Hi, I’m Dr. Mary Barbera ,autism mom and board certified behavior analyst. I’m also the author of “The Verbal Behavior Approach: How to Teach Children With Autism and Related Disorders” which was published over a decade ago and is now available in nine languages. As a behavior analyst, I know that any behavior, including vocal language and speech sounds, can be increased using using proven ABA strategies. In this week’s video blog, I’m going to discuss techniques I use when working with a child who is non vocal or minimally vocal. As you may know if you’ve watched my other video blogs, or have read my book, the first step to changing any behavior is to complete a thorough assessment. Before working on getting a child to talk, we must first assess not just his language, but we need to assess the whole child and the supports and services that are currently in place. We can’t just zone right in on the child’s language and only focus on assessing that. I think we need to take a step back and take a look at the whole situation, including especially things like feeding. I have found that most children with autism who are not speaking by the age of 2 or 3 usually also have feeding issues. They might still be using a bottle, or a pacifier, or they might refuse mushy foods on utensils, or be extremely picky. We need to do a full assessment on these feeding issues and so for an example, if the child is still taking a bottle or drinking out of a sippy cup, it might be reasonable to put a plan in place to teach open cup and straw drinking, as these steps may help with local speech. We also have the problem where there’s a very short supply availability of speech and language pathologist, or SLPs, especially SLPs with ABA knowledge or expertise. In my almost two decades in the autism world, I believe children with autism, especially those without any vocal speech really need a team of professionals, including an SLP, who are all familiar with ABA principals to have the child make the most progress possible. I’m fortunate to have worked with several speech pathologists along the way and they have taught me a ton about how to get initial speech sounds and first words. I’ve also developed some interventions to help parents improve articulation and get their children with pop out words talking a lot more. When I say kids with pop out words, I’m referring to those kids who only say a word here or there on their own terms. The first place to start is to assess the whole situation, as I said previously, and then specifically, we need to assess the speech sounds or words the child can currently say. If your child or client is non vocal or minimally vocal, it’s probably because you do not have echoic control. This is when I say “say ball” and if I had echoic control the child would say “ball” with no ball present. We are going to assume at this point that your child or client cannot echo sounds or words on command. The next step is to assess whether the child is making any sounds, word approximations, or saying any words spontaneously. A lot of infants babble they start babbling “bah bah bah bah bah” and “Dada Dada Dada.” They might be babbling all these different sounds. So when the baby’s dad hears “Dada Dada Dada,” the dad is going to get excited and start reinforcing that “Dada da” by telling the baby you said “Dada dada,” providing smiles and other reinforcement. When the baby then babbles “ba ba ba ba,” the mom or dad may think to give the baby a bottle and of course when they finally say “ma-ma-ma-ma-ma,” mom is going to get very excited too. This is the way language gets shaped up. With our non vocal older children with autism, we have to ask the question “are they babbling at all?” Next assess if they have any word approximations, and assess whether they have any pop-out words. They may not say much, but they may have been heard to say different words throughout the day, or maybe even only a couple times a week you might hear a pop out word. You need to be a little bit of a detective here. If mom says “my child does say some things here or there,” I say “okay tell me what those things are. Does he say mama, hi? Does he see bye-bye or is it Dada? Does he say movie?” Another strategy I came up with many years ago is to formulate a list of words that you’ve heard the client or child say and if you put them on an excel sheet you can keep them in alphabetical order, as that list grows. If you’re going up the stairs, instead of saying “Johnny let’s go up the stairs, Johnny you’re a good boy,” and using a lot of language, you just want to say “up, up, up,” and then take a couple of steps up the stairs. Then say “up, up, up.” You see my voice is a little more exaggerated, a little slower and more playful, so and most importantly, we’re just emphasizing one word. In conclusion, we want to always assess the situation, assess the whole picture, specifically focus on assessing feeding and spontaneous babbling sounds and words. We then want to pair sounds and words with reinforcement throughout the day, both at the table teaching sessions, as well as within the natural environment. I hope you found this video blog helpful and I would encourage you to join me next week where I’ll discuss how we teach kids who have some ability to speak, to talk in longer utterances. See you next time.