Step by Step Way to Teach Autistic Children to Speak

Okay, so this video is a very practical and technical overview of how to get autistic children to start talking. In the very beginning, when you go for an assessment or you, you come back from the doctor's appointment, most of the time, 80% of the time, an autistic child is going to be non verbal and non verbal. There are different things and definitions out there, or pre verbal or whatever don't need to care about what the diagnosis label is. What we need to discern to know is whether it's a speech case or a language case. So I'm going to talk about what it is real quick. But every time when we're teaching a child, we need to know where the bottleneck is, right? Why is he not communicating? Right. Is it because of a speech issue or a language issue? So real quick, speech just means anyone who has a difficulty with, with creating speech sounds, the language may well be intact. And this is very apparent in adult cases, which is easier to explain. So for instance, if someone had a stroke, they cannot move their muscles, their oral muscles well enough to say something, but they know what the message is, the language. Then practically they're a speech case because they're unable to create a speech sound. Whereas a language case would be that a good segue would be like, for instance, I can make all the sounds, but I don't understand the underlying meaning. And I always draw. And this is frowned upon because language development versus, like first and second language will be different for a lot of therapists and theorists and professors out there. But let's say that I go to Japan, I know all the alphabetical. They call it hiragana, right? I'm able to read all the hiragana, but I have no understanding of what the word means. So this could be true for children who are, who are on the spectrum. They're hyperlexic, right? They can read English words, they can read Arabic, they can read Japanese, they can read Indonesian, bahasa, like balayu, whichever you like. But they don't understand the meaning, the message. Right? So then that would be a language case. Okay. And you see this a lot when children start singing, right? And they can recite ABCs and talk about numbers and whatnot, but then they lack understanding of the communication functions, meaning, the message involved, why they're talking about it, so on, so forth. Okay? So you have to know which one, speech and language, most of the time it's both, but which one is causing more of a deficit for children? Okay. Once you know, then you can go down the rabbit hole of creating a treatment plan. Okay. So a lot of times before we get to a place where we can make the decision, the very first skill that we need to acquire is verbal imitation. Because without that, it will be very hard to know. So for instance, there's a mother who is Indonesian, but she moved to the usa. She is currently working with us and I think around half a year ago, right? I think, yes. When they came on, I told her the exact thing. We don't know at this point whether your child is a speech case or a language case because the therapy that she was getting in America was very play based. So never got the child to sit down and do a bunch of imitation. Because if you don't have verbal imitation, you're very limited about what type of assessment tasks you can do for speech. For instance, if we want to get a child's speech sound repertoire just meaning what sounds they have, the best way is to get a child to go through a word list and tell them to go say, so what's this, what's this, what's this? And once we get the words, we can transcribe them into actual speech, those phonetic symbols that you see in the dictionary and we will know what their repertoire is. What is their phonetic infantry, so to speak. That's the word for it. Before that, the very first skill is all always verbal imitation. And for that mother, we got to that place at around two weeks ago and we hopped on the call. She was like, oh, now we know it's actually more of a speech case because when he says da, he goes B. Right? When he tries to say vowels, he cannot control his mouth that well. So then we start thinking, what could it be, right? Or is that he's out of practice because he never ever said a thing before. So at least then we know it's a speech problem. But then is it a disorder? Is it a delay? We don't know yet. And I don't want to go into what a disorder or delay just yet because it doesn't really help with the whole treatment process. So we need to get verbal imitation in place first. And to get verbal imitation in place, you need to get your child to sit down with you. Right? Because those are learning to learn skills. And this is something that I will, I will probably get a lot of like people talking back to me and saying, hey, nowadays speech therapy is all about being naturalistic. We don't want to like push our ideas on onto children and whatnot. The problem is that if we don't have learning to learn Skills. We don't have a time where we sit with our children to teach something very specific, then it'll be super hard for us to get the imitations down to a T. The reason why I'm so big on verbal imitation is because that's exactly how we learn language by. By copying, right? If we don't say it back, well, we won't be able to. To converse, to. To use language. And this came out from. From a friend who has a child and a bilingual, bilingual environment. And he was asking me, friend to friend, oh, do you think I should get my child to speak Cantonese? Because we're from Hong Kong, right? Because I feel like if I speak Cantonese to my child, he'll probably pick it up, right? I'm like, no, if you don't use it, right? If someone doesn't repeat after you, they might understand the language, but they won't necessarily get tone, right? The grammar, the accent, right? And he will not sound like a person who knows and understands Cantonese, my friend. So then once he understood that, he knew the value of what a verbal imitation is. Okay, to get the verbal imitation, there are loads. There's just a few steps. To be honest, we get your child to sit down. If your child is snatching or hand leading, we need to turn that into an opportunity for learning, right? So that when they're snatching, we turn it around and do an open palm instead. So that they're waiting for you to receive instead of trying to get right. If they're waiting to receive, you have a block in time to teach something. Because they're waiting, right? If they're not waiting, then the stuff that you do will be very difficult because you're always trying to, like, tell your child, okay, wait, give me a second. Do some, like, kung fu with your child. I've seen it many times. Like a standoff at the kitchen counter, right? What do you want? Say cookie first. Say whatever first. And I've done many videos about it. So this whole process, and I'll give it to you for free. But it's going to take sitting of around two hours to learn this over the Internet. And then you will have to do it yourself. So go to agentsofspeech.com course. We have a free course that goes through exactly how to go to verbal imitation. The name is called zero to words. Just go there and check it out. So once you get the verbal imitation, then you can discern whether if it's speech or language. I'll talk about the easy one. First language cases are Always going to be pretty straightforward. Because if they have one word. Okay, then make two words. Okay. If they have two words, they make it three. But the biggest problem I see, and this is where a lot of parents are stuck, is people in general, trainers, therapists, teachers, parents, they like to add I want in front. But because children who are on the spectrum, they are rigid, right? Right. They look for rules. That's why they like letters, that's why they like spelling out words, because there's rule based involved. Right? So then what happens here is that we need to take a good look about what we're doing when we're adding I want, I want. This phrase adds no, absolutely no meaning to a word or phrase. Right. If I say cookie. Right. If I say cookie in Japan and Indonesia and in Russia and uae, it means that I want a cookie. Doesn't matter if I add I want in front. Right. Or I'll give me in front. There's no absolute gain and meaning when I add that word in front. So that's where a lot of people get stuck. Because you're asking your child, asking an autistic child to go through a bunch of loops, you get the same thing. And a lot of children who are on the spectrum are not willing to make that trait because talking is hard. If talking were easy, they would have done it already, my friend. You're asking more of something for the same reward or the same outcome. And when I say this, parents are like, oh, I see, I get it now. And the reason is because, like, we use this so often in, in therapy. And I see it in, in many cultures. I see it here in Hong Kong, in mainland China, Indonesia and Malaysia and Singapore. It doesn't matter what language you're in. It's going to be like encanto, it's going to be like. And in Indonesian, it's going to, it becomes a way to prompt a child to start talking. It doesn't add any meaning to it. Right. When you see someone, a parent, teaching a child who is on a spectrum, when the child wants something, the parent will say, what do you say? I want? And then the child says one word and then the parents will not say the whole thing, I want. And then it's just, it goes back and forth because there's no absolute gain in meaning and it becomes a way of prompting the word and it sucks. So language, teaching language, what you need to do is to add meaningful chunks so that it makes sense for the child to communicate more, to get something specific. So if I say cookie it's because I read the context of what the child wants from me. I know if you say cookie at this time, this way, it means you want me to give you a cookie. But if I were to teach an autistic child the language intricacies, I would take a cookie and shove it somewhere else. Cookie? Yeah, that's a cookie. What do you mean? Yeah, cookie. I'll throw it in a bit, right? I'll put it in the fridge. I'll put it in the cupboard. Oh, you want me to toss cookie. That's cool. You want me to flip cookie? That's cool. So there must be a verb in front. And verbs are very important. So if you talk to any linguist, if you've taken a linguistic course, right, Whether it's in English or whatever. Or whatever language. The noun phrase, right? And this is. I'm going to talk about this in a little bit. There's a noun phrase and a verb phrase, right? The verb phrase is always the huge chunk. A verb is a nucleus. It's the center of the whole piece. So then if you don't have. If someone doesn't have a verb, it doesn't dictate the action to take. And us humans, we take action, right? This is what we do. I'm filming a video. I don't say, I video. I'm filming. I'm explaining something. So if you don't have a verb, it's going to be very difficult. When you're teaching your childhood on the spectrum, the most important thing that you need to do is to teach the verb, okay? So if you don't, if you say cookie, what do you want me to do? You want me to open the cookie package? You want me to eat it? What? Who's eating it? You're eating it. I'm eating it. So then it's like programming a computer. If you don't have a very specific word for the specific action, and you allow one word to have 10 meanings, saying cookie, it involves maybe five steps already there. So it could be like, get the cookie jar, open the cookie jar, dip the cookie and the milk. Give cookie, give the cookie to you, and you eat the cookie. There's so many words and things that are absorbed into one word. And all the parent wants or the clinician wants is, I want turkey out of it. That's not going to help the child to learn, especially if they're on the spectrum, because the whole thing gets rewarded, man. Like, the whole struggle, the whole thing I want. And then they only say cookie, and the whole Thing gets rewarded. Remember that when you're teaching a child on the spectrum, when the moment you give a reward, everything before that behavior gets rewarded, okay? So if you are struggling with a child, if you're teaching a bunch of stuff and you're prompting, you're saying one thing, and then your child walks away. It comes, he comes back, he picks that up. The whole thing gets rewarded, okay? So make sure that when you're teaching, teach the verbs, okay? And there's no easy way to teach it, that there is an easy way. It's simple, but it's not easy, okay? Because it takes skill. A lot of times, children who are on the spectrum in category in terms of vocab, the nouns might be like crazy amount. There may be 500 something for nouns that they know, but adjectives and verbs are very lacking thereof. And therefore, there's this thing going on. It's like, oh, my child has so much, so many vocab. I've done, like the questionnaire about vocabulary and stuff, and the expressive is better than the receptive. That doesn't really help because, like, when expressive is all nouns, how do you make a sentence with a bunch of nouns? I'm just going to ask that. How are you going to do that? You need verbs, right? So that's the missing piece that a lot of therapists aren't explaining is that it doesn't matter the size of vocab. It needs to be the correct words. All right? If you're learning a new language, let's say Spanish, right? For me, functionally, all I needed to know when I was in Mexico City was numbers and the question, quanto questa, and then I'll live. But then the thing is, when someone asks me something, I cannot make up a sentence because I don't have the vocab. I might know the nouns, but then I cannot string it into a sentence, right? So all this you can just go to agents of Speech.com course inside of the community, the big community that we have 15,000 parents inside. There's a course inside that's called Word Combiners. It'll help you go through. I'll teach you from A to Z how to get a child to speak in a sentence from single words. So language in itself is pretty straightforward. When we get to sentences, what we want to do is to start getting a child to answer more questions. So answering who questions where questions. Okay? So these help children on the spectrum understand the categories of words that there are places, there are people, right? And most of the time, people is Always a very difficult category for autistic people, full stop, period. If you don't teach it that way, the who, everything's just a thing. So it's very difficult to probe some child on the spectrum to speak more. All right? Because once you get where and who down, what you can do now is that if a child is saying a sentence and is lacking of a subject and location or whatever information that's missing, you ask those questions so that your child would know, oh, mom's asking for clarification. So anyways, so we're up to sentences. So when we get to sentences, the next logical step for language is actually verbal reasoning. So if a child is able to describe something, and mind you, when we started off with single words, it's usually only for asking for things from you, like requesting or in, maybe they call it manding. We need to shift towards describing. Okay, Describing. And this is where sentences come into play. The answer of who and where questions asking for clarification. These are all new language functions. Okay? And like when we get here, the next logical step is verbal reasoning. Because then a child will start to either describe why something happened and they need to do it in multiple steps or sentences, right? By this time, your child would most probably be school ready because then they can understand the reasonings behind what a teacher says and they can ask and answer why questions. At the very least, they would understand, oh, this because, oh, I have to line up because everyone has a turn and it's easier to manage behavior. When it comes to this stage, I'm a stop here. And obviously I can keep on going about stories and stuff, but I feel like language is pretty straightforward once you get to this stage. Any type of therapy would, like speech therapy, AB therapy would be helpful. Is going to be easy. The hardest thing for autistic children is the hardest stuck points are verbal imitation, getting them to repeat after us, and describing in sentences. These are just like the two things that are like blockages, okay? So circling back to speech. So speech is a big hairy problem because in contrast to language, we need to know what the errors are, why the errors are happening, why can't they say specific sounds? Just today inside of our community, a parent was like, oh, my speech therapist says that there might be a hidden cleft palate going on because there's a lot of nasality, meaning when they talk, there's a lot of nasal sound, meaning it's as if they don't know how to close the soft palate inside. I can talk about this for another 30 minutes man. But once you know that, you need a check, right? And you need a speech therapist to know what to check. Okay? You cannot just say in this instance, what kind of speech assessment, speech tests have you done to verify or not verify that he has a nasality problem? That's a question we have to ask when there's a speech case which is rather a speech therapist knows it or he doesn't know it. And it takes a lot of practice. For instance, I'm just going to tell you, if there's a nasality issue, we're going to have to try to do some speech assessment, a task that goes from ma B, ma B. So why is it M versus B? It's because the difference between the M and the B is that the M has a lot has the nasal sound, the B doesn't. So if we're going in quick successions between M and a B, it's basically the soft path going up and down, closing the nasal passage. So if a child has this kind of problem doing this task, you would basically just hear, mama, ma. Okay, if you go, speech is like very targeted so that it would be very difficult for me to give you a roadmap about speech here. It's error specific, is sound specific. It really depends on how is. Right. So my best advice here, once you get the verbal imitation for autistic child. Because 80% of autistic people have comorbidities, meaning, like stuff that they are like that they have concurrently happening. So a lot of times it might be a sensory issue, right? Yeah, most of the time a sensory issue. So as the term, you may or may not know, the term for moving is sensory. Motor. Sensory comes before motor. If you don't feel it, you can't move. It's every time I say this, the parents. Oh, yeah, that makes sense. If you come out of the dentist, like you went to the dentist, right? And you got painkillers to remove, I don't know, a tooth or whatever, you come out, you basically cannot speak. The reason is because you can't feel it. The muscles can move. You're numb. You can't feel where the muscles are, therefore you can't move it properly. Okay. And it's not about that you couldn't, like your muscles are weak or whatever. It's that you can't even feel it. So then if there's a problem with the sensory, we have to fix that first. Okay. And that's something you really have to find a speech therapist, someone to look into the reasons behind the speech Errors. But you cannot get there without doing the verbal imitation first. Okay? So don't overthink. Right now you're going to think, oh, my God, my child has apraxia of speech. My child is Dysartria. My child has this X, X, A, Y, B. Like all things under the sun, there might be a chance. I'm not going to say, ah. I'm not going to shoot you down. Say ah. That's only 0.01% of the population. I'm not going to shoot you down and say, nah, that's not. I wish I was right most of the time if I shot someone down. But there is. I'm not going to risk my professional. Oh, but I'm not going to say something without seeing your child first. At the end of the day, you have to understand, get your child to verbal imitation, right? For autistic children, very important. It doesn't matter what people are saying about, oh, we have to keep it like following child's lead, like doing XYZ Link and play, or use AC or pacs. Picture Exchange Communication Systems has the word for it, but at the end of the day, it's giving a framework for your child to learn verbal imitation. It's like there are many steps, many ways to get to the same point and to say that because your child needs more, like language development, you use ac, right? If your child has a speech impediment, like a speech disorder, a speech case, then of course you're going to use AC, too. One thing doesn't. If it's like, you cannot keep on using the same thing over, like, the same tool to achieve different results, at least that's what I think. Okay? And I'm gonna say this is my personal view, not speech therapy advice here. There's a lot of literature out there that's saying, oh, AACs, iPads, communication devices, Picture Exchange communication systems. It helps with language development and whatever. I'm not gonna discount that. I like using them too, for specific cases, but I don't think it's a blanket solution. That's what I'm saying, because I'm saying this is because some colleagues of mine will see this and say, oh, my God, this is. I can't believe you're saying it like, acs don't work or whatever. That's crazy. The first thing is, how do you even do a speech assessment without speech, Verbal imitation, Everything is just going to be. Either you just hear a sound and you start marking it down, or you play and you try to elicit something. Out of the child. You try to record that, but it's going to take forever and it's not going to be all the sounds that the child is able to do. So a very good example is I didn't even know I could do the first go until my dad did it in front of me and I could imitate it, right? If he didn't do it and tell me to try, I wouldn't have known at all that I could do a trill, that this is called a trill R trill like that and so I would have known I could do it. And the other is true as well. There's trill for lip trill. There's a tongue twill like I did and there's a trill for the back, that soft palate. I can't even do it. My wife can do it, she did it. I tried to imitate it. I couldn't and then I knew I couldn't do it. But then you cannot know whether you can or cannot do something without imitation, right? So I hope this long video of me banging and banging over and over again to just to tell you to get to verbal imitation first. That's the only goal that you should care about for now if your child is non verbal, especially if he is on the spectrum or she's on the spectrum, right? So once you get to verbal imitation, the road is a lot more clear. Because if you don't have imitation, you have nothing, my friend. There's not much you can do because if you don't have verbal imitation or at least you know that your child is trying and nothing comes out, then you can do more action imitation and teach sign language or use C in this point. But you need to shoot for verbal imitation, my friend. Okay, I hope I've said this enough times already and if this resonates with you, just let me know. If that doesn't also let me know. Okay? All the things that you need to learn to get the verbal imitation and beyond is inside of our free courses. Just go to agents of Speech.com course. I've been talking too long. So that's all for now. Please let me know if you have other questions inside of the community. And that's all for now. If you want to watch the video next year. Thanks.