Communication in Early Intervention

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Original Editor - Dawn Willard

Top Contributors - Ewa Jaraczewska, Jess Bell and Kim Jackson  

Introduction

Motor problems in children often co-occur with communication problems. Up to 81% of children with mild to moderate functional mobility limitations are diagnosed with communication problems. This article will discuss how and why the child communicates, analyse parents' behaviour and communication style.  Additionally, the article will offer basic communication strategies the parents can immediately utilise in everyday routines.

Methods and Stages of Children's Communication

Children have different communication strategies starting from infancy to the age when they become verbal.

Non-verbal Communication

• Non-verbal communication
  • eye-gaze
  • smile
  • pointing,
  • some noises that they might make,
  • grabbing
  • crying
• Stimulus–response relations (12 months of age)
  • gazes at the mother to search for cues
  • critical for an infant learning gestural communication
  • absence of sustained infant eye contact with caregivers may indicate that the infant may have language delay
• Joint attention (9-12 months of age)
  • "infant’s ability to make eye contact with another individual, shift her gaze to some stimuli and regain eye contact with the same caregiver."
  • helps in the early learning of language skills including naming. Provides a basis for cognitive development and social referencing.
  • social reinforcers (nod or a gestural expression) facilitate and maintain infant's joint attention
• Social referencing
  • "behaviour chain in which two individuals (caregiver and child) were involved in an interaction" including eye contact, gaze shift to a new stimulus, return of gaze shift to each other, altered facial cues.

Verbal communication

• Responding to symbolic language cues (6 months)
• Pointing and naming objects (12 months)
  • It involves several steps:
    • eye gaze of the person naming the object
    • determining what the person is naming
    • repeating the name in the presence of the object
    • looking back at the caregiver for confirmation

• • receptive language can contain above 100 words
  • expressive vocabulary develops by the age of 18 months

Child and Parent Styles of Communication

Understanding how the child communicates:

To help the parents understand how their child communicates, use the following strategies to make them recognise their own purpose of communication. They should complete the following exercises:

• analyse how and why they communicate
  • what did they do to communicate with others?
• start to identify similar to their own communication behaviours in their children
• start to understand and anticipate how to help their child communicate more

Understanding what is the child style of communication:

To help the parent understand their child style of communication, ask them to respond to the following questions:

• Is your child a very sociable child?
• Does your child have an easy back and forth conversation and communication?
• Is your child passive during conversation and communication?
• Does your child have a reluctant style of communication

Understanding what is the parent style of communication:

To better help the parent to communicate with their child, respond to the following questions:

• What kind of style does the parent have that you are trying to help?
• Do they have a passive style?
• Do they have a sociable style?

Understanding how the environment and personal feeling affect communication:

To help the parents understand that communication depends on our environment and how we are feeling, you should explain the following:

• We cannot always expect our children to communicate in every environment at all times
• The child may not want to communicate after a long day, just like an adult

Child's Stage of Development

We can identify four stages of child's development: discoverer stage, communicator stage, first word user stage , and combiner stage. Each child is unique and can transition to the next step of development at different times. One may move slower than other from the same age group, especially when influenced by developmental delay or illness. Understanding where the child is in their development will help to set expectation and goals.

1. Discoverer stage (birth to 8 months)
   • Infancy stage
   • No back and forth reaction
   • Communicates through crying to get the needs met
2. Communicator stage(8-13 months )
   • Eye gaze
   • Understands meaningful conversation, starting to intent or send messages with intent by
   • Uses pointing or grunting to send messages with intent
   • Non-verbal communication only
3. First word user stage (12-18 months )
   • Uses words or signs on a regular basis
4. Combiner stage (18-24 months )
   • Begins to combine words
   • Starts combining two- and three-word phrases

Communication Strategies for Parents

General qualities of a good person to have a conversation with are as follow:

• listens to us
• does not interrupt
• follows our lead

Get Face to Face

• Standing over the child can be intimidating and uncomfortable for them.
• Speaking on the same level as your child make them feel more comfortable, less intimidating, and more fluid.
• Getting face to face with your child will:
  • ease their interaction
  • help them understand what you are saying to them
  • help them model some of those words that you might be saying to them by looking at your mouth
• The following are the examples of NOT the best times for interaction with your child, because you are not face to face with your child:
  • Walking or pushing the stroller
  • Talking from your back, like standing at the kitchen sink preparing dinner and the child is playing on the kitchen floor
  • Driving a car with your child in the car seat

Observe the Child

Clinician's role is to teach the parent to become a better tuned-in listener, to understand the importance of getting face to face with a child, and to wait and observe how their child is communicating.

Careful observation will help the parent to acknowledge the following:

• What is my child trying to tell me?
• What messages are they sending?
• How does my child communicate? Are they pointing? Are they grunting? Are they smiling?
• Why are they choosing this style of ommunication? Because they are happy? Because they enjoyed something?

Respond To the Child's Communication

"When children learn to communicate, it's for a desire from within."---Dawn Willard

• Do not start your response with attempting to teach, control, or show
• Help your child learn to verbalise and communicate with you from a desire to tell you what they want
• As soon as your child sends a message, you need to respond right away
• If your child is not listened to, they may leave the interaction quickly

Follow the Child Lead

• Allow your child to initiate conversation. This is the real first step of children using expressive language or language in general to communicate with others.

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