Communication

Terms

• Social-emotional reciprocity: the back-and-forth communication that develops within the first year

• Emergent literacy: knowledge of reading and writing skills, and involves interaction with and learning from print

• Receptive language: how one understands the words that are heard

• Expressive language: how a child puts their thoughts into words & sentences

  • *can sometimes be delayed in children from bilingual households

• Pragmatic language: social use of language (e.g., taking turns speaking, staying on topic)

Language Development

• 2 months: begins to coo

• 4 months: babbling begins, has different cries based on different needs

• 6 months: "jabbering" with various consonants, but not yet functional communication

• 9 months: better at gesturing - can point and better understand the gesturing and facial expressions of others

• 12 months: should have words such as "dada", "mama", or "no" or "uh-oh"

• By two years old, a child should:

  • use 2–4-word sentences ("I want apple juice")

  • point to pictures when asked ("Where is the flower?")

  • marked improved gestural communication & identification 

• 2-3 years: carry on simple conversations and respond to questions more functionally; knows and can communicate name, sometimes age

• By four years old, a child should:

  • be able to converse with others, especially about things they like

  • sing simple rhymes or songs

  • able to copy language for functional tasks, such as the Pledge of Allegiance

• By five years old, a child should:

  • better able to express and follow rules for social play

  • tell a simple story using several sentences

    • marks more complex sequencing and recall

  • sing, dance & act

Interventions

Considerations

• use of choices to promote interest and motivation

  • asking "do you want to put on your shoes" gives the child an opportunity to say "no"

  • instead, you can ask "do you want to walk or hop to go put on your shoes" to still give them a choice while giving independence to do tasks

• modeling of strategies (either adult or peer)

• frequent collaboration with other team members to increase skill acquisition and generalization

  • family/caregivers

  • SLP

  • teacher or daycare provider

Strategies to Promote Social Participation & Communication

AAC - Augmentative & Alternative Communication

a set of tools and strategies that an individual uses to solve every day communicative challenges

• effective communication occurs when the intent and meaning of one individual is understood by another person - the form is less important than the successful understanding of the message

• Aided AAC: any device, either electronic or non-electronic, that is used to transmit or receive messages, ranging from communication books or boards to speech-generating devices

  • Pictures

  • Communication boards/books

  • Speech generating devices

  • Single message devices

  • AAC software on a device

• Unaided AAC: does not require special outside tools or any supplemental materials, because it is based on natural communication such as facial expressions, gestures, body language, informal vocalization, and even implies sign languages

  • Facial expressions

  • Pointing

  • Vocalizations/Verbalizations

  • Body language

  • Gestures

• Remember:

  • The form is less important than the successful understanding of the message - sometimes we get stuck doing things one specific way that other communication is missed out

• Ask yourself:

  • Does this form of AAC facilitate this client's occupations? 

  • If yes, reflect on what is going well. 

  • If no, how can we change/modify/adapt? 

• Consider contexts!!

  • expectations of contexts differ (home v. school/work v. clinic v. community)

  • thinking about who we need to communicate with and why helps to reframe what we are looking for in AAC. 

• Goals:

  • providing a means for individual to say what they want to say and how they want to say it, when they want, and to whom they want - autonomy of an individual's communication should be central

OT's Role

The PRC Advantage - AAC & Speech Devices from PRC