Difficulty with Nonverbal Skills

Language Assessments 

Observational Play-Based Sample: The clinician will assess how the child not only uses nonverbal communication, but also how the child responds to others using nonverbal communication. In this case, it would be ideal for the caregivers to participate in the play-based assessment because they are familiar to the child.

• Strengths

  •  Can see how the child reacts and uses nonverbal communication with no parameters or "rules" as there would be in a standardized  test

  • Requires less attention from the child than standardized tests

• Weakness

  •  There is no way to statistically measure if the child is in the same range as their peers in terms of nonverbal communication 

The Rossetti Infant Toddler Language Scale: A play-based assessment used to identify at-risk and developmentally delayed children. 

• Strengths:

  • Easy to administer 

  • Play-based 

  • No set time to administer  

  • The test is available in Spanish

  • Included gestural subtest

  • Severity ratings that compare a child to their peers

• Weaknesses: 

  • Does not provide standardized scores 

  • Subjective scoring 

McArthur Bates Communicative Development Inventory (MBCDI): A parent report instrument used to gain information atbout the childs early language development (vocabulary, comprehension, production, gestures and grammar) 

• Strength: 

  • The test is available in Spanish

    • Adaptation in other languages are available 

  • Includes caregiver 

  • Targets current and emerging developmental behaviors 

  • Short administration 

• Weakness: 

  • Manual is difficult to comprehend

  • Includes a long form for the caregiver to fill out 

Two Language Intervention Approaches

Routine-Based Intervention: Embedding instruction into the everyday activities of the child 

• • Strengths:

    • Naturalistic  

    • Involves caregivers

    • Easier carryover to everyday activities due to the child learning in familiar contexts

  • Weaknesses: 

    • The client will have to use nonverbal skills in all contexts not just familiar places

    • More effective when used in conjunction with coaching

    • More effective when toys from home are brought into the sessions

Milieu Communication Training: Builds upon three parameters; 

1. Environmental Arrangement: The use of the client's natural environment to promote the use of specific forms or functions

2. Responsive Interaction: Frequent responses from clinicians and caregivers

3. Conversation-based contexts: The use of a child's interests along with opportunities for modeling in prompting communication that occurs every day  

• Strength: 

  • Naturalistic 

  • Allows the use of:

    •  Incidental teaching: Environment is manipulated so the child has to rely on requesting followed by a response from the clinician

    •  Mand-Model: If a child shows interest, the clinician prompts the child for an utterance

    • Communicative Temptation: The clinician manipulates the toy in order to get a response from the child in any form

  • Targets clients interests 

• Weakness: 

  • Requires a lot of involvement from the clinician and the child's caregivers 

  • Need to be extremely familiar with the client

Alternative Approach

An alternative approach can be teaching these children to advocate for themselves by asking their communication partners to explain what they are thinking and feeling when they use nonverbal communication. In addition, communication partners can be trained to overtly tell the child what they mean when they are using nonverbal communication!