As you may know, I’m an autism mom and Board Certified Behavior Analyst. I am also the author of The Verbal Behavior Approach: How to Teach Children with Autism and Related Disorders. As a Behavior Analyst, I know that any behavior (including speech sound development) can be increased using proven ABA strategies. In this week’s video blog, I’m going to discuss techniques I use when working with a child who is non-vocal or minimally vocal.
There’s also limited availability of Speech and Language Pathologists (SLPs). Especially SLPs with ABA knowledge or expertise. I believe children with autism, especially those without any vocal speech, really need a team of professionals helping them so the child can make the most progress possible.
I’m fortunate to have worked with several speech pathologists along the way and they have taught me a ton about how to get initial speech sounds and first words. I’ve also developed some interventions to help parents improve articulation and get their children talking a lot more with “pop-out” words. When I say pop-out words, I’m referring to a word here or there on their own terms.
The next step is to assess whether the child is making any sounds, word approximations, or saying any words spontaneously. A lot of infants babble. They start babbling “ba ba ba ba” and “da da da da.” They might be babbling all these different speech sounds to get reinforcement. When the baby’s dad hears da da da da, the dad gets excited and starts reinforcing that da da da da. When the baby babbles “Baba” for a bottle, the child then may get the bottle. The same thing happens with “Ma ma ma ma”. This is the way language gets shaped up.
With our non-vocal children with autism, we have to ask the question, “Are they babbling at all?” Next assess if they have any word approximations, or “pop-out” words. They may not say much, but they have been heard to say different words throughout the day or maybe a couple of times a week? You need to be a little bit of a detective here. If the mom says, “My child does say some things here and there.” Okay, what are those things? Is it mama? Does he say hi? Bye-bye? Is it da da? Is it a movie?
Another strategy I came up with many years ago is to formulate a list of words that you have heard your child or client say. Sit and watch your child and record spontaneous babbling and word approximations. Take 15 minutes of data when they are engaged in playing Legos or something alone. Then take 15 minutes of data when you are swinging them or bouncing on a ball. And then another 15 minutes of where you are giving them little bits of reinforcement while saying words.
Once we have our baseline assessment done, we want to use stimulus-stimulus pairing throughout our days to try to get the babbling up and to try to get word approximations and sounds up.
Now the term stimulus-stimulus pairing sounds really complicated but it’s not. It is basically saying a word 3x before delivering reinforcement. You want to sit with the child. I usually like to sit catty-corner. We want to hold the reinforcers to our mouth. Make the sound or word loudly and elongate if possible. So if we are having the child build a simple inset puzzle and we are holding a puzzle piece of a pig up, we say “pig, pig, pig” as we hand the child the puzzle piece.
With each pairing, we want to get the reinforcer a little closer and we don’t want to hold out. We want to deliver the reinforcer after a successful sound or after the third try, whichever comes first.
You also want to be pairing words all the time. So, if you’re going up the stairs instead of saying, “Johnny, let’s go up the stairs. Johnny is a good boy,” you just want to say, “Up, up, up.” And then take a couple of steps up.
In conclusion, we want to always assess the situation, assess the whole picture, and specifically focus on feeding and spontaneous babbling, speech sounds, and words. We then want to pair sounds and words with reinforcement throughout the day, both at table teaching sessions and within the natural environment.
