Reluctant Communicators- When Plan A doesn’t work

In all of my blog posts so far, I’ve talked about how wonderful the power of communication is…I mean, who doesn’t love to chat?! Who doesn’t want to tell a story, give an opinion, ask a question…?!

Well, actually quite a number of children with communication difficulties! I’m sure we have all experienced working with children who don’t have that burning desire to communicate (and how many of us can relate to that feeling ourselves, when we’re running on empty and the caffeine has worn off?!)

Children with complex needs often have fantastically supportive adults around them who can read what they want or need…This telepathy can be a useful skill but the problem is, sometimes our children no longer feel the need to communicate. We see them glance at the telly so we turn it on. Maybe they look a little rosy cheeked, so we take their jumper off. It’s 11am so they are probably hungry, let’s give them a yoghurt…

This pre-empting can often cause one of two problems:
1. The child gets frustrated at not having a choice in what happens to them, resulting in communication through behaviour,
2. The child becomes passive. They have learned that things happen regardless of how they think or feel. Communication seems to have no real value.

Today I’m going to focus on child number 2. How do we motivate a passive child? How do we find a way to develop intentional communication?

Plan A doesn’t always work. I’ve been there before; I’ve tried something that I think is guaranteed to work and then I am baffled when it doesn’t. So I now have a selection of back-up plans- Plans A, B and C!

PLAN A- Find a motivator… and then stop

Before I start working with any child, I always like to find out from class staff or family what the child is interested in…What really floats their boat!

And I always bring along my trusty tool kit of motivators which includes all of the usual things that SaLTs cram into their handbags- bubbles, a ball, an iPad filled with pre-stored music (theme tunes, chart hits), chocolate buttons, a cause and effect type toy, etc, etc! As you can imagine, my work bag is pretty big…!

Having a strong motivator provides the child with a reason to communicate. But the catalyst for communication really occurs when we suddenly stop that motivational activity- when we put the lid on the bubbles or pause the music.

And then we wait.

We wait for the child to indicate that they want more of this activity. This might be through a vocalisation or grasping for the object. Or it might be something as simple as making direct eye-contact.

After the child has initiated communication through some means,  I then like to introduce the symbol for the word ‘more’. I model its meaning and allow the child to become familiar with using the symbol as I frequently pause their motivational activity.

Sometimes I record ‘more’ on a Big Mack switch if the child needs more auditory reinforcement.

‘More’ is always a powerful word to start with when working with a reluctant communicator…and then once they’ve mastered ‘more’, you can introduce the symbol for ‘stop’ to increase their control of the activity!

PLAN B- The red herring

RED HERRING

Choice-making is often a great starting point for communication. But it’s not quite as simple as holding up 2 toys from which a child can make a choice.

Think of it this way- If you present a child with 2 highly motivating activities to choose from, the chances are that the child might think, “Both of these activities are fun…I don’t care which one we do!”

The child appears passive because they know they will get to play with something that they like regardless of what they do.

This is why I like to introduce a red herring-something that the child is disinterested in. I try to find the most boring thing possible, like a paper towel or a sock.

The child might think you are crazy, but they quickly realise that they better make a choice before they end up playing with a sock!

Once you have established some definite choice-making, you can gradually phase out the red herring and develop choice boards or simple choice pages on low or high-tech AAC devices.

The image below is a template for a Go Talk 4, looking at choice making when singing nursery rhymes, also incorporating ‘more’ and ‘finished’.

PLAN C- Creative silliness

I used to work with a child who was a bit of a puzzle to me. I tried every possible motivator I could think of, but nothing seemed to interest him.

One morning, I was supporting him in his classroom during an art activity. Whilst walking across the classroom to get some coloured card, I tripped- a full on, comedy fall, with my arms waving above me!

Then I heard a giggle.

I looked up and my ‘hard-to-motivate’ child was grinning at me! Yes!!! I’d found something that he liked!! Some of the children who we typically find difficult to motivate simply don’t find communication fun…And it’s our job to show them just how fun it can be!

So I made some ‘Simon Says’ style eye pointing boards with 4 symbols. He immediately loved this activity, enjoying the element of control by making me pretend to sleep, dance, cry or fall!

Children love a bit of creative silliness! ‘Simon Says’ is just one example but basically the sillier the better!

Another fun example is a game of ‘dress up’- you can get the children to choose an item of clothing and then who they want to wear it. You can even introduce symbols such as ‘like’ and ‘don’t like’ to expand on the communication, making comments as well as requests.

 

The important thing to remember is that once a child starts to demonstrate intentional communication as a result of Plans A, B or C (or other variations…!), build on that! They are demonstrating that yes, they DO want to communicate but they need reasons to do so. Let’s not be so quick to jump in, assuming the child’s wants and needs. Let’s give them a little time and the vocabulary to take back some control!

 

Communication on tour!

When I started working as a Speech and Language Therapist, I was based in a clinic- One small room, with one large, bright window. Don’t get me wrong; I’m not complaining- some Speech Therapists don’t even have a window…!

Even on wet, drizzly days (which was the norm, as I was working in Northern Ireland!), I used to glance out the window between appointments and think, “That’s where all the proper communication is happening- beyond that window!”

When I started working in schools, I could stretch my legs a bit more- joining students in the occasional cookery lesson, making use of the sensory room, sometimes even venturing outside with the children into the playground…it felt like a little taste of freedom!

So when some of my forward-thinking colleagues invited me to join them on trips beyond the confines of the school gate to support some of our students using alternative forms of communication, it didn’t take me long to grab my coat and a selection of core symbols!

This has now become a bit of a regular part of my job; something I refer to as ‘Communication in the Community’. Catchy, right?!

I see it as having 3 main functions:

  1. Real life communication experience- Many of the students who I work with are quite confident using their alternative forms of communication in the school environment. They don’t feel different or that they ‘stand out’ – In their class they have plenty of other friends using communication books, iPads, switches or eye-gaze devices to communicate.

Similarly, in their home-environment, they have support from their family who understand their communication system.

Once we venture out beyond the safe zones of school and home, there is the daunting prospect of communicating with people who have never interacted with anyone who  uses something other than their voice to communicate. This can make some of our children a little nervous, a little withdrawn or sometimes frustrated. By easing them in to the idea of communicating beyond their comfort zone, with a little bit of extra support, we can help to bridge that gap and boost their confidence.

  1. Motivation!! The best communication happens when our students are highly motivated! And let’s face it, sometimes it’s difficult to think of new, innovative ways to encourage our children to initiate communication, carry on a conversation, ask a question or make a comment.

But once you take them to a popular bargain store (naming no names…!), and they have a few pounds to spend, watch that student become incredibly motivated to let you know what they want! Or maybe it’s a trip to a cafe and they see a delicious chocolate fudge cake perched temptingly on the counter…Or perhaps it’s the local Pet Shop and you know they desperately want to pet that Guinea Pig..!

Every student is enthused by something different but once you find that motivation, those communication targets seem well within reach!

  1. Educating others- This ties in with my first point. It is so important for the wider world to understand that people communicate in different ways. We rarely see people using communication aids on TV or in the mainstream media (with the exception of the fantastic Stephen Hawking!).

What I find is that the general public are often very intrigued by the resources and technology that our students are using on our trips into the community. On a trip to the supermarket, a lady approached the young girl who I was working with and said, “Wow, what a great idea- having a little TV on her wheelchair!” I was then able to explain that actually, this was a communication aid, and my superstar communicator was able to demonstrate by introducing herself!

 

So if you think this sounds like an interesting idea and you fancy taking your communication session on a day trip, here are a few essential things that you may need to pack:

  • Core symbols- Core symbols consist of words that we use again and again across multiple activities. Even if your student is using a high-tech communication aid, I think ‘no-tech’ back-ups are essential. Sometimes technology lets us down or we need to take a step back if our student is working on new vocabulary.

I tend to wear core symbols on a lanyard around my neck or carry them in a small zippy wallet. The symbols that I tend to carry most often include:- ‘yes’, ‘no’, ‘more’, ‘stop’, ‘want’, ‘help’,’ like’, ‘don’t like’ and ‘something different’.

In an activity such as feeding the ducks at the park, the child can use these symbols to indicate that they 1) ‘want’ to feed the ducks, 2) that they want some ‘more’ bread but that they need ‘help’ to throw it in the pond, 3) that they ‘like’ the ducks and then finally, 4) that they want to ‘stop’ and do ‘something different’.

  • Custom-made communication boards- Our students’ communication books can help them to talk about most things that they want to, but if you are going somewhere new, you might need some specific vocabulary. It’s easy to quickly rustle up a communication board on software such as Boardmaker or Matrix Maker.

For example, I took some of my students to the Fire Station a few months ago and I made the communication board below not only for the students to use but also for me to model new vocabulary to them. As you can imagine they loved telling me to put on the helmet…!

  • A switch- If your student isn’t using a high-tech communication aid, they may want a way to greet others or to initiate communication. Something like a Big Mack Switch or a Talking Tin Lid is the perfect way to do this.                            Some of the children who accompany me on trips, like to use their communication book to tell me what they want at the cafe but then prefer me to then record their order on to a switch- That way, they can order their own food using the switch, without trying to reach the impossibly high counter with their communication book!

Another fun way that I’ve recently used a switch, was on a trip to the toy shop- I recorded, “I want to look at that toy!” on one girl’s switch and as we walked up and down the aisles of the store, she took great delight in pressing her switch to let me know when she’d seen something she wanted to have a closer look at!

 

If you are a Speech and Language Therapist and you like the idea of a change of scenery, give it a go! Take communication on tour! The students will love it and I’m pretty sure you’ll be ticking off targets with every trip out!

 

* With thanks to the team at Highfurlong School for always supporting new and innovative ways to promote communication!