HOW SHALL I COMMUNICATE WITH YOU?

Two years ago, a 10 year old boy living with autism came to our school in Ile-Ife. He could echo what people said, but could not communicate his needs. He was violent; he used to bite his wrist and he would attack the adults in the school. In fact, because of my stature, I seemed like his favourite target. After a few weeks of observation, we concluded that he showed this behaviour whenever he was hungry. As they say “Behaviour is communication”, so this boy was obviously telling us “give me food”. What we had to do was teach him an appropriate way to communicate his need for food. We taught him to sign “eat” with the Makaton sign language while saying “eat”. Not long afterwards, he would conveniently sign and say “eat” whenever he was hungry. We moved forward by teaching him to say “I want to eat”. Now he can tell us what he wants to eat (eba, amala, rice, groundnut, cheese balls etc.). His language has greatly improved in two years.

Usually, when I speak with parents of a child with autism and no or little speech, they would tell me that their most important need is speech. But I have learnt from experience that our major need for the child is the ability to communicate his/her needs.

                                                        photo credit: www.communityrun.org

This brings me to an important topic; Augmentative and Alternative Communication (AAC). Augmentative and Alternative Communication is an umbrella term that refers to communication aids or systems that are implemented to replace or support spoken or written language. It allows people with communication difficulties to express their thoughts, emotions, ideas, and needs. AAC systems range from using simple tools such as one’s body to communicate to using electronic devices; usually based on the severity of the communication limitations. These systems can be aided or unaided. Unaided systems refer to communication with the use of body parts, which may include sign language and gestures. Aided involves using the help of equipment outside the human body; such as pictures, communication boards, communication notebooks, I-pads, speech producing devices etc.

                                     A picture board showing different types of food, copied from Wikipedia

Imagine yourself in a strange land looking for directions and nobody around you understands the English language. I can imagine how frustrating that would be. Won’t it be a relief if you have a picture to express your thoughts? Or somebody around you understands the gestures you are using to communicate? Communication difficulties can cause frustration and anxiety. AAC gives us an opportunity to relieve such frustration and anxiety. AAC has been reported to provide individuals with good quality of life. In children with autism, AAC systems have been shown to improve speech and social interaction, and help reduce unwanted behaviours.

                                           photo credit: www.learningworksforkids.com

But then, many parents express fear that by introducing an alternative form of communication, their children may never see a reason to speak. On the contrary, there are many reports of people whose speech improved significantly after they were introduced to other means of communication. In the school I worked in Ife, we have a girl who two years ago had no speech and could not communicate her needs at age 8. We introduced her to Makaton sign language and picture exchange communications system, and now she communicates her needs quite well. In fact, now she has started echoing when the teacher talks to her.

                                               Makaton symbols copied from www.widgit.com

Augmentative and Alternative Communication systems will meet the communication needs of a child living with autism, regardless of the severity of the condition. One just has to find the right system that will work for that child. But it is important to say that AAC does NOT WORK LIKE MAGIC. It is important to be patient as the child learns to use the communication aid. We do not learn sign language once and become “pro”, it takes time. It may also take time for the child to get accustomed to the chose AAC system, please be patient. You will eventually enjoy the rewards.

With all my love this season... Muah