Recognizing Communication

Did you say something to me?

When we think of "communication" we often think of words people exchange back and forth. It is so much more than that. I can tell a comedian that he is hilarious through my laughter, show my children I love them through a kiss, or tell the same adorable children that they better knock it off simply through a look. In each of these cases, I never said anything, but did I successfully communicate?

YES!!! 

Communication is when the ideas in one person's head are successfully conveyed to another person's head - regardless of the medium. Communication only requires two things: 1) At least two people are involved and 2) it has to be intentional. And communication absolutely requires that these two things be linked - the message is conveyed to the other person with intentionality. 

Particularly when working with kiddos on the spectrum, I am most interested in the intent behind any word, gesture, or action. Most of the kids I work with (severe preK), are not adept communicators. But that does not mean that they are not communicating. 

Some of my kids seem like they are communicating when they are not and some of my kids seem like they are not communicating when they are!

What does that mean?

If a child says, at any point in the day, "I want you to put your shoes on" but never looks to see if anyone heard her, this is not communication. We have two requirements: 1) the first requirement may be partially met, there could be another person in the same general vicinity and 2) the second requirement may be partially met, the child obviously intended to say what she did. BUT, the piece of communication was not intentional towards the other person. She never looked or demonstrated that she was aware another person was listening. So she did not say the phrase to impact the other person's behavior or to convey something she was thinking about to another person (as far as we can see). 

That same child, however, may say the same sentence at a later time to communicate something (such as, "I would very much like to leave now"). The child will most likely indicate she is communicating through her eye gaze, waiting for a response from you (at least for a second or two), repeating her phrase, or having a tantrum. Eye gaze is not the same as eye contact, and eye contact is not a requirement for communication. It can be super tricky to notice! But the more you practice tuning in to an individual child's actions, the better you get at identifying when he/she is purposefully communicating. Sometimes it can be extremely subtle and, most likely, we do not always notice it to receive the communication attempt. 

For instance, a little guy might really enjoy receiving tight hugs--and after you have established that you are an awesome person to help him get this need met-- one day, he might push his back flat against your arm. This may be his way to communicate that he would like another hug from you! Is he standing there waiting to see if you will react? It might not be effective, easily recognizable communication, but it is still communication. 

When a child is not speaking, or not speaking in a functional way, it really behooves us as therapists and caretakers to ask ourselves, what is my child telling me by this action?? Sometimes, when a mild child starts having aggressive behaviors, it can actually be really exciting because now the child is communicating!!

Methods of communication:

• Words
• Gestures
• Pointing
• Sign language
• Pictures
• Eye gaze
• Touch
• Vocalization
• "Behaviors"
• Tantrums

The more you practice identifying communication from a specific child, the better you get. And hopefully, through you recognizing the communicative attempts made by that child, the child will repeat the attempts and gradually improve his ability to convey himself to you. 

All we can do is continue to try,

Amanda

Reinforcement

A child learns something new because there is something that is inherently motivating to the thing being learned. Motivation can be from a variety of different sources. It can be something tangible (e.g., food or toys), it can be a reduction in effort (e.g., Using a spoon gets my cereal into my mouth quicker and more easily), or getting some type of need met (e.g., attention). One way to talk about motivation in connection with learning is to talk about reinforcement. Reinforcement is anything that increases the likelihood that something will happen again.

When you are teaching a child a new skill (or they are simply learning a new skill on their own without tutelage), imperatively, you have to think, if I were the child - would I do the thing you are asking me to? Why would I? Why would I want to? If you are trying to potty train your child, but every time they use the potty, the child has to sit there bored and then, when she finally does go, she has to laboriously take the stupid sticker off the stupid paper and put it on another stupid paper! When if she had just gone in her diaper? The child could have continued to play without interruption! Being able to play is much more motivating! A sticker might make sense to an adult, but whether or not it is motivating to a child, depends on that specific child!

The single most reinforcing thing we can DO to influence another person, across the board, is positive social attention. This is not referring to praise. Positive social attention is literally paying 100% attention to another along with a smile. Attention and a smile. You do this so often, you probably don't even realize you are doing it.

Baby waves hand up and down at you. You pay attention, you smile. Baby moves hand up and down again! You pay attention. You smile even bigger! Baby thinks "Wow! This is magic!!" 

There also might be opportunities where this type of reinforcement would be superior to what we typically do in United States culture. We provide positive attention all day long to children to shape their behavior. The tricky thing is for kids with social deficits, is that, positive attention may not, yet, be reinforcing.

If this is our own child or a child we are working with, we have to find alternative ways to provide reinforcement. Which can be tricky, because we smile and pay attention without usually thinking about it. A child will give you clues when positive social attention is not reinforcing to him and her: the child gives absolutely no reaction to your type of reinforcement (not even a subtle reaction), the child's behavior does not change over time, (by behavior I mean ANYTHING a child does, not just "naughty behavior"). 

Fortunately, kids usually find something motivating, even if it is somewhat tricky to figure out because it may not be something you or I would find motivating. The following are my top two alternative reinforcers for kids with social deficits:

1.  Provide sensory input

•  Deep pressure is my GO TO for kids on the spectrum. Pressure on the hands, pressure on the shoulders, wherever that specific child seems to enjoy it. I have had several kids that have liked pressure on the sides of their heads. Pay attention and notice if the child relaxes, moves in closer, or does any other subtle cue.

2.  Provide a tangible reinforcer

• Some situations lend themselves to providing a tangible reinforcer easier than others. But you can get creative - it might help to build tangible reinforcers into routines so that a child can learn to expect it. You can also use "First, then" (whether with words or with pictures). The tricky thing with first-then, is that the child never, ever, gets the second thing unless the first one happens. For examples, "First come here, then squishy." If the child never "comes here," then he never gets his squishy.

That being said, however, a long term goal is to help a child develop greater social relationships and as part of those relationships, find social "stuff" more meaningful and reinforcing. Always pair sensory and tangible reinforcers with a smile and positive attention. 

All we can do is continue to try,

Amanda

hello.

Working with kids is the absolute best, but there was a time in my life when I was sure I wanted to work in adult rehab with stroke and brain injury patients. Clearly, that was the time when I was, ahem, out of my mind. Luckily, then, for the first time, I was given the opportunity to work with a child. I have never looked back.

I am an early childhood speech language pathologist. For those of you who don't know what that means, it means that I work as a communication therapist with children (mostly under the age of 6) targeting primarily speech, language, and interaction. My favorite communication skills to work on are the skills that precede any verbal development. A child must learn so many things before they ever utter their first word.

For example, children in the very first months of life learn that vocalizing has a fairly consistent effect on those around them ("When I yell, coo, or scream, Mommy looks at me"). 

I specialize in working with preschool age-children who are not using any words in a meaningful way and do not engage with other people in ways that we would expect. Most of these children exhibit behaviors consistent with a diagnosis of autism spectrum disorder.

My primary goals for these kids are: 1) develop a meaningful connection/shared attention and 2) empower a child with the tools they need to communicate meaningfully. This blog is my best attempt at sharing the knowledge and strategies I have learned over the last 7 years with the parents and families of those amazing kids.

Amanda