Teaching a child to enjoy social encounters

Some children do not like social encounters and will actively avoid them. This will serve to delay communication because communication requires interaction with others. Therefore, an early part of their communication program should include teaching them how to take pleasure from social engagement with others (Schweigert, 1989). The following techniques can be used to accomplish this.

• The adult can try to attract the interest of the child by initially attempting to enter the child’s world. The adult starts by merely being in the physical proximity of the child, and, over time, begins to move closer to the child. If this is successful, the adult can then begin to imitate the child. If the child starts to watch the adult, indicating an interest in what is happening, the adult can increase the intensity of movements and sound, and/or begin to engage the child more directly. For example, if the child enjoys touching a particular object, the adult may start by touching a similar object in the same way, and then go on to touching the child’s object. This could lead to a game in which the adult playfully takes the child's object, briefly does something with it, (e.g. puts it on the adult’s own head), and then gives it back to the child. When the child is comfortable with this routine, communication instruction may be initiated with the adult waiting for the child to reach for the object before giving it back (Mirenda & Schuler, 1988).

• When reinforcing the child, always pair a non-social reward (e.g. toys or food) with adult attention. The child can then begin to associate attention with the pleasure derived from the non-social reinforcement. Eventually, the attention should come to be regarded as desirable in and of itself. The Early Communication Process developed by Schweigert and Rowland (1992) includes teaching a developmentally young child to enjoy social attention.

• Visually cued instruction is another structured program that is excellent for children with little awareness of social skills. It can be used with children who do not yet exhibit intentional communication or the understanding of symbols.

After a child has mastered non-symbolic communication, such as requesting by pointing to or looking at desired objects, or pushing away unwanted objects, the next step is for the child to learn how to use symbols. Communicating with symbols allows the child to refer to objects and events that are not immmediately present (i.e. objects that are not physically present, and events that have already occurred or have yet to occur). Symbols are also necessary for the discussion of abstract concepts, and, thus, are essential in academic endeavors. Many children naturally gain an understanding of symbols as they develop cognitively. However, some children, in particular those who are severely cognitively impaired, may have to be explicitly taught symbols. (See Assessing intentionality, and the understanding of means-end, causality, and symbols, Issues with symbol systems, and Types of symbol systems.)

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Some children easily confuse different symbols, especially those that are similar-looking. A child may be able to correctly use the first few symbols learned, but, as more are added, begin to mix them up or produce symbols at random. This suggests that the child is unable to remember the symbols well enough to distinguish them. One solution is, at least initially, to choose symbols that are sufficiently different from each other to allow the child to distinguish among them (Franklin, Mirenda, & Phillips, 1996). This means that some children will start out with symbols that differ greatly, while others can be taught symbols that are more similar in preparation for differentiating symbols that are very similar-looking (Reichle, York, & Sigafoos, 1991). Sometimes it is beneficial to give a child explicit practice in differentiating symbols, such as a symbol matching task Thorley, Ward, Binepal, & Dolan, 1991).

Van Tatenhove (1987) recommends starting with real objects when teaching symbols to children who are still pre-symbolic. (See Assessing intentionality, causality, means-end, and the understanding of symbols.)

• Make sure the child is able to communicate intentionally, and, in particular, to make requests. (See The first goal: Intentional communication and Requesting.)

• Use two identical sets of objects that the child enjoys. When the child requests one of the objects, do not give the child the object that was indicated, but its identical pair. Van Tatenhove refers to this as an object-to-object representation. When the child comprehends that indicating one object is the way to access its pair, the child has developed an understanding of symbols.

Once the child has mastered object-to-object representations, he or she can be taught more abstract symbols, such as picture symbols. (See Start with objects as symbols.) Again, pairs of identical objects are used initailly (Van Tatenhove, 1987).

• The child will begin with object-to-object representations, that is the child will be indicating an object in order to receive its identical pair. This time, however, a photograph of the object is placed above each of the objects from which the child will be requesting. When indicating an object in order to request it, the child should begin to link the picture with its object. Over successive trials, the child can be assisted in shifting attention from the object to its picture, by making the object less, and the photograph more, prominent. For example, their relative positions could be slowly changed so that the photograph becomes more centered and the object pushed towards the back (Reichle, York & Sigafoos, 1991; Van Tatenhove, 1987). (See Prompts designed into the AAC.)
• Later remove the objects, so that the child can indicate only the pictures to make requests. It often helps to explicitly state the connection between using the photograph to make the request and receiving the object simultaneously, for example, "You are looking at the picture of the puzzle. Here is the puzzle" (Van Tatenhove, 1987).

OTHER RESOURCES:

• "Picture this: Teaching Icon Associations" from Prentke Romich Co. at www.prentrom.com/teaching/picture.html.

Sign language is another major symbol system. It is frequently taught using simultaneous communication, milieu teaching, and prompting and prompt-free strategies.

Direct selection or scanning must be used when a child has to choose among an array of messages, as with, for example, communication boards or voice output communication aids (VOCAs), as opposed to directly producing the desired message such as with speech and sign language. In direct selection, the child independently locates and then activates the message. In scanning, the child waits while an external navigator, either another person or the device itself, moves through the messages highlighting each one separately. When the desired message is reached the child indicates or activates it.

In general, direct selection is considered preferable to scanning since it has the potential to be faster. Scanning involves long waiting times during which the child must remain attentive and remember the intended message, increasing cognitive demands as well as the likelihood of fatigue and boredom (Ratcliff, 1994).

Scanning is typically used with children with motor disabilities who are unable to push or touch one of a series of buttons or pictures, but are capable of activating a switch or indicating an affirmative to a partner. If it is unclear whether direct selection or scanning is preferable for a child, then both may be taught simultaneously. This is also a good idea if a child’s motor skills are degenerating such that he or she is currently capable of direct selection, but will lose that ability in the future.

Scanning can be visual (e.g. pointing to each choice in a series), auditory (verbally labeling each choice) or both (for example, if each choice is verbally identified as well as pointed to). Using a combined visual and auditory scanning technique may enhance receptive (i.e. the child's ability to understand) as well as expressive language skills.

Auditory scanning is considered more difficult than visual scanning for the following reasons:

• In the visual mode, items are permanently available. The child can examine any picture at any time.

• In the auditory mode, once a choice is presented, it is no longer accessible. If the child is being presented with an unfamiliar list of choices, he or she may have to listen to the entire sequence in order to know everything in it, and then have the sequence repeated in order to, then, make a choice. Memory and attention requirements are greater than they are for the visual mode.

Because of the difficulties inherent in auditory scanning, some children may always choose the first or the last item in the sequence to reduce the effort required, particularly during the learning stage. To prevent this, neutral items can be mixed with highly preferred items. In addition, the relative positions can be frequently changed, the list of items can be reduced in length, or auditory cues can be given (e.g. stating known preferred items in a louder voice) to help the child get started in using scanning (Light, 1993; Reichle, York, & Sigafoos, 1991). (See Prompts designed into the AAC.)

OTHER RESOURCES:

• "Auditory Scanning ListServ" at espse.ed.psu.edu/SPLED/McN/ auditoryscanning/JoinLS.html

• Cynthia Cress' Sept. 29, 1997 response under "single switch info request" discusses teaching switches to very young children on the ACOLUG listserv archives at listserv.temple.edu/cgi-bin/wa?A2=ind9709&L=acolug &F=&S=&P=26678.

• "My son...can play with toys, through a switch, but we don't know where to go after that..." from an article by R. J. Cooper at www.closingthegap.com/cgi-bin/lib/libDsply.pl?a=1011&b=6.

  Help me—and everyone who reads this site—by mailing your suggestions, criticisms and personal experiences to Ruth Ballinger at yaack@iname.com

• "Cerebral palsy and visual impairment: An access challenge" by Cynthia Brown and Tracy Shepherd at www.closingthegap.com/cgi-bin/lib/libDsply.pl?a=1013&b=8.

• "Scanning anyone?" by Vicki Nelson at www.closingthegap.com/cgi-bin/lib/libDsply.pl?a=1106&b=3.

• Beukelman and Mirenda have a section on direct selection and scanning in Augmentative and Alternative Communication Management of Severe Communication Disorders in Children and Adults.

Reichle, York, & Sigafoos (1991) offer an excellent strategy for teaching a child how to scan utilizing a choice-making format. The assumption is that the child is a beginning communication board or voice output communcation aid (VOCA) user. If the child is also pre-symbolic, then real objects can be used. Prior to beginning teaching, a signal for yes or switch that the child will be using to indicate a preference must have already been established.

• Initially just one item, a preferred one, is presented. The child has to learn to wait until the partner or device indicates the item before producing the yes signal or switch activation response in order to request the item. The position of the item on the board should be changed randomly each time so that the child becomes aware of the entire board. While teaching, the child’s attention can be redirected to the board, if necessary, with verbal prompts ("Look over here"), auditory prompts (tapping the pictures with a finger) or physical prompts (gently redirecting the child to face the board). Otherwise, it is best not to say or do anything else so as not to distract the child. Scanning should take place at an appropriate speed, slowly enough for the child to be able to follow.

• When the child has mastered waiting, a "distractor" (i.e. a neutral item) is added. The adult may indicate either the neutral or the preferred item first and, again, the child has to learn to wait until the desired item is indicated before responding. The positions of the distractor and desired item should be frequently changed.

• When the child has mastered selecting the preferred item from among the two options, more items can be added. Their positions should continue to be changed, as well as the order in which they are indicated. If necessary, cues can be used, such as enlarging the desired item to make it more prominent, adding a colorful border, etc. In auditory scanning, the desired item may be stated in a louder voice. Eventually the cues can be gradually faded (i.e. the size reduced or a normal tone of voice used). (See Fading prompts.)

• Once the child has mastered scanning, the positions of items can be fixed. This allows the child to remember where they are located, necessitating less attention on the part of the child, and allowing an increase in the speed of the scanning.

Row-column scanning can be taught by initially teaching the child how to scan through a vertically-positioned column of general-category items.

Eat
Drink
Play

When the child is able to choose among these, more specific items can be added to the horizontal rows on the right. An example of such a communication board follows.

Help me—and everyone who reads this site—by mailing your suggestions, criticisms and personal experiences to Ruth Ballinger at yaack@iname.com

Eat	banana	cookie	popcorn
Drink	juice	milk	soda
Play	cars	playdough	slide

The child must learn to first choose only among the items vertically arranged in the left-most column. Once this choice is made, the child then has to focus only on the items in the horizontal row to the right of the initial selection (Reichle, York, & Sigafoos, 1991; Van Tatenhove, 1987).