Download PDF If you are a parent of an autistic child who is non-verbal, one of the biggest challenges you are likely to face is how to help your child start to talk as this will allow you to understand their wants and needs more easily. Most parents want nothing more than to be able to know when their child is in need of attention or is hungry or thirsty. If your child is autistic then you may have communication issues trying to understand what they are telling you, or whether they are scared and bewildered or amused with what is happening to them. If you are unable to easily understand your child’s needs as a result of communication difficulties, you may fall into the trap of thinking that you are not being the best parent that you could be. This is simply not true. Remember, too, that there are many alternative forms of communication besides speech. Think how often you communicate by email, text, instant messenger and even by things like waving across a room or just a look! What is non-verbal autism? Non-verbal autism is where an autistic child does not develop speech and language communication skills in the same way and at the same rate as other children of the same age. Up to half of all autistic children exhibit speech delay, so it is not an unknown condition and you are not alone as a parent in facing the challenges of helping a non-verbal child and wondering when an autistic child will start talking. In the past it was believed that if a child was diagnosed as being non-verbal after the age of 4, that they would never speak. However, a study in 2013 by the American Academy of Paediatrics showed that this was simply not the case. The study was based on 500 children and the conclusion that they came to was that non-verbal children can potentially be taught to speak at any age, with some of the children who were studied learning how to communicate fluently as late as in their teenage years. This means that if your child is diagnosed as being non-verbal then you should not be resigned to the fact that you will be communicating by non-verbal methods forever. New breakthroughs in research have shown that you can use non-verbal methods of communication, such as specially designed apps, as a way to begin encouraging your child to start using words while you develop other effective strategies for knowing what it is that they want and need. Some of the patterns of language or behaviour your autistic child may display can include: Repetitive or rigid language – such as responding to questions with questions, or talking in a specific way such as a robot voice or using a high-pitched sing-song voice Uneven language development – they may develop a rich vocabulary in a specific area of interest, they may be able to read really well but have no understanding of what they have read, or they may not respond to their name or the speech of others Poor nonverbal skills – they may avoid eye contact and be unable to use gestures such as pointing to help with their speech In the past it was assumed that all nonverbal autistic children were also intellectually disabled – meaning their IQ scores would be 70 or below, but this is just not true. Recent research has shown that IQ tests are actually not a great way to measure intellectual activity in children, especially autistic ones, and even more so when these children are considered non-verbal. It is really important to remember that no two autistic children are the same. An autism communication strategy that works well for one child may not work at all for another – but that applies to all aspects of parenting of all children! It is not enough to just know how to help an autistic child– you need to find out how to help your autistic child. There are some tried and tested strategies that parents can use to try and get through to a non-verbal child, and more importantly that may allow the child to be able to convey their wants and desires to their parents. In all likelihood, some will work better for you than others, and you need to find which are most effective for you and your child. Remember, you are not alone, and you can do this. Why do some autistic children not speak? One of the least known facts about non-verbal autism is that no-one really knows why non-verbal autistic people don’t, or can’t, use language. What is especially puzzling about it is that some non-verbal people can communicate and do so using sign language, picture cards, communication apps such as app2Vox, and other digital tools. Some autistic children have also been diagnosed with apraxia of speech, which is a neurological disorder which makes the use of spoken language especially difficult. This said, most nonverbal children do not suffer with apraxia, they just don’t speak. There must be something different in their brain functions which inhibits their use of spoken language but at this moment in time there is no agreement amongst researchers as to what these differences are or how they impact individuals. Will my non-verbal autistic child ever talk? Nowadays therapists tend to use the word ‘preverbal’ rather than ‘non-verbal’ as many autistic children who don’t use spoken language do actually gain the ability to communicate over time. Some may gain a few words, if any, while others can become quite fluent. The problem is it can be quite hard to assess non-verbal children with standard tests in order to categorise them into non-verbal (no spoken language), preverbal (not yet developed language), or non-communicative (no verbal or nonverbal communication). What is non-verbal communication? Communication is what happens when one person sends a message to another person, either verbally or by non-verbal means, or by using a mixture of the two. If two people communicate with each other and they each respond to the other person’s communication, then this is classed as interaction. Non-verbal communication is any form of interaction which does not use speech, including sign language, gestures, written messages and technological solutions such as text messages and email. Although getting their child to talk is the goal for many parents of non-verbal children, it can be equally effective to communicate with your children in a non-verbal way. In fact, many non-verbal communications are the building blocks for effective verbal communication, such as eye contact and hand gestures. So, it is important to encourage non-verbal communication as well as verbal communication as a precursor to speech. You can encourage your child’s non-verbal communication by making it easy for them to copy you by exaggerating your own hand gestures – however embarrassed you may feel. For example, you can hold out your arms or clap loudly – these are universally recognised gestures which children should be easily able to interpret. What are the stages of communication? The National Autistic Society says the stages of communication that a person may go through depends on three things: Their ability to interact with other people How and why they want to communicate Their understanding of communication The Hanen Programme (a charity focused on supporting children with language delays) develops this idea further by stating that there are four different stages of communication: The ‘own agenda’ stage – the person prefers to do activities on their own and appears uninterested in interacting with others The ‘requester’ stage – the person has begun to realise that their actions have an effect on others, and can communicate their wants and needs by pulling you towards objects The ‘early communicator’ stage – interactions become more intentional and start to lengthen in time. They may start to point to things that they want to show you, such as an advert for something they are interested in, and they may begin to engage in two-way interaction The ‘partner’ stage – the person is able to use speech and carry out a two-way conversation. They may appear confident to do this at home, but struggle in a more unfamiliar setting While these models are useful in understanding the process of how communication often develops, remember that no model of any aspect of human behaviour will be a perfect fit for all individuals. If you cannot place your child in any particular stage or their development follows a different pattern, there is nothing wrong and nothing to worry about. How to support the development of communication There are many ways that you can help to support communication development in your autistic child. Not all of these will be effective with all children, so try lots of different approaches and find the ones that work best for you and your child. Above all, keep it fun – everyone learns better when they are enjoying themselves! Follow their lead. Do not direct them, take it at their pace. They will be more likely to focus on an activity they have chosen themselves and may learn things such as how to make their own choices. Use single words in the early stages. If they have only just started to communicate, keep things simple by using single words to communicate with them – for example, repeating the name of their favourite toy when they reach for it. Add more words as they get more confident. Once they have started to pick up the single words, try adding one of two more words to the sentence – adding the colour of their favourite toy to the name, for example. Make sure you take time to communicate every day. If your child is non-verbal it can be tempting to do things for them all the time, for example pouring them a drink or giving them a biscuit. However, if you do this you are reducing the opportunities, they have to communicate with you. It can be difficult to decide how much to do for them, so try asking them if they need help with anything and give them some time to think of and communicate an answer. Stay face to face when you communicate so that it is easier for you to see what is resonating with them and what they are interested in. It will also enable them to see any facial expressions you make when you are communicating with them. However, be aware that having to process visual information as well as verbal information may make things more challenging for them, and that many autistic people find maintaining eye contact difficult and sometimes even painful. Use imitation. When you are trying to communicate with your child imitate the things that they do – from banging their cutlery on the table to spinning. This will show them that you are trying to communicate with them, and it gives you the opportunity to add something new into your exchange and see if they copy you. Try using gestures and other visual clues. You can nod when you say ‘yes’, shake your head when saying ‘no’ and wave your hand for ‘hello’ and ‘goodbye’. You can also use images to help you communicate things, such as a picture of the person you are speaking about. Picture timelines, such as app2Vox, can also be a great help when it comes to increasing your child’s understanding. Use role play and songs. Use role play to act out social interactions with your child and help them understand the things that may go wrong. You can also try using songs and then pausing to see if they sing the next part by themselves. Give them feedback when you can see they are trying to understand and communicate – as this will increase the likelihood that they will try to do it again. When you praise them for doing something, they will start to see the connection between what they are doing and specific words. Give them opportunities to communicate, such as placing their favourite toy somewhere that is out of reach or offering them a game that is difficult to operate so that they need to ask for help. Ask open-ended questions. Instead of asking questions which require a yes or no answer only, try asking more open-ended questions. So instead of saying ‘Do you like the pasta?’ you could ask ‘Do you like the pasta or not like the pasta?’ This gives the child the option to expand on their answer and give you more information than just saying yes or no. Teach them phrases and figures of speech. Autistic children (and adults!) often struggle with simple phrases and figures of speech, such as ‘can you catch the waiter’s eye please?’ Helping them to learn that there are some sentences we use that don’t actually mean exactly what they seem to imply can be a hard lesson for them to learn, but one that is well worth teaching them. Don’t be overly critical. Sometimes they may use phrases that you are not expecting – the aim is to keep them practicing their verbal skills and developing their language so encourage them as much as you can. How can I encourage my autistic child to communicate? There are many things that can be done at home to help your autistic child to develop their language skills. Of course, every child is different and you as a parent know your child best, so make sure to use the tips as a guide only and modify them to fit your situation. Make it a game Research has shown that all children learn through playing, and this is especially true for autistic children. Playing is also a great way for children to learn and interact socially and so playing games that your children enjoy is a great option to help them work on communication, as well as visual and motor skills. You can do this by playing games which involve matching and sorting. Games that encourage your child to use their hands, such as making things with plasticine, also encourage them to describe their experiences, through gestures at first and then through the use of words. It is interesting to note that the connection between physical sensations and being compelled to describe the feeling involved. You can imitate the noises your child makes when playing, and the actions they are undertaking in order to encourage interaction and vocalisation. You may feel silly copying your child’s actions but keep at it as it will encourage your child to copy you in return – silly play is part of all parenting and can be lots of fun! You can sing songs, repeat nursery rhymes – anything you like to encourage your child to make noises and keep moving. Build on your child’s communication skills Whenever you are playing with or communicating with your child, make sure you are on their level so they can make eye contact if they are comfortable doing so and can see the facial expressions you are making so that they can copy them. You should also try and narrate everything you and your child are doing together, so that you can start to model their language skills. For example, if your child is playing with a toy car you could say ‘car’ and then make the sound ‘vroom’ when they are pushing the car. Keep your language simple and descriptive so that it is easy for your child to pick up. Once your child starts to talk during play make sure you respond promptly and in a positive way by repeating what your child says, and by adding an extra word. For example, if your child points to the toy and says ‘car’ hand your child the car and say ‘red car’ or ‘car drives’. Responding quickly like this and adding another word will not only reward your child’s effort but also demonstrate the power of communication and help to push their language skills further. Enter into your child’s world Using play as a way to encourage your child to communicate is one way to get into your child’s world, but it isn’t the only way. Get to know your child’s preferred language style, their mannerisms, expressions and interests. Note where, when and how they attempt to communicate and use motivating items and people. For example, if they prefer to talk hidden under a blanket on their bed, encourage them to communicate more by sitting next to the bed or get under the blanket as well. Showing a willingness to enter their world will encourage your child to try entering yours. It is really important to let your child set the pace and take the lead. Allowing them to choose the topic helps to ensure they do not lose focus. Follow along with whatever activity your child chooses to do and narrate what they are doing. For example, if your child is sorting shapes, say ‘rectangle’ when they hold up the shape and ‘in’ when they place the shape in the basket. By doing this you are allowing your child to focus on things they are interested in and encouraging them to connect their favourite activities with certain words. You may also want to choose simple words such as ‘take’ and ‘ball’ to start with making it easier for your child to understand and imitate. Then when your child starts to use these words you can add another word in, such as ‘take car’ or ‘roll ball.’ Keep on doing this and building more and more phrases until you are helping your child to convey full sentences. Overemphasise your body language Most people say you should emphasise your body language when with a non-verbal autistic child, but really it should be about over emphasising your movements and gestures. If you look carefully at much of our normal everyday communication you can see that it is non-verbal, but sometimes we can be so focussed on the child’s inability to use language that we can forget about all of the other tools we have available. When communicating with your child, exaggerate your eye contact and gestures to match the language. This could include pointing to the item you are talking about, nodding or shaking your head when saying ‘yes’ or ‘no’, or clapping your hands to indicate excitement. Many parents have reported success in teaching their children simple terms such as ‘hungry’ and ‘thirsty’ using this technique. Give Your Child Some Space Your child may not always respond to you in the way you want them to, or even at all. It is important to remember that this is OK. You may feel an urge to help them by completing their sentences, answering questions on their behalf when other people ask them things, or mouthing the responses to them that you would like them to say. However, autistic children will generally need a little time and space to be able to process things, and sometimes they may just not want to answer. It is therefore OK to give them space to answer in their own time and in their own way, even if the answer never comes! You can help them by reinforcing positive behaviour though, by watching them closely for any sound or movement when they are asked a question and reacting quickly if you see any sort of response. This can act as a positive reinforcement for them and empower them to communicate more. Use communication devices There are a number of devices and apps for children with special needs out there on the market, from language apps that allow children to combine pictures, words and sounds that help children to build their vocabulary to AAC devices (Augmentative and Alternative Communication). Since many autistic children relate better to objects than people, these devices can help them to focus their communication efforts in a way that is non-threatening. Use visual clues Visual clues are another form of non-verbal communication which are not aimed at replacing language, but rather helping it to take root and grow. Creating picture books with your child or sharing social stories with them can help to reinforce daily routines such as getting ready for bed or help to get them prepared for big events. Spend time looking at pictures together and talk about what you see in each picture. Any of these strategies will work best when used in conjunction with what is being used at school or nursery, or by your child’s speech therapist if they have one. Any professionals who are helping your child will also be able to also give you other strategies to try at home. The most important point to remember is that communicating with a non-verbal autistic child requires both a lot of patience and an all-round approach that combines both aided (such as the use of a text to speech app) and unaided communication. Don’t just use one method of communication and expect your child to conform to that way of communicating, instead pay careful attention to their preferred way of communicating and support them in that. What to do if they get frustrated As with other children, autistic children can get frustrated if they feel they are not being understood, and their emotions can escalate ending up with them becoming exasperated. We have all experienced situations where we could not make ourselves understood, perhaps because we did not know the language of a place we were visiting, and it is extremely frustrating. As a parent you are probably pretty good at identifying when your autistic child is becoming frustrated with their communication difficulties, but there may be some clues that you still miss. For example, it could be that your child starts to rock before they are going to start banging their head which you are aware of, but you may have missed the fact that they started to clap before they rocked. If you are missing these cues it is through no fault of your own. You could be too close to the situation in hand or may be busy doing something else at the time. It happens. This is where a therapist could come in useful as they can help to pinpoint certain behaviours and help you to understand ways to deal with it. A lot of the time, frustration can also be reduced if you can set up a routine for your child which is followed every day and which means that they are aware of what is going to happen next. For example, if your child likes to watch TV after they have finished their tea then why not agree with them that you will put the remote control on her mat once she has finished her tea. This will let them know that their needs are being listened to and that her reward is coming. Is sign language useful? Many parents don’t use sign language with their non-verbal child, as they feel it will affect their speech development – and this just isn’t the case. It can actually provide a bridge from them not being able to communicate to being able to speak. It also does away with any frustration that they might feel from not being able to communicate. Sign language can be great for younger children, but some older children may stop using it as they have wider social networks in the school environment and not everyone in this network is able to sign. It becomes less about what way of communicating they are most comfortable with, and more about a way of communicating that the majority of people can understand. How Augmentative and Alternative Communication (AAC) systems can help AAC systems are systems which help non-verbal autistic children and adults to communicate in a way which they choose. Non-verbal children can become quite distressed if they are unable to express their feelings clearly and their needs are not being met, and so an AAC device can offer them another way to communicate. app2Vox is one example of an AAC system which offers a text to speech app offering nonverbal children the opportunity to interact with their parents, friends and carers through the use of picture cards and a phrase builder. Voice output communication aids, or augmentative and alternative communication (AAC) are terms used to describe various methods of communication that are available to non-verbal autistic people which allow them to communicate when they have little or no speech skills at all. AAC systems tend to be made up of many different components, which may include some or all of the following: a core language board, gestures, signs, symbols, speech-generating devices and some spoken words. These systems are either un-aided: gestures and sign language, or aided: photos, picture cards, and speech generating devices for example. An autistic child learning to communicate with an AAC device needs access to a certain level of vocabulary, which will be expanded on and will grow with all the new opportunities presented to them. Core vocabulary they will learn includes words such as I, this, that, want, help and so on – the words which make up 80% of our daily vocabulary. The other 20% is made up of vocabulary that is specific to the user, such as teachers names, friends names, favourite food and so on. Further Help and Support Inevitably a resource of this type can only give an overview of communication issues which may arise from autism. Every person is different and will have different needs and different learning preferences. It is essential that every person is valued for who they are and allowed to be themselves. There is a huge amount of support and help available for autistic people and those who love and care for them. Some key resources that may be helpful are: Autism Together National Autistic Society NHS Child Autism Autism Support UK Autism Alliance Download the PDF Other Resources How Alternative and Augmentative Communication (AAC) can help your autistic child This resource gives an overview of alternative communication methods, including AAC devices and how they can be used to help non-verbal autistic children. What is Non-Verbal Autism? This resource aims to provide a range of information, support and ideas about how to help a child with autism.