The communication Ladder

I know supporting communication is my job and I should think about it carefully all the time but sometimes you just go about your daily job without really putting thought into it. But recently I have been challenged to really consider it, to break it down and to turn it inside out.

I have had a number of children coming to me who are pre verbal and all the added issues that come along with that, for them such as frustration and isolation. But also the parents. They feel frustration: why are they not talking? What do they want? Isolation: its not fun going to groups where all the other children are talking and anxiety: what will happen? Will they talk?

And rightly so these parents come and say ‘I need my child to talk’ and it was this that got me thinking.

What is communication?

In it’s simplest form the Oxford Dictionary defines it as “Imparting or Exchanging information by speaking, writing, or using some other medium.”

It’s being able to express the Childs needs, wants and feelings to the people who are caring for them. Some of the children I meet really struggle to get their needs and wants across. This can be because of their lack of speech, their lack of confidence or maybe they struggle to understand what they need.

Information being shared

But even though this definition seems quite simple there is a whole lot involved in communication, which those of us who find communicating easy tend to take for granted.

Whenever I think about this I imagine it visually as a ladder, you accomplish the first run and move up. Can I just add at this moment, that it’s not the same ladder for all children. They will each have their own ladder to climb and the runs on each of the ladders will be different depending on where they started. Some children will also skip a few runs and some children might slip down a few runs (which by the way is not failure, it’s development!)

So what is on each of these runs?

The communication ladder

Understanding what they need.

This is such a key part of communication as firstly you have to have something to communicate.

Kids tend to know if they want food or need a drink or most of the kids I work with often want a biscuit. But even babies sometimes cry and they don’t know why and you don’t know why. Little children experience really big emotions and sometimes they don’t know why!

Children need to be heard and to know they are going to be responded too. This probably should be a whole step on the ladder by itself. Bowlby, J suggests that babies are born with a need to communicate/relate to others mainly because this helps them survive. But a huge part of forming an attachment is communication - it’s the smiles and the laughs. It’s the knowledge that when they cry someone comes to them, it’s knowing that they won’t be ignored and know that their needs will be met. These first stages are so crucial in brain development and the development of communication in the future.

So they know their needs will be met, but do they know what their needs are? Especially when it comes to emotions. It may be a good idea quite early on to have pictures around the house of different emotions. You as the parent can express what you are feeling, so they begin to understand that other people feel emotions and get to hear a vocabulary surrounding emotions.

Some children with additional needs may not realise they are hungry or thirsty or forget to get that need met. Maybe at the start carers have to be responsible for this and gradually you could add in a picture timetable, so they get in a routine about eating and drinking. Every time you hand them a drink or a snack, tell them what you are doing, this not only develops their speech but clearly embeds the fact you are meeting a need.

Other forms of communication

Notice that I am not saying ‘talking’ throughout writing this. I am saying communication. This is because, we need to be ok with children communicating through what ever means possible. This is not to say we will get them this far and no further, it’s to acknowledge that this is another run on the ladder.

Teaching children to communicate in other ways again is not failure in fact, it can be a real bonding moment between you and your child.

Allow them to take your hand and take you to what they want. I have one child I work with who doesn’t even wait for you to be on your feet he confidently takes your hand and drags you! I find it hilarious! When you are at the thing they want you to see, or do, talk about it. ‘O you wanted me to see the….’

Hand

Use Symbols to help them and you communicate. A number of the children we are working with, have been given a pack of communication cards. They all have minimal vocabulary, and can get really frustrated if they can’t get their point across. We started one boy using communication cards and at first it was us showing him the cards to help him understand what was happening next. One day we were standing around chatting and this little boy walked over to me and my pack of communication cards and found the  card for home. This was his way of saying he wanted to go home, so instead of walking around crying which he has done in the past, he realised that there was a way he could communicate. There were no tears (apart from mine from sheer joy) or screaming. He and mum calmly walked out and he knew in that moment that he could be heard and understood.

Symbols can be used for all sorts of things transitioning from one event to another, understanding what is happening, communicating needs and wants. One of the parents I am working with has made symbols  for the wall in the living room, mats for the table and symbols for the front door, so that her child can point to the symbols and communicate what he needs through dinner time especially.

A parents wall with symbols on to help with communication 

Signing is another great way to communicate and it can be taught from as early as 6 months. 50% of communication for a talking person is non verbal. We use our hands, we use facial expressions, gestures and pointing etc. All of this is included with sign language. It’s a way to express needs and wants clearly and again helps you tune into your child. In a session recently having realised a child loved numbers and he was feeling a bit unsettled; I made a song up on the spot about counting owls. After a while when I finished the song he came up to me and signed 1 to say I should start again at 1. Now this is great, as he is starting to realise that if he makes specific shapes with his hands, I know what he means and he gets his needs met.

Another part of communicating is actually being able to make sounds. This is any type of sound, not just letter sounds. There was one boy I worked with who loved the toy microwave we had and we would practice making the ping sound when the cooking is finished. Another child and I love making the sound that happens when you flick your tongue in and out of your mouth. So yes it’s not necessarily communicating, but it is about having the confidence to make sound and feeling confident enough to make sounds in front of others. It’s also about strengthening the muscles in the mouth, when the muscles around the mouth are stronger speech development is supported. So make silly noises, blow bubbles, squeeze lips together, sing, hum, blow poms-poms across the table by blowing through a straw. You may not feel like you are supporting speech development but you really are.

Blowing Bubbles

Another key part of communication is Comprehension. Understanding what is being said to them and being able to put that in it’s right context. Now this is something that happens over time. For some children you will need to specifically teach them why things are like that or what certain things mean. But some children will just pick up things naturally. You can practice comprehension. Play games, like putting the car ‘In’ the garage for example or put the bear ‘on’ the tree. Or ask questions when you are out and about. Recently we had an owl party and it was interesting to have children of the same age and asking them where is the beak?, where are the eyes? Some could do it and some couldn’t. But that’s useful feedback as you now know what you need to work on. Some of those children we’ll go back to basics and take a while.

Facial Expressions are a huge part of communication. For some children they can pick up what facial expressions mean in others and for some it doesn’t come naturally and you might have to teach them. When signing BSL or Makaton facial expressions are a fundamental part of the communication, facial expressions help tell the whole story. You don’t just sign cold, you also show it on your face that you are cold. When you are signing if you combine it with great facial expressions, you are painting a really clear picture of the point you are getting across. The girl in this picture is showing sheer Joy (she’d just eaten a LOT of ice cream) on her face, but I guess it could also be understood as being silly or cheeky. We all see facial expressions slightly differently and our brains interpret facial expressions in different ways. But they are something you can teach.

Happy Girl

Dr. Paul Ekman says there are 7 main facial expressions:

Anger, Contempt, Disgust, Fear,  Happiness, Sadness, Surprise

Top Tip - Practice making facial expressions about these different feelings, and eventually the children will realise which feeling they belong to. Again communicate the name of the expression when they are doing it. There is a lot going on here! This presentation has been a deep dive into the specifics of communication and what communication is made up of.

We need to understand that some children may take a long time to get to the top of the ladder and that is ok. Some of the runs of the ladder will be taken quicker than others and some you will have to come back to, to fully embed. But with patience and lots of intervention, communication is possible.