Book>Table of Contents>If Only He'd Talk

“If only he'd talk, he'd be alright!”

Being able to copy words is not talking

The autistic child’s ‘speechlessness’ seems to be the most obvious difference from his age-mates, and people often hope: "if only he'd talk, he'd be alright!". Teaching someone to say some words does not seem to take much. But despite daily efforts, the autistic child usually does not begin to talk. If he does learn to say a few word-like sounds, he does not use these words spontaneously to communicate like other children his age. Is something wrong with his mouth, throat, teeth or tongue? Is it a sign of his autism? Is the teaching-method at fault? Should the adult persist with her training?

Wanting to teach Tyrone to speak, his mother held a bag of crisps high above her head saying "What is it? What is it?! Crisps, Tyrone! Say Crisps, Tyrone! Crisps!! What is it? CRISPS! Tyrone, say Crisps! Crisps!! ...". Tyrone, his eyes firmly fixed on the bag, jumped to reach them, straining, whingeing and yapping, but made no speech-like sounds.

We don’t know exactly how language develops in the autistic child, if and when it does (Ricks 1975, Tager-Flusberg 1981). But all communicative language-development must follow the same pattern. Before speech can develop, the child must have become a good communicator without words. Without being able to communicate, words have no meaning. Without meaning they have no communicative value. After all, some people use sign-language just as effectively to communicate and 'talk', because they, or their parents, are deaf. Parents often complain that the autistic child needs daily sessions with a trained speech/language therapist. But even a trained speech-therapist cannot teach him to talk! Even if he can say some words, this does not mean that he will use them, or even that he understands what they mean. He needs first to catch up with the basics of communication, necessary for all subsequent speech-development. These develop only in interaction with another human being, and out of the baby’s early communicativeness that needs no words:

At 9 months, Anushka picks up a teddy while crawling around. She makes babbling noises, then looks up and smiles at me. Holding teddy, she pulls herself up to stand by her pram, looks round at mum, hen to me, smiles, stretches up with great effort, as if wanting to put him into the pram, too high for her to reach. She makes straining-noises and turns to her mum, who now comes over and says:”Oh, you want to put teddy in?” Anushka looks back and forth between mum, pram and teddy, straining more, which feels like a confirmation of her mother’s question. Her mother puts teddy into the pram. Anushka lifts up her own arms, looks at mum making straining noises again. Her mother understands, lifts her up and says ”Look, teddy’s in Anushka’s pram!”. Together they look at teddy. Anushka points her finger and says “Da!”. Her mother agrees “Yes, teddy! Teddy is in your pram!”

At 10 months, Anushka crawls to the stairs, very fast, then stops looking back at her mum with a wide expectant grin. Her mother swoops her into her arms, laughing, and kisses her. “This is her new game: she knows she is not to crawl up the stairs by herself, and she keeps teasing me about it. Sometimes it gets really irritating! But really it’s so sweet!”, she explains.

When a child begins to speak, words take their place alongside other communicative gestures he is already fully fluent with. It can not be the other way round, just as one cannot paint a house before it is built. The very beginnings of language lie in the moments when a mother follows with her eyes what her baby is looking at and joins him in this. Unlike the autistic child, Anushka is an efficient communicator who ‘speaks’ confidently via gestures, straining noises and communicative looking. Her mother has no difficulty in understanding what she means, putting Anushka’s communications into words. In fact they have a complex conversation. Anushka has clear ideas about what she wants to do with teddy. She calls her mother, asks for help and engages her in real team-work: to put teddy into her pram, and to be picked up herself to see him together. Her ‘word’ bore little resemblance to the actual word ‘teddy’, but her mother understood, ‘translated’ and agreed.

For a long time, the adult needs to home in to whatever the child, or baby, is interested in. A child can only learn to speak and use language, once he has a firm understanding of the importance, and the joys, of such a mutual focus on a common topic, of ‘shared attention’. In a way, mother and baby are having a ‘looking-conversation’: the baby’s silent eye-pointing may be a question that says “Can you see what I am looking at?”. His mum may answer with “Yes! It’s a butterfly! A lovely butterfly! Oops! Gone! Where is it gone?” In this way the baby gradually comes to understand that what he is looking at has meaning for his mum too, and she calls it ‘butterfly’. He comes to love sharing attention like that, and he wants to know what she thinks of things. He checks her face to see whether something is safe or dangerous, allowed or not, bringing a smile or a frown as response. This is called ‘social referencing’, the next stage on from ‘shared attention’. This is what autistic children find so very difficult, or fail to establish, and where the roots are for their not having learnt to talk. This is where we have to apply our nurturing, our most focussed attention, because without these foundations all other efforts will have little meaning and effect.

Most crucial for a child to learn language is that the adult firmly believes in the child’s communicative intent, i.e. being so focussed on the child, that one interprets and responds to all his actions and vocalisations (and non-vocalisations) as if they were a clear message: to see everything the child does, even the tiniest movements, as deliberate meassages from him (even if they aren’t!), all his utterances at least an attempt at communication, and tofollow the child’s eyes to see what he could mean.

Anushka’s teasing-game relies largely on ‘social referencing’: she checks her mother’s face for her reaction, and then either obeys or deliberately disobeys her mother’s message. Without words Anushka shows her mother, that she knows that her mother knows that Anushka knows, that her mother does not want her to climb those stairs, and she does it just for the heck of it, just because it gets them to have so much fun together. Many autistic children do also understand and use this kind of communication, and can be reached on this level.

But any ordinary development can be interrupted, blocked or led astray by a variety of factors, and it is helpful to keep in mind that in the young autistic child two processes occur simultaneously: the normal course of human communicative and language-development, and the autistic tendencies that try (often successfully) to pull this off course. While these need to be kept in check with appropriate teaching-approaches by the adult, we must also make the huge effort to encourage or push his maturational capacities for communicative language-development without being wiped out by autistic anti-tendencies.

The autistic child needs to learn to have a good time being, or mucking about with another person. If it’s fun he’ll want more. If he wants more, he’ll ask for it, - and asking for something is communication. At that moment he will be communicating, because he wants to, not because you are telling him. A child who does not communicate, does not need to learn to say words, - he needs to learn to want to communicate. If he does not want to communicate, he will not speak, even if he did have the words and language to say it. And if he did want to communicate, but could not speak (like the deaf child), he would point to things, using eye-contact and gestures, to try to make you understand what he has in mind (like Anushka). Our aim must be to show him that communicating with another person is fun.

Having fun and enjoying doing something together is what was missing between Tyrone and his mum. Although they seemed to have a common topic of conversation (crisps), it was really more of a misunderstanding: mum wanted him to use his mouth to say the word 'crisps', he wanted to eat whatever she was holding out of his reach. Whether he ate them or not, she did not care, while he cared about nothing else. From his point of view, she seemed, for some incomprehensible reason, to be tantalising him with "Look! I've got crisps! But I am not giving them to you!”. It is true that Tyrone did not try to figure out (as another child would) what his mother wanted. But neither did she pitch what she was doing to what he might have been feeling, wanting, needing, or even what he may have been trying to say or do. They were at cross purposes, their communication gone astray: Tyrone did not understand what his mother wanted and she did not understand why he did not obey. So she missed Tyrone’s communication!

Had his mother been focussed on what Tyrone was trying to communicate (i.e. his ‘communicative intent’ = wanting to eat the crisps), she might have been more responsive, perhaps talking to him like to a much younger baby: “Oh, you want these crisps, Tyrone! ‘Please, mummy’, says Tyrone, ‘give me those crisps!’ Come, let’s sit down on the settee together and open them. Do you want to have a go? Open! Pull! ... Oh, dear! Tyrone can’t open them. Shall we do it together? Lets open those crisps! ‘Hurry up, mummy!’, says Tyrone, ‘I want my crisps!’ There! Opened it! There are Tyrone’s crisps! Yum yum, crisps! Crisps all for Tyrone!”

In this way, she would have been helping him to do something he wanted to do, while giving words to what he might have been thinking, wanting and feeling. As adults we need to make an effort to fit our words and responses to what the child is trying to communicate. This kind of baby-communication makes the word ‘crisps’ stand out (being mentioned about 7x). Gradually, she may leave out the last letters of the word ‘crisps’, waiting expectantly and creating a suspenseful tension to encourage him to finish the word himself. Things have to be felt as making emotional sense, to fit like hand into glove, like a crying baby into mummy's soothing arms, like an anxious question finding a sensitive and receptive ear. It made no sense to Tyrone to be asked to say 'crisps', when his mother was saying it herself all the time already, and because all it needed for him to get them was to pull down her arm, or snatch them from her hand.

Had the crisps been up high on a cupboard next to some biscuits or fruit, then just jumping would not have been good enough. In this case, his mother could well have insisted he ‘say it’, waiting patiently for any sound or gesture, as with Anushka’s “da”. Or: standing in front of the closed cupboard where they both know crisps and other favorite foods are kept, there would be a real need for him to communicate when she asks "What do you want?" After all, it may be chocolate he wants today, or a biscuit! She may help him by starting the sentence for him to complete, stretching the bow of excitement and suspense for as long as it will go, e.g.: "Tyrone wants some (expectant pause) cr--- (?)! Yes, cr-isps! - Tyrone wants crisps!”

In our attempts to teach the young autistic child to speak, we have to make this enormous effort to create communicative situations of ‘shared attention’, that feel nice and make emotional sense to him, because they are on the level of his mental development (often of a baby between 2 or 8 months) -:

We would not tease a 9 month old with his bottle by holding it within sight but out of his reach, expecting him to understand that we want him to say 'bottle' or make a similar sound before giving it to him. Instead we would give him the bottle and talk to him, or carry him to the kitchen to look for the bottle together. At other times we copy his sounds, and play babbling and cooing games with him. Then he may copy our sounds, to recreate the memory of our nice time together! When he has progressed sufficiently from this early level of communicative development, enjoys our company and social games, and communicates well non-verbally, he will one day surprise us by saying ‘bottle’.

Because of the autistic child’s developmental delay we need to focus on the early baby-games that practice pure communication and dialogue-skills. We do not need words to have a conversation! If we copy his sounds, he is likely to respond with delight and echo them. At that moment we are having a dialogue, a babbling-conversation! We would have no problem doing this with a 4-month-old. So we can do it with the autistic 4-year-old, and have fun! The more often we can draw the autistic child into situations of shared attention in ways he enjoys so much that he wants more of it, the better.