Let's Talk About Talk!

Moving Beyond A Flawed Assumption

to Meaningful Communication

Marion Blank, Ph.D.

Mary Beth Cull
Columbia University
Research now shows that between
75-95% of children
who receive intensive
behavioral intervention will speak
by the age of five”
(Dawson, 2008)
Parent commenting on an
incident:

“I thought that all I wanted was for

him to talk. Now he's doing that,
but it's all wrong."
A teacher relaying an incident:

“We’ve been teaching him

language for years. And he can’t
even understand simple, basic
language that could save his
life.”
 Why Are These Occurring?

• First child: learned what was taught (not

what has been intended to be taught)

• Second child: did not learn what was not

taught (“holes” in the curriculum) (“failure
to generalize”)
 “Unintended consequences”

• Pervasive and often ignored

• Medicine: iatrogenic disease

• Education: “edugenic disability”

 How Did We Get “Here”?
• Alarming power of the “absence of
speech”

• Awareness of critical periods

• The stumbling block—“What can we get

children to say when they have little or no
speech?”
 Into the Void

• Nouns and some adjectives

• Occasionally a few verbs—often taught as

if they were nouns (“point to drinking”)
 Into the Void
• Unnoticed—cannot comprehend others
when language base is limited to nouns

• Unnoticed—cannot produce meaningful

utterances when language base is limited
to nouns
 And Totally Unnoticed

• The teaching often violates the social

context in which the language is used

• Example: What is your name?

 Into the Void
“Encouraging”
“Demanding”
“Requiring”

Request language (“I want…”)

 Into the Void
• Unnoticed—failure to generalize beyond
this “form” of language

• Understanding the failure of generalization

 the role of initiator
 request language makes minimal
demands re: understanding the speech
partner
 all other initiations require significant
understanding of the speech partner
This amazing array of forces owes
its existence to one key idea:

TALK IS GOOD
 Moving On
What will be the replacement?
 Taking a New Path
• Cognitive precursors of language

• Key structural components of language

• Distinction between language and

communication

• Bridge between language of school and

home
 Cognitive Precursors of
Language
• Developmental psychology—powerful role
of cognition prior to language (preverbal
cognition)

• Preverbal cognition is a prerequisite for

verbal cognition (language)

• But which of the many skills are central?

(critical for effective intervention)
 Temporal Sequencing

Pervasive and central to all of language

• Phonemes—the sounds of language (“fast
forward”)

• Babbling (“crib talk”)

• Deficiencies in this realm pervasive in ASD

• Extent of deficiencies can easily be overlooked

 Structuring the Teaching for
Temporal Sequencing

• Initially avoid the auditory realm!!!!

• Use the visual modality to mirror

characteristics of auditory modality
 Criteria for Selection
• The input is composed of several
elements

• The particular elements that are selected

follow a set order

• The order in which the elements are

presented is the order that the child must
process and reproduce
A Sample Activity
 More Examples
The adult performs and the child reproduces:
• a series of actions on objects rather than
symbols (e.g., turning over one object, putting
another in a container, tapping another object,
etc.)
• a sequence of actions on one’s body (e.g.,
touching the nose, a shoulder and a knee)
• reproducing sets of visual objects (e.g., sets of
colored blocks that are shown and then hidden
from view)
 The Structures of Language
• Language & communication are not
equivalent

• Language is a system combining nouns

and verbs to create meaning

• A central, but overlooked, component

resides in the “little words”
The Power of the “Little Words”
• The boy was here.
• The boy is here.

• This is a dog.
• This is not a dog.

• The boy wants a dog.

• The boy wants that dog.
 The Little Words: Central to
Noun/Verb Categories
• Certain words attach to nouns (e.g., the,
these, a, that, etc.)
• Certain words attach to verbs (e.g., is, are,
were, did, have, etc.)
• Awareness and use of these words is
critical to mastery of nouns and verbs & to
understanding what other people are
expressing
 The “Little Words” and the
Representation of Time
• Present – is, are, have…

• Past – was, were, had, did…

• Future – is going to, will…

 ASD and the “Little Words”
• This realm represents one of the
problematic areas for the children

• Much teaching reinforces their

weaknesses by avoiding these words
 Some Consequences for the Child
with ASD
When child is confined to the one word
level, then the following represent the
same utterance
• “What is the boy doing?”
• “Where is the boy?”
• “What does the boy want?”
• “What was the boy doing?”
• “Who is with the boy?”
 Structuring the Teaching for
Language Mastery
• Content focused on complete sentences
containing linked nouns and verbs
birds fly, kids run, bugs crawl, fish swim
• Length just at & beyond child’s level
• Method is based on sentence imitation
• Resulting sentences might include:
Here are some birds; they are flying.
This kid can run. He is running.
If Spoken Language Production Not
Feasible
• Literacy (written language) provides an
alternate route

• When reading and writing structured to

reflect spoken language, the same
processes are put into operation
 Language & Communication

“The trouble with her is that she lacks the

power of conversation but not the power of
speech.”

George Bernard Shaw, Irish Nobel Laureate

 Language & Communication
• Linked but separate domains

• Pre-verbal communication exists in

absence of language

• Verbal communication uses pre-verbal

communication and language to send and
receive messages
The Two Worlds of Verbal
Communication

Language Communication

Verbal
Communication
 Communication
• Clear recognition of the deficits in ASD

• Minimal analysis of complexities of

communication in intervention

• Pre-verbal (averbal) communication – a

skill that may not be “teachable”
 A Sample Exchange
• Child: (pointing to a box on the table)
Mommy, what’s that?
• Mother: That’s chocolate pudding mix. I
thought we’d make some for some for
supper tonight.
• Child: Can I mix and help you?
• Mother: Sure you can.
Blank & Franklin, 1980, p. 139
 Communication: Two or More
Persons
• Two central roles: initiator & responder

• Initiation: a role that cannot be taught

• Appropriate initiation: far more complex

than appropriate responding

• Responder: clear path set by initiator;

responder need only follow the path
Structuring the Teaching for Verbal
Communication
• Creating situations accepting absence or
paucity of pre-verbal communication
• Focusing on the responder role
• Recognizing the limitations facing the
initiator
commands
statements
questions
 In “Typical” Development:
Pathways for Questions
• Social intuition (pre-verbal
communication): sensing the intent of the
speaker
“Could you pass the salt?”
“Do you know the time?”
• Present in young child (2 year old)
Mother: “Can I fix your bed?”
Child: Removes toys
 In “Typical” Development:
Pathways for Questions
• “Verbal links”: perceiving the unexpressed
links between questions & answers
What is the boy doing?
(The boy is) swimming.
 Using the Links as a Therapeutic
Bridge
• Q: Who are these?
• A: These are boys.
• Q: Where is the cat?
• A: Here is the cat
• Q: What are they doing?
• A: They are running.
• Q: What were the birds doing?
• A: The birds were resting.
 A Beginning Topic: Intermixing
Command, Statements, Questions
• Who is this?
• This man has something.
What does he have?
• The window is broken.
Point to the broken
window.
• He is going to use the
glass to fix the window.
What is he going to do?
A Beginning Topic: Continued

• Point to the window

that was broken
• Is the window broken
now?
• Who fixed the
window?
 Language at School and at
Home: Bridging the Gap

• Can the intervention be brought into the

home?
 Language at School and at
Home: Bridging the Gap

• The complexities of natural language

 Language at School and at
Home: Bridging the Gap
• Revisiting the pragmatics of statements
vs. questions
• Because statements do not require a
response, they are ideal for lessening the
demands of coping with natural exchange
• Statements (comments) are fine
• Questions should be reduced or
eliminated to the degree possible
And Now : The “Invisible” 800
Pound Gorilla

Problematic
Behavior
The “Behavior” We Are Not Talking
About

• Overtly aggressive actions

• Self-injurious actions

• Destructive actions
 The “Behavior” We Are Talking
About
• New situations—ignoring adults &
gravitating to objects (“oh, he’s just
curious”)
• Feigning ignorance
• Subtle “stims” that absorb child
• Needing “rewards” (“bribes”) for most
“imposed” activities
 A Parent’s Comments
“I thought we were doing a great job…I
thought we nipped the weird behaviors in
the bud…but the stim behavior never went
away.”
• Advice to others
“If it was more out there, if we knew about
it, maybe we could address the problems
sooner.”
 Why Do These Behaviors Occur?
• “Typical” adult-child interaction is based on an
unbelievably complex, subtle “give and take” (of body
language, tone of voice, facial expressions, etc.)
• This system is “incomprehensible” to children with ASD
• Leaves parents bereft of the “signals” they need to
understand the child & to respond effectively to him/her
• Parents often attempt to fill the vacuum by “pleasing” the
child—granting the child what s/he wants
• The “I want…” strategy is often reinforced by intervention
programs
Reinforcing “I Want…”: A Potential
Recipe for Disaster

• It creates an unspoken but potentially

destructive “social contract”

• This “contract” that has a high likelihood of

producing devastating effects—particularly
as the child moves into adolescence
Another Complication of the Failure
in “Give and Take”
• Apart from “stims” & highly desired
activities (e.g., swimming, elevators, etc.)
children rarely initiate
• To fill the void, children kept occupied by
intensive hours of programming
• A common consequence: the children
cannot tolerate “nothingness”
 What Can Be Done?
• The good news: a lot

• The bad news:

 it takes work that is demanding – not in terms
of physical effort but steady awareness of
minute behaviors
 it requires techniques that run counter to our
habits & intuitions
 it is best established before 6 years of age
 Why Do It?
• It gives the child a future that offers a
better quality of life

• It creates the interpersonal matrix that is

needed to be a life long learner

• It permits efficient learning

• It counters the deterioration that sets in

when continued learning does not occur
 Goal: Step 1

• INHIBITION!!!!

• Presence of an adult signifies that quiet,

attentive, controlled behavior is required
 The Key Demands: For the Adult
• Effective management of all basic routines
(eating, sleeping, TV, dressing, etc.)
• Simplifying the world—eliminating all unnecessary
demands
• When demands are made—imposing only those
that adult can ensure will be carried out
• Eliminating all “acting out” behavior—when with
others
• Being totally aware of what you are saying &
ensuring that any direction be carried out correctly &
in a suitable manner
• Endless patience
 The Key Demands: For the Child
• COMPLIANCE

• Learning to tolerate “nothingness”

• Learning to respond in a calm, focused,

deliberate manner
 Goal: Step 2
• “Activation”—via simple commands for
action that child can easily execute

• Teaching child to tolerate the “uncertain”

 The Next Step

“Now vee may perhaps to begin. Yes?"

Portnoy’s Complaint by Philip Roth