Happy Halloween! (Belated)

            
Isn’t it interesting that so many of my 0-3 EI kiddos struggle to develop their vocabulary, phrase development, communicative functions, and motor speech skills…but have been able to say “Trick or Treat” or an extremely close approximation over the past month or so? Why might that be? Certainly this phenomenon could be discussed in a variety of ways, but let’s start with keeping it simple: Attention and Motivation. 

Children want to talk about things that are interesting to them. That’s one reason during my early intervention therapy sessions I encourage caregivers to follow their child’s lead. Children want to talk about things THEY are interested in, not what we think they “should” be interested in. Many of the children I work with are interested in various aspects of Halloween (Some are not, and that’s okay, too!). My own daughter (y’all know I can’t get through a conversation without bringing up her or our dogs) loves all things spooky. It’s inexplicable. I have never enjoyed Halloween or scary things, so I’m not sure where she got it from!. One of my EI kiddos loves skeletons. His dad bought him a baby skeleton. (Yikes!)  Kiddo dances with it, sits at the table with it, pretends to feed it, and yes, talks to and about it. Lots of my kiddos like the Halloween candy or other small treats to put in their buckets or bags. Some just like the novelty or social experience of trick or treating. Either way, it all comes down to motivation. They are motivated, and it keeps their attention.

It also keeps our, the adults’, attention. We kneel down to look in their eyes as they say “Trick or Treat,” and we drop a little something special in to their waiting containers. Both the sender and the receiver of the message are present and engaged in the interaction.

Is that the secret then? Find something they want, then make them say it. I find many well-meaning family members, physicians, and even therapists believe this.

“Just don’t give him the juice until he says juice!” they say. My response? “If that was all it took, I’d be out of a job.” We can’t MAKE someone talk. All we can do is create the circumstances that best allow them to, through environmental modifications and appropriate treatment strategies and communication modes. 

“But that’s what my cousin’s friend’s wife did, and her kid started talking.” Someone inevitably tells me. 

“Do a back flip,” I reply. Some people may respond by doing as I ask, but many won’t.  If you can’t do a back flip, I can’t make you do one…but perhaps over time a qualified back-flip instructor can teach you the skills. And if you practice, practice, practice, you may learn to do a back flip.  This brings us to our next element: Routines and repetition. 

That back flip you are learning to do? It’s going to take daily practice in many different contexts. You might not get it quite right at first.  Maybe you need to work on some component skills (like jumping!) or just build your confidence. Even once you land one, you won’t get it quite right every time., and to truly perfect it, you’ll need to practice it on a variety of surfaces.  Early words are kind of the same way. What’s the best way to practice words in a variety of contexts? Through routines and repetition.  Routines allow your child to develop a sense of anticipation of what’s coming next. They help build daily practice and confidence that your child knows the words to say, and eventually how to say them. They create the context for repetition, repetition, repetition. Some of the routines I most commonly use during EI are mealtime, playtime, and shared bookreading.  Families do them everyday, sometimes many times, and they create a nice context for practicing language.  One of my daughter’s favorite routines is feeding the dogs. We do it twice a day, and use the same words each time. Repetition, repetition, repetition.  “Trick-or-treat” is a routine by itself. Suppose you’re trick or treating door-to-door in your neighborhood. At the first house, your child might not be so sure of what to do. You gently lead him/her toward the house, knock on the door, and….”Trick-or-Treat!”  Then comes the reward – immediate satisfaction of a treat in the container.  Then you do the exact same thing at subsequent houses. Each time, your child grows more familiar with this routine, knowing what comes next.  After multiple repetitions, your child is saying it independently!  Even if it’s not perfectly clear, because the routine creates a clear context, if your child says even a simple approximation such as “i-or-eat!”, communication partners identify and respond to his or her communication attempts.

Does that sound like a lead-in to my next point?  It is! Routines create the foundation for sensitivity and responsivity of communication partners. This is extremely important.  If you are trying do your back flip, and your back-flip instructor has no idea you’re trying to do a back flip, they can’t be of much help to you. If a child says “i-or-eat” while their caregiver is looking out the window and there’s nothing Halloween-related in sight, we might not make the same guesss about what he or she is saying. Recognizing that a child has made a communication attempt (sensitivity) and responding accordingly (responsivity) is elemental to communication development.  
            
​One day last week I saw one of my kiddos at daycare. He imitates mostly vowel sounds, and supplements his speech with signs, pictures, and an iPad-based speech-generating device.  We originally hadn’t planned on doing Halloween-related with this child, but the teachers in his classroom asked how he could participate in a trick-or-treating activity going from classroom to classroom. We tried getting him to imitate “trick-or-treat” using speech alone. He struggled.  We modeled the sign “candy.”  He began signing ”apple.” Finally I programmed the TouchChat application on his iPad with a button that said “Trick or Treat” and included a photograph of him dressed in his costume. When we pressed the button, it showed a brief brief video of the sign “candy.” We practiced in the classroom several times, and I coached the teachers to first provided a model on his device by activating the button, then saying and signing candy while dropping the candy into his bucket. After several models in the classroom, he was imitating activating the button on his speech-generating device, and then signing candy and vocalizing.  By the time we reached the second classroom during the actual activity, he was no longer needed a model. By the 4th classroom, he was verbally approximating “Trick or Treat.” After the 5th and final classroom, the children were allowed to choose one piece of candy to eat. After I opened his for him, he said “’anks.”  “You’re quite welcome,” I told him.