana Resource Center for Autism has a visual support library.  

As a child becomes older, it may be useful to request an Assistive Technology evaluation.  A trained therapist will work with a child to find the best speech generating communication system. There are many options available from lower technology devices, such as a Big Mac or Cheap Talk 4, to more sophisticated devices, such as Nova Chat or Dynavox. There are newer systems that use iPad or Android apps. Easter Seals Crossroads INDATA program can sometimes be used to trial different devices. They can be reached at 888-466-1314. For more information on requesting an AT evaluation, contact Family Voices Indiana.

On many internet forums, you will find parents trying to obtain an iPad for communication purposes. There are challenges to using an iPad for communication.  The speakers on iPad are not often loud enough for others to hear across a crowded room. There are some adaptions for an iPad that can amplify the speaker. Other problems with the iPad are related to battery life and access to other apps.  If a child is using the device to play games, the battery may be too low when they need to use a communication app.  A feature called Guided Access can lock the iPad to a certain app.  Finally, some insurance companies may not pay for an iPad since it can be used for other applications. Some adapted, dedicated iPad devices may be covered by insurance. For more information on funding sources, contact Family Voices Indiana.

Once you have found a communication system for your child, you need to make sure the system is always nearby.  The system will become your child's voice and will need to be with them everywhere they go.

My son uses a combination of AAC systems. His electronic device is his main method for communication. When he is near a pool or it is raining, we use a laminated sheet.  When he is participating in sports, we attach laminated cards to a bracelet. Think outside the box.  Family Voices Indiana has a Pinterest page devoted to communication ideas.

I still long to hear his voice. We still have people asking us if he will ever talk.  We do not know the future. He may surprise us one day. We still pursue speech therapy, but his main goal is functional use of his communication device.

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