What Will Help Your Child Speak: Signs or Pictures?
Quite often parents complain that their children simply won’t tell them anything,
but for families with children diagnosed with autism spectrum disorder (ASD) that are truly nonvocal, simple things such as knowing what their child is asking for become impossibilities. When fifty percent of children with autism experience challenges with verbal communication (American Sign…), there are many families who suffer frustration and need aid. Being nonvocal can lead to the use of “unconventional, or inappropriate behaviors to communicate, such as self-injurious behavior, aggression, or tantrums” (5 Development…, Pg 49). It should be noted that “aggression, tantrums, and self-injury [are] more likely to occur in situations with a high level of task difficulty and a low level of adult attention.” Knowing this is not a solution, but merely a start to understanding why your child may be acting in such ways. What is the solution then? Behavioral analysts often use one of two alternative or augmentative communication (AAC) forms when a “purely verbal program is not producing significant improvements in spoken language” (American Sign…): American Sign Language (ASL) and Picture Exchange Communication System (PECS). While most people have heard of ASL, the term PECS is not as common. PECS “is a structured program that teaches the exchange of symbols for communication” (5 Development…, Pg 59). These symbols are usually pictures that the child can carry around in a book or that may be attached to objects in a room. PECS does not immediately inspire verbal communication. In fact, for most preschoolers “it [takes] more than 1 year after initiating PECS to observe independent speech, and many [continue] to have very limited spontaneous use of language.” With two options then, which is best for your child?
The first thing to remember is the importance of “individualizing early treatment,” meaning one size does not fit all (American Sign…). This is backed by modern research involving neural plasticity of young children, which is the brain’s ability to change its circuiting and re-program certain areas to take on tasks that other areas of the brain have either failed to or have been rendered incapable of performing. Additionally, once the child has been able to learn how to communicate such things as “‘Look at me’ (attention); ‘I want__’ (tangible); ‘I need a break’ (escape),” aggressive and self-injurious behaviors decrease (5 Development…, Pg 55). Knowing that relief is possible and that your child may do better with signing rather than PECS or vice versa, when one style doesn’t work for your child, try the other. One final fact to note is that whether your child learns how to sign, or uses PECS, the most successful speech acquisition programs start between two and two and a half years of age (Pg 57).
At Peak Interventions, we have found that most of our clients benefit the most from signing. We do not, however, advocate ASL as there is a great deal of technical difficulty with mastering ASL that is unnecessary. Our focus is instead on enabling the child a path to speech with simple signs they can use to ask for things they want, attention from their caregiver, or a break from an activity. When compared side-by-side, a child may say more to fewer people with signs, rather than the reverse using PECS. With the ability to ask for the “big, blue bottle” rather than the “bottle,” it is no wonder that “sign language enhances the use of speech for some children” (Pg 58). Verbal Behavior Analyst expert Patrick McGreevy, is a strong proponent for the use of signs, especially “for kids who may never be verbal ‘he strongly [recommends] Sign not PECS’” (Some Things…). He quotes the same fact previously mentioned that signing allows the child to say more. In answer to the critique that fewer people will understand the child using signs rather than PECS, one must consider that the child will not be without a parent or care-giver, each who will be learning signs ahead of the child to help advance the child’s communication skills. In this way they are never in a situation where someone cannot understand what they are trying to communicate. Additionally “typical children [are] fascinated by the use of sign language and work to learn it without adult supports” (American Sign…), and thus even the children around your child will pick up signing as a means of communication. Your child will not be isolated if they use signs. In fact, in two different studies, children using signing showed greater acquisition of vocalization than those using PECS. In Matt Tincani’s doctoral dissertation, he found that “sign language training produced a higher percentage of vocalizations during training,” and according to Vincent Carbone (a verbal behavior analysis expert), “manual sign language may facilitate the development of vocal responding” (Vincent J Carbone et. al.). Finally, there is the advantage of not needing the supplies of velcro and pictures to accomplish communication. All the child needs is a knowledge of signs, and this can be obtained exceptionally quickly. Astonishingly, Patrick McGreevy was able to teach a “very severely ASD child with frequent self -injurious behavior who supposedly had an IQ of 20 how to make 2-3 signs in [about] 20 minutes” (Some Things…).
In the end the question is not whether PECS or signing will be the final solution, for neither are “intended to be the end-point in the development of language for children with autism,” (American Sign…) but rather are bridges to total speech. It is understandable that the frustrations of your child’s struggle with communication may make you want to rush the process. Have patience though knowing that your behavioral analyst will guide you and your child in the right direction, but as with all things, learning takes time.
Citations:
“5 Development of Communication.” Educating Children with Autism. Washington, DC: The National Academies Press, 2001. Web. 12 Jun 2013.
“American Sign Language vs. Picture Exchange Communication System in the Development of Verbal Language in Children with Autism: A Review.” Behvior-Consultant Reinforcement Unlimited. Web. 12 Jun 2013.
“Some things I learned fm Patrick McGreevy.” Autism-PDD. Autism-PDD.net. Web. 12 Jun 2013.
Vincent J Carbone, Emily J Sweeney-Kerwin, Vivian Attanasio, Tamara Kasper J Appl Behav Anal. 2010 Winter; 43(4): 705–709. doi: 10.1901/jaba.2010.43-705. Web. 12 Jun 2013.
