Maureen Mulligan LaRossa, R.N.
For some children learning to speak is a difficult and lengthy journey. These children need a method of communication to use while they are working on oral communication. There are a number of alternatives to oral communication for children who have difficulties learning to speak. You should explore options with your child's doctor and or therapists. It is very important to try to figure out a system for a young child to communicate to his/her family and other people he/she has contact with. Being able to communicate one's choice about what food or toy you want is a very important developmental milestone for a child to accomplish. It might also make it easier for a family to consider a school program or child care setting if they knew their child could communicate, at least at a very basic level, with care givers. The method of alternative communication outlined here is one that any family can use, requiring no special equipment and little training. It can be used along with other methods. The key is to engage in meaningful communication with your child and allow your child to have some of the control and choices that same aged children with oral communication have.
- To start moving your child towards a consistent communication system, first determine if he/she can let you know his/her preference between two choices. If your child does not use a consistent signal to indicate a choice, you may want to teach him/her how to do so. You could pick a movement your child can make and consistently help him/her indicate the choice you think he/she wants until the child learns to do this him/herself. To begin you should offer two choices, then pick the choice you think your child wants. As you make the choice move your child's arm, hand, finger, or head towards the object. After repeated experience with helping your child to indicate a choice, test to see if he/she can do it by him/herself. Once a clear choice signal has been established move on to the next step.
- Ask your child which of two different foods he/she would like. Hold each of the choices up for your child to see. Ask which he/she wants and note what he/she does with his/her eyes and/or body. Does your child steadily look at one of the objects or move a hand towards his/her choice. If any indication of a preference is given the child should immediately be given the object. This should be done in an animated way, verbally reinforcing what he/she asked for. Make sure your child receives praise each time you think he/she has made an indication of a choice. Eventually your child will consistently be able to indicate a choice.
- Once you feel your child is using a gesture to indicate a choice, move to using pictures for communication. Have two objects visible but also hold a picture of each object up and ask which he/she wants. If your child can make the switch to a representation (picture vs. the actual object) it will allow for an expansion of his/her ability to communicate. You can then move to giving your child choices about toys, clothes to wear, places to go or people to see through pictures. This will enable you to have a stack of communication cards that you or anyone can use to communicate with your child.