
Most people think that psychologists are smart. I am sure that most of us are pretty bright, since we went to school for so long and were able to complete multiple degrees. The process of assessment, whether it is for ADHD, learning differences, autism, because of a head injury, or a mood disorder, can reveal a wealth of helpful information about how a child processes information, can identify their strengths, and can help determine whether there are any gaps in how a child’s cognitive functions are developing so that you can directly support growth for the future. Even though this is a technical process and requires a combination of skill and artistry (how else would you convince a child to hang out with you for hours doing lots of hard thinking?), I always start my conversations with parents after testing with one true fact. I am not the expert even though I have the fancy title. Each child is different, despite lots of commonalities. I will know an awful lot about a child after a thorough evaluation. But the true experts on any child are their caregivers. The few hours of observation that I get are not enough to truly be expert on that one child. The moments that a caregiver interacts with a child from birth to the present create the ability to anticipate their needs, understand the unwritten thinking revealed in their movements and gestures, and to comprehend all the “inside” information that it takes years to develop. This parent super power is a double edged sword.
From the day that you are handed your newborn and told to take them home and take good care of them (truly the most terrifying experience of my life, TWICE!), you are trying to figure out what they are communicating with you. There is a difference between the cry for bored, tired, hungry, wet/dirty, and hurt. You don’t know this the first day but, with some studying and listening, you begin to understand the differences and to anticipate your newborn, and later your infant’s, needs. At the late end of infancy and in transition to toddlerhood, children start to communicate with oral language. Some children make this transition smoothly, starting with dada (this is one of the easier sounds for babies to make) and shooting straight to the part where they use words to actually TELL you that they are cold, scared, hungry, bored, in pain, or sick. It makes life much easier. But, not all toddlers gain these language skills as quickly. Some parents will seek early intervention services to address lags in language development that they observe in their child. I have had the pleasure of working with some spectacular speech language pathologists over the years in children’s hospitals and developmental clinics. They are often some of the kindest, most optimistic, and patient people I have ever met (looking at you Clare and Megan!). I used to have the pleasure of heading a developmental testing team including myself, a speech therapist, and an occupational therapist. This offered lots of opportunities to benefit from the guidance offered from a language specialist to a parent. So today, I impart that to you fine people. Big thanks to Creating Voices Therapy, where I borrowed the content for this post.
My favorite advice is to resist the temptation to anticipate needs. Part of the process of learning to use oral language effectively is to figure out that grunting, pointing, tugging, pushing, screaming, and crying (all baby and infant communication methods) aren’t going to get all your needs met. So, all you Supermoms and Superdads out there who are true experts on what your child is communicating with these methods, please hear this; you need to stop anticipating your child’s every need or desire. If your child gets what they want without communication for it (with words that is), they will not use more sophisticated skills like learning and using sounds and words. If it ain’t broke, don’t fix it right? In comes the concept of communication temptations (Wetherby and Prizant). Communication temptations are just what they sound like: you have the ability to set up an environment that can foster communication by tempting your child to communicate with you. The rationale for using this method is pretty simple: a child is much more likely to communicate if he has a reason for doing so!
The creators of this method suggest several ways to use temptation to build more effective communication skills. They suggested things such as:
• Offering your child something to eat you know he dislikes,
• Putting a toy in a see-through bag and shaking it to get the child’s attention and to build interest,
• Putting your child’s hand in something sticky or gooey such as pudding (assuming this is going to illicit a strong response), and
• Waving bye-bye and saying “bye” as you put toys in a box three times, then pausing right before you put away the next toy.
Each of these ideas has one thing in common- the environment you create is set up so that your child is tempted to communicate about something (“no, I don’t want that!” “what is that?” “yuck” or “bye!”). I think of this as being a little intentionally antagonistic (for a good cause, so don’t feel guilty). This may be why I like this method. You don’t usually get the opportunity to be intentionally frustrating when using appropriate social skills. The dark side of me likes the free pass to do so (don’t judge me).
Another form of communication temptation involves enticing a child to make a request. This is a great place to start for any child, but it’s especially good for kids with autism and other social perceptual delays, because requesting is often the easiest form of communication for these children initially. The steps to this type of communication temptation are as follows:
- Find an activity or an object that your child really enjoys. Look for an activity that is easily stopped and started (e.g., bubbles, a swing, a musical toy with a switch) or an object that has multiple parts that you can hand to your child (e.g., crackers that he loves to eat, cars for a car track, pieces for a puzzle).
- Arrange the environment so that you create an obstacle to getting that object, but so that your child can see the object. For example, put your child’s favorite crackers up on a high shelf, put the cars in see-through container he can’t open, or keep their snack in a plastic Ziploc bag and hold it out of reach.
- Start the activity, create some enthusiasm with fun and then stop (put the lid on the bubbles, pull him back in the swing but don’t let him go, hold the bag so that it can be seen but is out of reach and make eye contact in) or give him only one item (e.g., give him one cracker or one car).
- Wait! Many parents forget this part, but it’s an important one. Give your child a chance to communicate first. Ideally, we want the child to communicate without us helping them (we want him to start the communication without you prompting), so always wait first. See what your child does. Look expectantly at him, like you are waiting for him to do something (which, of course, you are!)
- When he communicates with you (either verbally or nonverbally):
• Give him what he wants and cheer him on–especially if it’s the first time he’s used that particular word or two-word phrase, or
• Build on his communication just a bit to help him move into the next stage of speech and language development.
What you actually do for this last step depends completely on your child and her current level of communication. You continue to use the same methods, but up the bar for expectation as your child uses more and more complex methods to communicate with you. If your child isn’t yet using words, wait until she does something–anything– to indicate that she wants more (moves his body in anticipation, points, reaches); when she does (and she will!), say the word for what she wants, wait just a few moments more, and give it to her (you hold the back of crackers, they reach and grunt toward the bag, you say “crackers” and wait, then give your child a cracker).
If your child vocalizes (squeals, squeaks, shouts, says something that is gibberish) to indicate he wants more but doesn’t actually say the word, say the word for him, wait just a few more seconds, and give him what he wants. If your child imitates the word, or even part of the word, give him what he wants and cheer him on! If your child always imitates your words, but doesn’t say them on his own without a prompt or you saying it to demonstrate first, try waiting progressively longer before you say the word for what he wants; wait for one second and then say the word, then (the next time), wait for two seconds before saying the word, then (the next time, wait for three seconds before saying the word….and so on). If he gets frustrated, go back to waiting a shorter amount of time and build up again. This is not meant to create negative experiences. This method presses with temptation and anticipation to create a moment that you can praise explicitly. This linkage between a specific method of communication and them getting what they want is the motivation to do it again and more. If your child uses one word to request more of the item, use the process of expansion to put his word into a two-word phrase for him (your child: swing! you: “more swing!”), wait for just a few more moments, and then give him what he requested. If your child uses one word, you might also want to use a choice that involves two different two-word phrases (your child: cracker!; you: “big cracker or little cracker?”) and encourage her to use the two-word phrase to make a choice. If your child uses a longer phrase, but makes an error, you can correct his error by conversationally repeating what he said (your child: “wing!” you: “sssssswing!”) and encourage him to imitate you accurately. You might also think about using communication temptations to teach your child to use baby signs or pictures to communicate.
No matter what your child’s level of skill is, communication temptations are often a very successful means to create opportunities for your child to advance her communication skills. So, put those parent superpowers on pause and build intentional opportunities to have your child communicate with you to get what they want. This is how we move from grunts to “I love you mama!” That’s a pretty sweet moment.