Boy signing more

Communication begins with relationships.  It is through back and forth social interactions that we all learn to communicate in a meaningful manner.  So what do we do when a child isn’t learning to communicate in the typical manner?  Typical intervention starts with speech therapy.  It is an outdated belief system, however, that a child needs to be “ready” for speech therapy.  Most experts working with children with communication delays/disorders support the Total Communication approach.

Total Communication is a holistic view of communication that can be used with infants and adults. It involves not only oral language to build communication skills, but introduces gestures, sign language, and other visual communication systems.  Speech therapists using this approach think “outside the box” to create a system of communication that works for each individual.   For example, when working with a one-year-old, a speech therapist may coach the parents to play babbling games to encourage back and forth mimicking of sounds.  For a two-year-old who is not yet using words, the speech therapist may introduce sign language to help pair verbal words with signs to improve communication.  If a child is showing more extreme difficulty with verbal communication, then a speech therapist may introduce using a letter board or augmentative device, so the child can type his/her communication.  Many children and adults with Autism have shared a deep expressive world through the use of a keyboard or letter board. See or the film, Wretches & Jabberers.

Some parents are concerned that using sign language or pictures and letter boards may impede a child’s oral communication skills. Research supports that teaching speech and other modalities of communication together will increase the likelihood that the child will speak.  This is because talking or using sign language actually activates the same area of the brain responsible for communication.  There is no evidence to support that using other methods of communication, such as sign language, will discourage the use of speech.

Ultimately, the goal is for a child to communicate with others and the world.  It starts with gestures and moves to voice, the child’s “voice” can be expressed in many different ways.  It’s important that parents and professionals know that using a Total Communication approach is the most widely accepted speech and language treatment model.  It is our responsibility to ensure that all children have the tools needed to express themselves effectively.