Nonvocal learners are, most times, silent. For the sake of this conversation, let’s call them silent participators. There is no directed form of vocalization to demonstrate happiness, participation, or requesting. Most vocalization is seen in signs of displeasure. For me, as an SLP, the vocalization (any vocalization) found in any form of displeasure (cry, protest, refusal) becomes my baseline. Most parents of silent participators want them in speech so that talking can occur. And yes, they are correct in that the end goal is to support talk or verbal behavior. However, there are steps to be taken before we get to that point. Here are a few things to consider for parents when wanting to move from Nonvocal to Verbal.
1. Make sure the SLP understands that the end goal is Verbal Behavior. Understand the plan of intensity to make this happen.
2. Make sure the SLP is not treating in a box. That is, well run, supervised, and language based ABA programs are very beneficial (please note the criteria for ABA in well run, supervised, and language based) in that they should be targeting imitation (gross, fine, speech motor) and heavy manding/requesting programs. Because speech motor is the most finite of the motor system, it is clear that it is, in most cases, the last developed. First crawling, then walking, grabbing and manipulating objects, then talking.
3. Nonvocal or silent participators must be taught to move their mouths AND pair vocalizations in vocal play like activities. This can be done in play, during eating, and requesting.
4. Teaching silent participators to Reach, Point, and Request is essential. The truth is that communication is more than a verbal exchange. It is a whole body experience comprised of at least 50% being nonverbal. It’s how you say it and what you say that makes a message.
Communication development can be best described in the development of babies and toddlers. They learn to gesture, pair vocalizations with mouth movements, they play with sounds in babble, they point and request, they make up their own language to speak and communicate meaningfully, and then they then create words. This is the process that is taught to children who are silent participators, nonverbal and nonvocal. The challenge is that it is socially acceptable and safer for babies and toddlers to be nonverbal because we know developmentally they will improve and then own the communcation standard of their environment. In contrast, it is not safe, does not foster independence, nor promote social acceptance when the seven year old with autism is silent and nonvocal. With the latter child, there is a greater sense of urgency. With this urgency, the intensity should be present in an intensive combined ABA and speech therapy program.
ABA alone is not best in promoting speech simply because there is a science to it beyond Shaping Theory. SLPs learn and have foundational knowledge isn anatomy and physiology. SLPs understand muscle movement patterns, nerves that evoke responses, are foundationally taught how to elicit sounds and which muscle movements matter most. SLPs write in phonetic symbols that can track how your child produces sound systems. With that, speech therapy (including oral motor) in isolation is not best when trying to evoke and promote communication in silent participators. Applied behavior analysis done well provides the repetition, behavior momentum, and frequency that the brain needs. Combined together, they are purposeful and promote progress. When they are at odds with each other and not combined, not implemented from an evidenced based perspective, or have less than optimal credentials, the child and family are the ones who lose.
Speech-language therapy should be an integral and heavy portion of our ABA programs. Why? Because communication and language are everything. SLPs are instrumental to that process.
I do believe that Mr. Daniel Webster put it best “If all my possessions were taken from me with one exception, I would choose to keep the power of communication, for by it I would soon regain all the rest”
I was inspired to write this as I listen to a child who is no longer a silent participator but now babbling nonstop, move his mouth, pair vocalizations, and produce “Ma” for mama.