
Chapter 7: Developing Communication Abilities
REFERENCE: Reinhartsen, D., & Pierce, P. (no date). Developing Communication
Abilities. In P. Pierce, (ed.). Baby Power: A Guide For Families For Using Assistive
Technology With Their Infants and Toddlers. Chapel Hill, NC: The Center for Literacy and
Disabilities Studies, University of North Carolina at Chapel Hill.
It is reprinted here with permission of the editor.
Description of chapter:
The authors discuss various means of communication in young children and the role
communication plays in everyday learning. For children with cognitive and/or physical
disabilities, however, the communication process may be far more challenging and
alternative methods of instruction must be explored. The authors stress the importance of
assistive technology and early intervention tools in the development of communication
skills.
Introduction
Nuts and Bolts
Great Strategies To Try
Intervention
Assessment
Sample Individual Family Service Plan (IFSP) Goals
Next Steps (Transition Issues)
Resources
CHAPTER AUTHOR(S): Baby Power is a collaborative project of The Center for
Literacy and Disabilities Studies (CLDS), CB# 8135, 730 Airport Road, Suite 200,
University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599-8135 and
The Clinical Center for the Study of Development and Learning (CDL), CB# 7255, BSRC,
University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599-7255.
Patsy Pierce, Ph.D., holds a doctorate in Early Childhood Special Education and Literacy
from UNC-CH. Patsy has been a speech-language pathologist working with children with
severe speech and physical impairments for the past 11 years. She was the Associate
Director for Education at the CLDS, UNC-CH.
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Introduction
Communication is a life long learning process beginning at birth. We communicate in
many different ways like listening, speaking, gesturing, reading, and writing.
Communication abilities help children to learn, form social relationships, express
feelings, and participate in everyday activities. Some children, due to cognitive and/or
physical impairments, may have difficulty expressing themselves clearly or understanding
what is being said to them. For those children, assistive technology can help to develop
communication abilities, overcome communication problems, and provide a link between them
and their daily life experiences.
Nuts and Bolts
- Communication begins in the womb. Even before a child is born, he or she
communicates. A baby's kicking, rolling, hiccuping - all of these movements communicate
something to the mother. The baby may be saying, "Mom, the food you ate was too
spicy," or "You've been too busy, please slow down," or maybe the baby
simply needs a change of position. Immediately after birth parents listen for a cry to let
them know that their baby is breathing. Families watch their baby's facial expressions,
feel his or her movements, and listen to his or her sounds. From birth babies constantly
send signals. Through their eyes, ears, and touch they receive our responses to their
early communicative signals.
- Early communication signals include movement and sound. As soon as they are born,
babies communicate feelings of displeasure by crying or by physically turning away from
something they don't like. Some babies will communicate feelings of displeasure through
hiccuping, yawning, stretching out their arms, holding out their hands with fingers apart,
placing a hand over the eyes, grimacing, or even falling asleep. All of these actions are
signs that a baby may want something or may be stressed because of the things that are
happening around him.
- Sometimes baby's early communication signals are hard to recognize. Some parents
and other caregivers respond to their baby's signals with ease. Other parents or
caregivers may need assistance in learning how to read their child's communication cues.
Sometimes it is difficult to read a baby's early communication signals because of his or
her physical or motor difficulties. Some children are born with conditions such as Down
Syndrome or Cerebral Palsy which may place them at risk for having difficulty
communicating their early messages. Their physical limitations may prevent them from
turning away, opening their fingers, sucking their thumb, or yawning, all indications of
possible pleasure or displeasure. Sometimes these babies or babies who are sick, sleepy,
or who were born prematurely send very subtle and inconsistent communication signals. This
inconsistency may make it difficult to figure out what the baby may need. When these
children are not able to send their messages accurately, their communication partners may
be unable to clearly read their cues. Parents and other caregivers consequently may not be
able to respond to the baby's needs. When a baby's or young child's communication signals
are not understood, his needs may go unmet. Because of this communication breakdown, he or
she may not learn how to communicate like other children who are sending more clear and
consistent signals.
- Read, Recognize, and Respond to early communication signals. All of a baby's
caregivers must learn to RECOGNIZE communication signals, READ (interpret) them
appropriately, and RESPOND to these communication signals as quickly and as consistently
as possible. These three R's of early communication development help a baby learn that he
or she can have an affect on the world. When a parent is able to recognize, read, and
respond to early communication signals by changing the child's surroundings, feeding the
child, holding the child, and/or swaddling the child, parents gain a feeling of self worth
by having met the child's needs. The child is also learning to become an effective
communicator by gaining attention and getting his needs met.
- Early signals can develop into spoken words. Children's early communication
signals consist of bodily movements, facial expressions, gestures, cries and coos. These
early signals eventually become speech-like sounds, then words, then sentences. Children
develop these more adult-like and more easily recognized ways of communicating through
exploring their environment, through hearing and seeing models (other people talking),
through turn-taking in games, play, and talking, and by practicing. Usually by a child's
first birthday, he or she may say a few clearly understood words. Most children begin
putting words together around their second birthday. Children develop speech, however, at
different rates. Communication development involving listening, speaking, gesturing,
reading, and writing continues throughout life and requires access to all aspects of the
child's world.
- Assistive technology is an option to help young children communicate. Help for
children who are at risk for difficulty in developing, sending, and receiving early
communication signals and for their caregivers is available through the use of assistive
technology. Assistive technology includes a wide range of low and high technology options.
One example of a low or no technology option to facilitate communication is keeping an
accurate log of an infant's cues and their meanings to be shared by all caregivers. Using
a little more technology, the harder to recognize and read signals may be seen by
videotaping babies interacting with their caregivers. The caregivers can look at the
videotapes together and with professionals who work with infants and toddlers. As a team
they can decide what the baby's behaviors mean and how to respond to these early signals.
Other examples of assistive technology useful to aid communication development include
adapting crib mobiles so they may be controlled by a switch placed in an infant's bootie.
All the child has to do is move his or her foot to turn the mobile's music and movements
on or off. This ability to control the outside world, even at this early age, helps babies
to learn that their actions cause a reaction-the foundation for learning to communicate.
There are also a wide variety of small devices which can "talk" for toddlers
until they can say the words themselves. These devices are called augmentative
communication systems and can sound like human or robotic voices. Having a way to control
their world and to say what they are thinking, helps all children to develop their skills
to the best of their abilities. These assistive technologies may be just the tools needed
to help development occur.
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Great Strategies To Try
Intervention
If someone has recommended that your child receive early intervention services it may be
helpful to keep the following communication guidelines in mind.
- Communication has no prerequisites. Children begin to communicate at birth so no time is
too early to begin early intervention services.
- Communication involves at least two people. When a child is young the primary focus of
intervention should be on the communication partners of the child which will probably
include the parents, primary caregivers and siblings. If assistive technology is involved
be sure to ask for individualized training on any piece of technology recommended for your
child. This training should also include using the technology in as many activities
(feeding, playing, using the bathroom) as possible.
- An adequate hearing environment is crucial. Before beginning early intervention services
be sure that a child has an adequate hearing screening or evaluation. Also make sure that
the child has a quiet place to play, eat, and do other activities so that he or she will
be sure to hear parents and other caregivers talk with them.
- Using gestures, augmentative communication devices and any communication forms other
than speech will not interfere with the development of spoken language. Everybody
communicates in different ways. As previously mentioned, we communicate through gestures,
facial expressions, body postures, speech, reading, writing, drawing, and music. Babies
communicate without words (nonverbally) long before they learn to communicate through the
use of sounds and words. Clinical studies report that other forms of communication will
not keep young children with disabilities from learning to talk.
- Speech and sound making should be encouraged no matter how involved a child's physical,
thinking (cognitive), or seeing, hearing, touching (sensory) abilities may be. The most
rapid period of speech development occurs between birth and 7 years of age. During this
time children have to learn to use about 100 different muscles to talk. Even if an
augmentative communication system is recommended, developing and using speech sounds
should still be encouraged. Speech sounds, even if not true words, can often be
interpreted by listeners as communication signals.
Ways to encourage sound production:
- imitate any sounds a baby makes;
- make visible sounds to a baby like "B" and "M" sounds, raspberries
with your lips;
- play sound games like "patty cake" or make animal and car noises;
- have sound (music, words) output attached to toys
- Assistive technology should be incorporated into a child's already existing
communication system of cooing, babbling, gesturing, and talking. Keep in mind that
children already communicate in a variety of different ways such as the use of gestures,
body posture, speech, and pointing to pictures and objects. When an augmentative
communication device is recommended for a child it should not replace these other modes of
communication but complement them. It is far better for a child to roll their eyes for
"that's ridiculous" than to point to two pictures representing the same concept.
When designing an intervention program it is important to remember that communication
intervention should not focus only on the child, but the partners with whom the child must
communicate, the context or different situations in which a child must communicate, and
the tasks the child needs to accomplish through communication.
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Assessment
When there are concerns about a child's communication abilities, it may be helpful for
a team of professionals to work with the parent. This team should be made up of a
speech-language pathologist and an occupational or physical therapist working with
educators, medical personnel, a social worker and a psychologist to meet a child's
developmental needs. A list of possible assessment teams in North Carolina are listed at
the end of the chapter. The team can help the family to find out what may be causing
communication problems and, more importantly, what to do to help the child gain
communication skills. The following questions may be useful in guiding parents through the
assessment process.
Before the assessment visit(s):
- What will my role as a parent be?
- How is the assessment process set up? Can team members come to my home and to my child's
day care provider's setting?
- Which professionals will be involved?
- How long will the assessment take?
- How will the information be conveyed to me?
- What information does the team need prior to the assessment?
- What can I bring or have available for my child to help him do his best?
- Can I invite anyone I want to participate in the assessment process?
During the assessment visit(s):
- I need to let you know:
- My child's strengths.
- My child's needs as I see them.
- My priorities for my child.
- My desired role in the assessment process (desired level of participation).
- What I hope to learn through the assessments.
- Who should see the results of the assessments.
After the assessment visit(s):
- Where do we go from here?
- How do the assessment results best fit into my child's daily life activities?
- What are my resources?
- What kind of follow up and consultation will be available?
- Where do I go if I need help for funding?
- If an assistive technology device is recommended for my child, how will my child's
caregivers and I be trained to use the device (or any type of technology)?
- Who would be the primary contact person?
As previously mentioned, assistive communication technologies can help children have a
way to talk and play so that they can better use the abilities they have. Assistive
communication technologies also help children to further develop their skills. Examples of
this type of assistive technology includes:
- holding up two toys or pictures of toys for a child to choose from;
- a child touching an adaptive switch to activate a tape player. The tape in the tape
player could have a child recorded on it saying, "Come here, please," or a part
of a story.
- a communication device that would give a young child from one to many choices of things
to say to and ask of others.
An example communication board is included at the end of this chapter. These Picture
Communication Symbols (Mayer Johnson, Inc.) represent early words a child might say. These
symbols can be used together or one at a time during play time.
Parents are partners in the assessment and intervention process. Parents are experts about
their children. If we as professionals do our job well and we as "partners"
share our expertise, hopefully through the assessment process we can select a
communication system which includes speech, gestures, and any necessary assistive
technology. This communication system will promote a child's independence to the fullest
in all areas of daily life.
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Sample Individual Family Service Plan (IFSP) Goals
- Joey will learn to control his mobile by kicking his legs and activating the switch
placed in his bootie.
- Nikki will request more juice by handing her caregiver her cup.
- Crystal will learn to make choices by reaching for the toy she wants when presented with
two different toys.
Next Steps (Transition Issues)
The primary goal of communication assessment and intervention is to facilitate the
child's independence. As the child progresses through the different levels of
communication, new levels and ways of communicating should be challenged. Children with
physical, cognitive and/or speech impairments may eventually rely on a sophisticated
augmentative communication device, a computer, sign language, a picture system or any
combination of systems. The options are many. Parents have the right to explore all of
these options before making purchase and intervention decisions.
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Resources
- Goosens', C., Crain, S., & Elder, P. (1992). Engineering the classroom environment
for interactive symbolic communication: An emphasis on the developmental period, 18 months
to five years. Southeast Augmentative Communication Conference, 2430 11th Ave. North,
Birmingham, AL, 35234
- Baumgart, D., Johnson, J. & Helmstetter, E., (1990). Augmentative and Alternative
Communication Systems for Persons with Moderate and Severe Disabilities. Baltimore, MD:
Brookes Pub. Co.
- Burkhart, L. (1993). Total augmentative communication in the early childhood classroom.
6201 Candle Court, Eldersburg, MD, 21784.
- Crestwood Company, 6625 N. Sidney Place, Milwaukee, Wisconsin, 53209-3259, (414)
354-5678. Nice catalogue of early communication aids.
- Don Johnston, Inc., P.O. Box 639, 1000 N. Rand Rd. 115, Wauconda, IL, 60084-0639, (800)
999-4660. Many augmentative communication and computer resources.
- Mayer-Johnson C., P.O. Box 1579, Solana Beach, CA, 92075-159, (619) 481-Assessment Teams
in North Carolina Serving Children Ages Birth-Three
- N.C. Assistive Technology and Birth to Three Resource Centers (listed on page 1 of this
guide)
- N.C. Developmental Evaluation Centers (Eighteen of these centers exist across the state.
Call the N.C. Department of Health, Environment, and Natural Resource at 919-733-2815 for
locations)
- The Clinical Center for the Study of Development and Learning, UNC-Chapel Hill,
919-966-7486. Kay Hains, Client Coordinator
- The Eastern Regional Assistive Device Clinic, Kinston, N.C., 919-559-5282, Kate
Snodgress, Director
- Local hospitals, health departments, and mental health and private therapy agencies may
also be resources for early intervention assessment and intervention.
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