Tace is 2 and a half. She doesn't look at or seem interested in her parents or anyone else. She loves wheels or anything that spins. She plays alone and likes running around the room. She cannot be persuaded to sit with the others for a story at nursery. She is very independent and shrugs off all attempts to help her. She will reach towards objects she wants. She has no words and will scream when she wants something.
Tace is a child at the 'Own Agenda stage' according to Hanen. Not all children will go through this phase but for parents of children who do, it is extremely frustrating and worrying.Tace does not realise that she can affect other people so her communication is mostly at a pre-intentional stage.We can tell what she's feeling by looking at her body movements, smiles, gestures and screams. She has been referred to the paediatrician.
So what can we do about it? Most parents just want the child to talk, after all that's what they should be doing at this age, surely? However, the goal of talking is a long way off for Tace. We need to get the background factors in place first so we can move the child from this stage to the next. In Hanen terms, this would be 'the requester stage' which we'll look at next month.
The initial goals for a child at this very early stage of communication development are to increase the child's attention/interaction with you and to increase the understanding of activities. I know that sounds too simple but it is vitally important to pick the right targets or we won't be successful.
With Tace, therefore, we looked at activities which she enjoys and turned them into games with her mother. She loves spinning so we put her in a spinner chair. We started the activity each time with, 'Shall we spin?', then we spun her a few times before stopping. She laughed and moved her whole body to show she enjoyed it. To begin with she didn't realise she could make it happen again. Then when her mother said, 'shall we spin?', and waited a little, she moved her body and her mother began the game again. Her mother had added meaning to the body movement and interpreted that it meant she was to do it again. This happened a few times before Tace realised that by moving her body she could get her mother to repeat the activity. She now regularly 'communicates' to her mother that she wants to do it again. She realises that the chair coming out means its going to happen and shows excitement when she sees it. She is also looking at her mother as another indication that she wants the game to start.
Tace's mother made it fun by using facial expressions and fun noises.
They are now generalising this ability with other games e.g. spinning her around or singing with action e.g. 'Row, row your boat'. She will soon be moving on to being an early communicator i.e. she sees that her actions can have an effect on someone else.
Tace's mother didn't see the point of my suggestions at first. 'What has this got to do with talking?' she might have asked. 'That's pretty crap!' she actually said!! As speech and language therapists we need to be able to look at a child and work out where we are and what the next step is. It can seem a world away from 'speech therapy' but it's essential we identify the right level so we can suggest the right way forwards.So please bear with us if what we say isn't what you want to hear. The whole process of communication is very complex and it's our job to un-pick it. Tace's Mum now says, 'I thought Libby was mad at first. She was very nice but wasn't saying what I wanted to hear. Fortunately, she convinced me to try and showed me the stages of communication we'd need to work through. I feel like we're getting somewhere now. I still hope that one day she'll talk.'
If you have a child like Tace, try using his/her interests to make simple games. Whether that's spinning like Tace or flapping, flicking, jumping..... make a game out of it so you can start the process of communication today.
www.hanen.org
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