Tonight I received this email from a mom desperate for advice. I’ve omitted her name, her children’s names, and the location to protect her anonymity, but I wanted to share her question because it’s the same one that many, many of you ask me everyday. Her question is here:
“I really really hope you can give me some advice as I don’t know what else to do. My name is *** and I live in ***. I am a mommy to my wonderful 3 years and a half twins who were diagnosed with autism when they were around 2 years old. I knew something was off especially when she stopped babbling after she turned 1 . She remained non verbal not even babble, but she makes noise and laughs and interacts with us.
My other twin always babbled and continued to do so but again not any real words. They also stopped responding to their names around that time. I got their hearing tested when they were 2 and one couldn’t hear at all and the other only had 20% hearing. They got tubes placed in and they are ok now hearing wise. The process here for early intervention is very delayed and we had to wait a year for them to be seen by a Doctor specializing in autism to assess them and diagnose them. She did see them in March before they got their tubes in June 2014. Since they got their tubes, one of our girls remains non verbal but makes a lot of noise and interacts with us and others, eye contact has improved however NO LANGUAGE at all.
I followed your advice and start at the bottom with eye contact and getting her to make noise but still no words. She is also very hyper child, on the move and loves physical activities. she will imitate some actions but not words or sounds. she loves spinning so I spin her on the floor on her back like a break dancer, I stop and then I showed her to more sign and she was able to do it right away – she is using that to request spinning…The point is that if there is something hugely motivating for her she will do it as she proved to me she can.
Our other child has a few words and I got her to say ball as her first real word by being animated and repeating it and showing it to her on a dvd and she repeated it right away…it was amazing, I cried.
We are doing speech and ABA therapy in the house, privately as they are on a waiting list for IBA and ABA which is free but the wait list is 2 years for ABA and 3 years for IBA which is ridiculous so in the meantime we are doing it privately at home only 6 hours as week as we cannot afford anymore.
We are working with a speech pathologist and I always ask this question – is our little girl going to talk EVER? Her play skills are great, but they are not apparently where they should be – she loves challenging things and I think basic play is too boring for her. I tried what you suggested for non verbal kids to play with them and tickle them and to illicit sounds from them – that is no problem she interacts and makes eye contact and laughs and plays and comes to us to request hugs and kisses and affection. I just don’t know what to do about language!
Our other child seems to be stuck at only 10 words. She does imitate sounds but not actions. She has low muscle tone and mouths almost any toy that has a round tip. She was seen by an OT and she thinks our child has some sensory issues. I’m not sure how this affects speech but her fine motor skills are not where they should be. She is also fixated on playing with string or anything that dangles and she stims on it – we all think its a visual sensory thing because she gets a kick out of it.
I’m so sorry for the long email I just don’t know what to do and no one here seems to have any idea of what’s going on.
Here was my response:
“Hi ****. You’ll have to keep building on those social games AND working on their cognitive skills in play AND helping them understand more words before you’re going to hear more words. Those pieces – the social interaction piece, cognition evidenced by more advanced play/interest in toys, and better language comprehension are the cornerstones of language development and until those pieces are better, consistently better, you won’t hear very many new words. Those pieces are also the hallmark of autism.
The good news is, you’ve seen some progress in all of those areas! Just keep at it! Expand those social games to the point where each girl is playing 10+ different games with you and learning to “do her part.” For example, signing “more” to continue her break dancing. (I love that by the way!) Try Ring Around the Rosies so that the 3 of you are playing together. Their part is holding hands and falling down. After they master that, make them pull you up to play again, or hide your hands behind your back so they have to grab you to play again. If you need more ideas, my book Teach Me To Play WITH You is full of those games. I don’t know if you’ve bought any products, but it’s one I would recommend you get TODAY : ) It’s the starting point for everything and it will be easy to see some progress with these things since you’ve had some initial success, but neither girl sounds like she’s mastered these kinds of interactions so start here.
The next thing is working on those cognitive skills with play. Are they using objects appropriately in play – feeding a doll, washing a doll’s face, putting the doll to sleep, etc…? If not, start there. If that’s too hard, back up to shape sorters, ring stackers, puzzles, etc… My guess is they are beyond that, but need help learning to use familiar objects functionally during play (first on themselves, then on you, then with a doll/character) and then beginning to sequence 2 to 3 actions in early pretend play. I have some older podcasts about that called Stages of Play that can give you some ideas. I’m also about to release a new book with DETAILED instructions for helping a child move on in play so keep your eyes out for that too.
As you’re working on those social games and play skills, you’ll also be targeting language comprehension which for your girls would be consistently following simple directions/commands during play and during daily routines. Are they throwing things away on request, putting their cups in the sink, getting their shoes when you ask them, finding toys like “Go get your ball,” etc… ? Be careful not to overestimate what they understand. If they don’t do it for you on request, chances are, they’re not really, really, really grasping what you mean when you give them a verbal direction. Get diligent about making sure they follow simple directions all day long with you. Unless they understand words, they’re not going to use them. The DVDs Teach Me to Listen and Obey 1 & 2 walk you through teaching children how to follow verbal directions and understand more words.
I hope that gives you enough to go on AND I hope your therapists are outlining your goals in this way.
There are no short cuts to talking – this is how ALL kids learn to communicate: social interest + cognitive skill development measured in play + language comprehension and then the words will come.
I hope it all makes sense to you!! Good luck!! Laura”
You’ll notice I did NOT directly answer her question, “Will she ever talk?” because frankly, I don’t know if she will talk without seeing her in person and working with her week after week after week. No one can tell you definitely if a child who is nonverbal with autism will talk based on a question on the internet…
Research tells us that 33 – 50% of children with autism will not become functional communicators verbally, meaning that they will not learn to use words to express their wants and needs, ask and answer questions, participate in conversations, and use words to accomplish all the things we use words for during our daily lives.
While that number is hard to swallow for lots of parents (and therapists too, by the way!), the good news is…
50 to 66% of children with autism WILL TALK and go on to learn to use language to communicate with others.
While studies vary, most of the time, the biggest predictive factors continue to be how well a child interacts with others, how well he or she plays with toys, and how he or she links meaning with words… so basically…. all the things we talked about helping a child learn to do.
Developing social skills, play skills, and language comprehension are VITAL to helping ALL toddlers, regardless of a diagnosis or WHY they’re not yet talking, learn to communicate.
If our speech therapy treatment plans for young children with autism are based on establishing those foundational skills and if we help parents learn how to target those skills at home, we know we’re doing everything we can to set the stage for a child to become verbal.
And THAT’S what I say we do about words…