finding
the words
by Marge Blanc
When They're "In There" Somewhere!
Helping your child retrieve the language he knows!
Part 4
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Welcome to our final column on language retrieval!
We promised you a story this time, one that ties together "real life" and
retrieval therapy. Alan's story does just that!
Alan is a happy, bright, socially-engaged eight year old with ASD. Over the years, his family has provided him with everything they could, especially their love. Currently, his home-based ABA team helps support his inclusive first grade program, and structured peer play provides a scaffold to his relationships with his classmates.
Marissa is another character in Alan's story. She has known Alan for several years, both as his SLP and trusted friend. Marissa is so trusted, in fact, that Alan gives her the "scary monster" role whenever he wants to play his creative version of a chase and squish game!
Alan's history sounds familiar. He was diagnosed with ASD at age three, when he was not responding to his name, or to many directions. His expressive language was described as mostly "jargon," with some echolalic phrases here and there. In-home therapy began shortly thereafter.
Alan's family concentrated their energies in their boy's behalf…starting biomedical, behavioral, and other therapies. And Alan progressed! But, in December 2003, when Alan was almost five, his family sought services with our clinic because they felt Alan needed more "stimulation to his verbal communication." His ABA team had taught him to follow directions, and to use several scripted phrases. Alan frequently made requests, using sentences like, "I want toys," "I want princess," "I want juice." And he also used some word combinations that weren't so patterned, "Genie. Lamp," and "Color. Paper" for instance. In this way, Alan commented on a favorite character, Aladdin, and suggested a coloring activity. Alan also used some more fluent sentences, such as "Give me a hand," and "That's awesome," clearly gestalts he had heard said by others.
We could quickly see that Alan's language development was all over the map…and that he was clearly in the middle of acquiring language the gestalt way! Alan had done everything people asked of him, and other things on his own. But Alan was stuck…his language progress had come to a stop.
Our first task was to sift through the dips and valleys of his language development, and determine which language was still at Stage 1 (gestalts), which was at Stage 2 (mitigations), and which was at Stage 3 and beyond (isolation of single words, and original combinations). Although Alan still had one foot firmly planted in Stage 1, he had some nice Stage 2 and 3 utterances too. We found the patterned sentence, "I want…," especially problematic to making smooth progress. Alan had learned it as a whole gestalt, because he was in Stage 1 at the time! Then he had to work hard to use it flexibly because he didn't have the Stage 2 skills to do so.
We wanted to make Alan's life much easier, so we surrounded him with a nice variety of Stage 1 gestalts, making sure they were easy to break down and reassemble. This way, Alan had the opportunity to move smoothly to Stage 2. Alan rewarded us by beginning to make steady progress! He was on his way to developing flexible, useful language.
But how did we know language retrieval was a factor? It was subtle at first, because kids have to develop some language in order to have something to retrieve! But once we became aware of Alan's useful vocabulary, we also noticed when he didn't use a particular word. The following illustrates a typical dialogue between Alan and his former SLP, Leslie, as Alan successfully retrieves the word "fish."
A Ariel.
L She swims.
A Fish.
After a year of therapy, Alan's language was no longer stuck. He was producing rich, beginning sentences, with fluid grammar, such as, "He's eat the tree," "I'm bouncing," "The door is open and close," and "No, no, don't say, 'Nice jumping.'"
Alan was also making progress with language retrieval. He had learned to rely on Leslie to help, as in the following dialogue:
A I want mermaid. No
mermaid.
L The other mermaid.
A The other mermaid.
Yes, it took "reading between the lines." But the farther Alan progressed with grammar, the more he had available to him to work on retrieval, which turned out to be his primary language disorder.
Marissa had already entered Alan's life by then, soon becoming Alan's SLP. And, as his grammar continued to blossom, Alan was able to concentrate more and more on strategies for language retrieval. The following game was Alan's creation, with Marissa playing the requisite "monster" role. It is interesting that, in this game, Alan packed together some of the "real life" challenges that tax retrieval: social pressures, time pressures, and self-regulation. Here's how the game sounded:
"Freeze!" Alan shouted this as he perched at the top of the slide, and Marissa surprised him at the bottom. "OK, now you can move," Alan continued, once he knew he was safe from attack. "OK, you're frozen, so you can't get me," he then announced once he'd escaped to a safe place. But, when Marissa was almost upon him again, Alan's language access was back-to-basics , and he resorted to the universal mono-syllable, delivered at full volume… "No!!"
Thus, Marissa played all those elements of "real life" Alan could control with his words. Often, these words were retrieved fluently and his sentences were as complex as his linguistic competence. But, that was when Marissa was far away. Whenever she was about to "attack," however, Alan panicked and he could only "find" the reliable, but linguistically unsophisticated, "No!!"
In activities like this one, Alan was preparing himself for situations he couldn't control as reliably as his good friend, Marissa. Other practice opportunities came up naturally, as the following dialogue illustrates. Alan liked to hide from his parents when they came to pick him up, and on this occasion, he invited a friend to join him. You will read how Marissa supported him:
M Mom and Dad will be
here in a few minutes…
A We gotta ask friend if he wants to hide!
M Oh, yeah, let's go…
A We gotta find…um…um…what's this boy's name? Um…um…um…Jake?
M Yeah, he hid with us last week.
M We gotta find Marge and…
A Jason!
A Where's Jason? Marge and Jason are gone?
Marissa's strategies were these: remain unhurried, even though time seemed "critical"; acknowledge Alan's idea, even though it was not fully expressed; take multiple turns in the dialogue, giving Alan ample opportunity to trigger the name, "Jason" on his own; and, provide cuing as needed, without fanfare or pressure.
So, what's next for Alan? Retrieval challenges don't just go away, because even though grammar matures, vocabulary gets more complex. But, on the other hand, a child's mental resources also continue to grow! Alan is becoming a reader, and is starting to become aware of his ability to visualize what he has stored in his head. He and Marissa have started to experiment with this method of retrieval now, with some nice preliminary results. So, pretty soon, Alan, himself, may be able to answer his own astute question, the question he recently posed to shis brother. "Oskar," Alan asked, "how do you find the word?"
From the mouths of babes! Have fun, dear reader, pondering this question…for yourself, and your child!
Marge Blanc, M.A., CCC-SLP founded the Communication Development
Center, in Madison, WI 10 years ago. Specializing in
physically-supported speech and language services for children with ASD
diagnoses, the center has successfully helped scores of children as they moved
through the stages of language acquisition.
Contact Marge and her
associates at:
Communication Development Center
700 Rayovac Drive, Suite 200
Madison, WI 53711
lyonblanc@aol.com
July-August 2007 ~ Autism Asperger's Digest Magazine
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