How to help an autistic child talk

Teaching nonverbal autistic children to talk

March 19, 2013

Still among our most popular advice posts, the following article was co-authored by Autism Speaks's first chief science officer, Geri Dawson, who is now director of the Duke University Center for Autism and Brain Development; and clinical psychologist Lauren Elder.

Researchers published the hopeful findings that, even after age 4, many nonverbal children with autism eventually develop language.

For good reason, families, teachers and others want to know how they can promote language development in nonverbal children or teenagers with autism. The good news is that research has produced a number of effective strategies.

But before we share our “top tips,” it’s important to remember that each person with autism is unique. Even with tremendous effort, a strategy that works well with one child or teenager may not work with another. And even though every person with autism can learn to communicate, it’s not always through spoken language. Nonverbal individuals with autism have much to contribute to society and can live fulfilling lives with the help of visual supports and assistive technologies.

Here are our top seven strategies for promoting language development in nonverbal children and adolescents with autism:

Encourage play and social interaction. Children learn through play, and that includes learning language. Interactive play provides enjoyable opportunities for you and your child to communicate. Try a variety of games to find those your child enjoys. Also try playful activities that promote social interaction. Examples include singing, reciting nursery rhymes and gentle roughhousing. During your interactions, position yourself in front of your child and close to eye level – so it’s easier for your child to see and hear you.
Imitate your child. Mimicking your child’s sounds and play behaviors will encourage more vocalizing and interaction. It also encourages your child to copy you and take turns. Make sure you imitate how your child is playing – so long as it’s a positive behavior. For example, when your child rolls a car, you roll a car. If he or she crashes the car, you crash yours too. But don’t imitate throwing the car!
Focus on nonverbal communication. Gestures and eye contact can build a foundation for language. Encourage your child by modeling and responding these behaviors. Exaggerate your gestures. Use both your body and your voice when communicating – for example, by extending your hand to point when you say “look” and nodding your head when you say “yes.” Use gestures that are easy for your child to imitate. Examples include clapping, opening hands, reaching out arms, etc. Respond to your child’s gestures: When she looks at or points to a toy, hand it to her or take the cue for you to play with it. Similarly, point to a toy you want before picking it up.
Leave “space” for your child to talk. It’s natural to feel the urge to fill in language when a child doesn’t immediately respond. But it’s so important to give your child lots of opportunities to communicate, even if he isn’t talking. When you ask a question or see that your child wants something, pause for several seconds while looking at him expectantly. Watch for any sound or body movement and respond promptly. The promptness of your response helps your child feel the power of communication.
Simplify your language. Doing so helps your child follow what you’re saying. It also makes it easier for her to imitate your speech. If your child is nonverbal, try speaking mostly in single words. (If she’s playing with a ball, you say “ball” or “roll.”) If your child is speaking single words, up the ante. Speak in short phrases, such as “roll ball” or “throw ball.” Keep following this “one-up” rule: Generally use phrases with one more word than your child is using.
Follow your child’s interests. Rather than interrupting your child’s focus, follow along with words. Using the one-up rule, narrate what your child is doing. If he’s playing with a shape sorter, you might say the word “in” when he puts a shape in its slot. You might say “shape” when he holds up the shape and “dump shapes” when he dumps them out to start over. By talking about what engages your child, you’ll help him learn the associated vocabulary.
Consider assistive devices and visual supports. Assistive technologies and visual supports can do more than take the place of speech. They can foster its development. Examples include devices and apps with pictures that your child touches to produce words. On a simpler level, visual supports can include pictures and groups of pictures that your child can use to indicate requests and thoughts. For more guidance on using visual supports, see Autism Speaks ATN/AIR-P Visual Supports Tool Kit.

Your child’s therapists are uniquely qualified to help you select and use these and other strategies for encouraging language development. Tell the therapist about your successes as well as any difficulties you’re having. By working with your child’s intervention team, you can help provide the support your child needs to find his or her unique “voice.”

Autism Speaks continues to fund research on therapies that promote language development as well as supports and services that can improve communication and quality of life for nonverbal individuals.

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How to Help Your Nonverbal Child with Autism Speak

Approximately one third of children with autism are nonverbal. This means that they never learn to speak more than a few words in their lives.

Why Can’t My Autistic Child Speak?

There may be a couple of reasons that a child with autism doesn’t speak. The primary identifying aspect for nonverbal autism is determining whether or not the individual speaks clearly or with interference.

Although there are individuals with autism that may struggle with having a back-and-forth conversation, these are not nonverbal autistic people. Those who are nonverbal don’t speak at all.

Let’s look at the reasons why this may be happening. Autistic children could lose the ability to speak later on as the disorder’s symptoms worsen over time.

The individual could also be suffering from apraxia. This can cause the person to not be able to say what they want to say.

Autistic individuals could also suffer from echolalia, which is the repetition of words and phrases. This could also hinder clear communication.

Read: How to treat Echolalia in a Child with Autism

In addition, there are social, behavioral and developmental symptoms for nonverbal autism.

Social symptoms: Social interaction difficulties are a hallmark symptom of autism spectrum disorder. Individuals generally avoid eye contact. They don’t respond when their names are called. These could cause the individual to feel left out and isolated and may lead to depression.

Developmental symptoms: Each individual is unique. Every autistic person develops at a different rate. While a child can develop at a typical rate, their developmental progress could be delayed after the age of 2 or 3. This could be the case for speech as well.

Behavioral symptoms: Individuals with autism strictly stick to routines. Interruptions in these routines or schedules could upset them. Some have really specific interests and obsessions about certain objects and topics. They may have a short attention span, causing their focus to switch from one thing to another, which could affect communication. Behavioral symptoms really differ for each person.

Not all individuals show the same symptoms, and symptoms may improve with age as they become less disruptive and severe.

Through speech therapy and speech interventions, nonverbal autistic children could become verbal in time with the right and continuous help and support.

A nonverbal autistic two years old may not respond when their name is called A nonverbal autistic three years old may not play pretend A nonverbal autistic four years old may repeat words and phrases that are not meaningful A nonverbal autistic five years old may have trouble interpreting gestures in communication setting.

Causes of Autism

The definitive cause of autism is still being studied. However, research suggests that there is no single cause for the disorder.

Autism appears to develop from a combination of genetic and environmental factors.

These factors are found to impact and increase the risk of a child developing autism spectrum disorder. Increased risk doesn’t mean that the individual will certainly develop the disorder.

Some of the individuals that have risk factors associated with autism don’t have the disorder.

Studies suggest that the disorder:

Could be inherited,
Could result from abnormal levels of chemicals in the brain
Could be caused by infection or the effects of an environmental toxin

Genetic risk factors: Genetics were found to affect the risk of some forms of autism. It is known that if an individual has a sibling or a parent with ASD, they are more likely to develop the disorder. In addition, some medical conditions were linked to autism spectrum disorder. Genetic disorders such as Fragile X syndrome are included in these conditions.

Environmental risk factors: Some experts suggest that exposure to heavy metals and toxins in the environment may raise the risk of developing ASD. Also, CDC indicates that children born to older parents are at higher risk for developing autism spectrum disorder. Certain prescription drugs such as thalidomide and valproic acid have been linked to autism development as well.

As can be seen, both genetics and environment could determine whether a child will develop autism or not. Autism is NOT caused by vaccines.

An abundance of research conducted on the matter concluded that the disorder is not caused by vaccines. The infamous study done in 1998 suggesting a link between autism and measles, mumps, and rubella (MMR) vaccine has been debunked multiple times and retracted in 2010 .

Diagnosis of Nonverbal Autism

There is no specific single test that determines nonverbal autism. A multi-phase process is conducted to diagnose the disorder.

When your child is at the pediatrician, they will be the first healthcare providers to assess for ASD. Parents and caregivers will sound their concerns to their doctor if they notice any symptoms.

The pediatrician then could request various tests to rule out other possible causes for the concerning symptoms. They may conduct physical examinations, blood tests, and MRI or CT scan imagings.

Pediatricians then refer your child to a specialist if they suspect autism spectrum disorder. Specialists will evaluate the medical history of the child as well as the parents.

After all of the extensive testing, autism-specific tests may be used to confirm the diagnosis of the disorder.

These tests include Childhood Autism Rating Scale Third Edition (GARS-3) and Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) They will help clinicians determine whether the child has nonverbal autism.

Do Nonverbal Autistic Toddlers Babble?

Around 40% of autistic children don’t speak. Some others may speak while also having limited language and communication skills.

Babbling occurs when a newborn is practicing for speech. They open and close their mouths, move their tongues in different ways.

When typically developing babies babble, they begin their early development of language.

People with autism sometimes produce certain nonsensical speech sounds. These are called jargon. Sometimes they are self-stimulatory behaviors.

Generally, they are not used to communicating with others. The rate of babbling in nonverbal autistic individuals is low compared to their typically developed peers.

However, babbling could represent precursors to speech in an autistic child with speech-language delay.

Research suggests that the majority of nonverbal 4-year-olds with autism can develop spoken language if they have relatively strong social engagement and don’t have intellectual disability.

If a nonverbal child with autism babbles along with eye contact or gestures directed towards other people, this behavior could be worked on to be used as a tool for meaningful social and communication exchanges.

When is it Decided an Autistic Child is Verbal/Nonverbal?

Each individual develops at their own rate. However, research showed that one third to half of parents of autistic children noticed issues before their child’s first birthday. Also, around 80% to 90% saw problems before the child turned 2.

There are certain symptoms that may indicate that the child has verbal/nonverbal autism. Here are some:

Not responding to their name by the age of 1
Not babbling towards parents or caregivers by the age of 1
Not pointing at objects of interest by the age of 14 months
Not imitating the parents or caregivers by the age of 18 months
Repeating words over and over
Flapping their hands
Rocking back and forth
Preferring to be alone
Avoiding eye contact
Not meeting developmental milestones in terms of speech and language

How to Teach an Autistic Child to Talk

Although there is no cure for autism, there are therapies and interventions that help the individual to be able to communicate.

It is important to remember that each child is unique. One effort that works with one child may not be helpful for another. In addition, although a child with autism can learn to communicate, this may not alway be through spoken language.

Nonverbal autistic individuals can have and live fulfilling and comfortable lives with the help of therapies and assistance.

Here are some of the treatment options for nonverbal autistic individuals:

Medicine: There is no medicine that will specifically cure autism. However, certain medication could help alleviate related symptoms and conditions. The child could have anxiety or depression, and medication could help with these.

Counselling: Counseling parents and caregivers as well as the siblings of the individual with autism could really benefit from therapy. Through counseling, they can learn how to approach the situation to achieve positive outcomes and to cope with the challenges of nonverbal autism.

Education: Children with autism respond really well to structured sessions. These sessions could help them develop skills and behaviors that will be beneficial in communication. They can gain social and language skills while also getting education and working on their development.

What Does the Future Look like for Nonverbal Children?

Nonverbal children with autism could have a comfortable and quality life. It is important that with the right help, they could equip themselves with the necessary skills to live their life normally.

Although nonverbal, children with autism use other methods to communicate. Certain strategies, which we will discuss here, could be used to leverage these methods and add on to them.

Not being able to speak to communicate should not be seen as a setback, but as a challenge that could be overcome. Although there is no magic cure to achieve speech, your child could go a long way with your support.

Once they understand and learn a way to express what they are feeling, be it verbal or nonverbal, they will have a more positive attitude towards communication.

What Age Do Autistic Children Talk?

Autistic children with verbal communication generally hit language milestones later than children with typical development.

While typically developing children produce their first words between 12 and 18 months old, autistic children were found to do so at an average of 36 months.Since each autistic child is unique in their development, the age when they produce their first words differs.

Until recently, parents and caregivers of children with autism were made to believe that their child would not speak ever if they did not do so by the time they turn 4 or five.

However, a recent study showed that most of the children participating in the study acquired language skills, and almost half of them became fluent speakers. More than 70% could speak in simple phrases. This indicates that language-delayed children with autism could eventually develop speech.

Nonverbal Autism Recovery

There is no “cure” for or “recovery” from autism. It is a lifelong condition that impacts major aspects of the individual. However, it is possible to manage signs and symptoms.

Through early intervention and treatment supports, the individual’s quality of life could increase. They can learn new sets of skills in terms of language and communication as well as behavior.

Techniques to Help Nonverbal Child Communicate

There are certain techniques you can try to encourage your nonverbal child to communicate. Here are a couple:

Encourage social interaction and play: Play, especially pretend play, is a great tool to teach children language skills. This will create fun opportunities for your child to communicate. You can also try certain activities like singing to promote social interaction. Make sure that it is easier for your child to see and hear you clearly during these activities.

Be patient: You may feel the need and urge to fill in the gaps in terms of language when your child doesn’t immediately respond. However, it is important to give the child the opportunity to gather their thoughts and communicate. This may not alway happen through speaking. But when you ask a question, just wait for a few seconds. Observe your child for the sounds and the gestures they make. When they make an attempt, be prompt to respond so that they will get the idea and feel like they are communicating.

Include your child’s areas of interest: Make sure that you are including the things and topics your child is interested in your communication attempts. Don’t interrupt their focus and go along with them. Describe what they are doing with the object of interest. By including what engages your child into these activities, they will be more likely to associate what they learned with the objects, and expand their vocabulary with the things they love.

Technology: There are various assistive technologies and visual aids out there in the market. Their purpose is more than just to replace speech. You can also use picture cards, which work similarly. They can also promote the development of this skill. Devices and applications with pictures and sounds where the child can engage with the object can help them produce words in time.

Otsimo is a great help in this area, as the application has hundreds of games designed to engage and help children learn skills, including speech and language.

Read: 10 Speech Exercises to do at Home

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How to Communicate with a Nonverbal Autistic Child

There are an abundance of ways to help promote communication with your nonverbal autistic child.

They don’t replace speech therapy or other interventions that are uniquely designed to the needs of your child. But they can be a great support at home, things that you can do to establish communication with your child.

Talk: Keep talking with your child. Describe things to them. Include them in conversations and don’t leave them out as if they are not there. Your child will still be able to learn from this action.

Use simple language: Refrain from using sentences with a lot of words in them. Try to use one or two word sentences. Once your child can use one word phrases, you can move into using two phrase sentences to give them direction or describe something. This will help them improve without overwhelming them.

Make the most of playtime: Play is an amazing tool to both entertain and practice with children. While playing, you can have the opportunity for communication. While playing with toys, you can encourage imitation. You can also involve fun activities like singing or dancing so as to foster social interaction.

Go different ways: Nonverbal children with autism may express their emotions through some other ways than speaking, like dancing, art, hand movements, and body movements. You can try to help them express themselves better through activities like finger painting or sensory activities.

Technology at your disposal: As we mentioned, there are various applications and devices out that can help with technology. You can use them on your smartphone or tablet as an assistive communication device.

Read: How To Use Otsimo Speech Therapy With Kids Who Have Articulation Disorder?

Face your child: Sit right in front of your child, at their eye level. This will put you in their field of view, where they can see your gestures, facial expressions and mouth movements. This way they can comprehend what you are communicating via your body language, too.

Tips to Help Your Child Find Their Voice

It is important to give your child the opportunity to find their voice while also supporting them. They may show some initiative but they may need direction while learning how to express themselves.

There are some exercises that you can practice to promote speech and encourage your child to express themselves clearly.

Make an effort to talk: It is a difficult situation. But don’t just avoid including your child into conversation. These attempts at conversation could actually be beneficial for them to understand the practice.

Keep it simple: Keep your sentences short and be direct. Adjust the conversation level to that the child can maintain. Wait for them to process fully.

Take note of nonverbal signals: Being nonverbal does not mean that your child is not communicating in some other way. Be aware of their behaviors. Since children with autism have difficulty in expressing themselves by using language, they refer to behaviors that could signal what they might try to verbalize.

Don’t push: Yes, of course increase the level of activities to expand the boundaries of your child’s capabilities. But if you feel like your child is overwhelmed, then take a break and try again later at a better time. Children with autism have very specific routines and they get.

Can a Child Be Nonverbal and Not Autistic?

As we have mentioned numerous times, children develop at their own rates. But there are some milestones they hit while growing up.

Studies show that typically developing children generally produce their first words between 12 and 18 months old. However, in the case of children with autism, this rate is reported to be an average age of 36 months.

Late speech does not necessarily mean autism diagnosis. A child could be nonverbal or have delayed speech for some other unrelated reasons. Here are some:

Problems with the mouth
Speech and language disorders
Hearing loss
Neurological problems
Intellectual disabilities
Autism spectrum disorder

You may ask yourself “will my nonverbal autistic child ever speak?”. The answer to that question is not easy to give.

Research shows that nonverbal children of age 4 who were nonverbal until that point could produce single words and phrases without verbs.

The important thing here is to provide the right support and help to your child, suitable to their needs. If your child is babbling, or trying to convey something through their behavior, you should lean into it and practice speech exercises.

Many parents and caregivers report that they have had success with such exercises at home, along with the help of professional intervention like speech therapy.

Speech Therapy for Nonverbal Toddlers

Speech-language pathologists can really help children with their language and speech problems. They will first assess the best way to approach the situation. Here are a couple of techniques used during speech therapy for toddlers:

Utilizing picture boards
Signing or typing
Exercising facial muscles to improve articulation
Modulating the tone of voice
Understanding body language

In speech therapy, the social communication and behaviors of the child are modified.

Caregivers and parents are also included in the process to create an approach best suited for the child. Certain techniques and combinations of them will be used in these sessions.

Read: Does my Child Need Speech Therapy?

Last Updated: 23 December 2022

How to help an autistic child learn to speak their first words • Autism is

The first strategy recommended for developing the speech of a non-speaking autistic child is learning to ask, verbally or through gestures or pictures. However, there are other key strategies that help predominantly non-verbal children improve their oral language skills. The following are examples of strategies that parents can use every day when communicating with their child.

Rewarding the child for any speech sounds

This means that any sounds, even “accidental”, allow the child to immediately receive something pleasant and good. This encourages the child to publish them more often. To do this, parents are advised to always carry a bag or a small bag with treats or toys that the child really likes.

If a child starts spontaneously babbling, for example, repeating some syllables, then it is important to immediately “reward” him - run up, pay attention, praise, hug or tickle (if the child likes it) or even give something tasty or whatever - a toy.

The goal is for the child to begin to vocalize more - pronounce different speech sounds and syllables throughout the day. Babble is a very important stage in the development of a child's speech. If the child has not passed it and rarely vocalizes, then it is important to encourage speech sounds in him. For a child, this is an important practice before moving on to words. Encouraging each sound is a way to increase this practice.

Associating a reward with a certain sound (part of a word or a short word)

Research has shown that when sounds are associated with a particular reward, a child is more likely to reproduce that sound later on. For example, for one three-year-old boy, the sound "iiiiii" was associated with riding down a hill. The child was helped down the hill five or ten times in a row, each time the instructor said "iiiiii". A week later, the boy began to say "iiiiii" during the day already spontaneously. In the future, you can move from the sound "iiiiii" to a whole word, for example, "down".

For this method, it is important that the sound (word) is repeated in conjunction with the encouragement every day and repeatedly. It is desirable that these be dozens of repetitions. For an adult, repeating a word or sound dozens of times in the same action can be strange and embarrassing. However, despite the simplicity and monotony, this technique very often leads to positive results.

Teaching a child to imitate

Imitation skills play a very important role in the development of speech, because we teach words by offering to repeat them after us. But first you need to make sure that the child can imitate gross motor movements following the adult (for example, jump up, clap his hands, raise his hands, push a toy car). Such movements are easier to distinguish from each other and easier to prompt the child during their implementation.

Then, you need to focus on more complex motor imitation (for example, connect two fingers, stick out your thumbs, and so on). This requires observation of less noticeable movements as well as fine motor skills. The next step is oral/facial imitation (e.g. open mouth, blink, stick out tongue, etc.). Now the child is learning to follow your oral motor skills.

Finally, try to make a sound during mouth movement that the child already knows how to imitate (for example, open your mouth and say “ahhhh”, purse your lips and say “mmmmm”, and so on). This gradual progression allows for a smooth transition to spoken language, while requiring a child to say “ooh” to ask for juice instead of a gesture can make the transition difficult.

Name something that caught the child's interest

It is important to teach the child words that make sense to him. These are people, objects and activities with which he deals every day, which he really likes and arouses great interest in him.

Pay close attention to what interests your child. Notice if he reaches for something or otherwise shows that he wants to get it. This is an opportunity to associate this item or action with a specific word.

For example, if he reaches for a cookie shelf, this is an ideal situation to practice - say "cookie" and hold out a piece of cookie. Repeat the same with the other piece of cookie. If the child is building a tower with blocks, try giving him new blocks and say "block" each time. Remember that it is easiest for a child to learn new words in a situation where he is motivated and involved in what is happening!

Repeat key words in different situations

It is important for children to hear words many times in different situations in order to really understand their meaning. Try to repeat words that are related to the child's usual activities during the day. For example, repeat the word "cold" when you go outside in cold weather, when you change the temperature of the tap to get your child to wash their hands, and when you treat your child to ice cream.

Visually demonstrate what the word means — point to an object, or mark the word with an action. For example, say "cold" and show that you are shivering.

It is not necessary to repeat only one word each time. Use very short, grammatically correct sentences with emphasis on the key word to help your child understand the different uses of the word. For example, “how cold it is here” or “cold water”.

Respond to the child's attempts at communication, even the most imperfect ones

If a child tries to pronounce a word, even if only one sound comes out or he pronounces it incorrectly, it is very important to immediately encourage this attempt. If the child somehow tried to communicate with you, then answer as if he had said the whole word. This shows that you are listening to him and understand what he is trying to communicate. This encourages him to keep trying to communicate with you.

It is important to remember that learning the first words is a slow process. In order to speak a word in a suitable situation, a child needs to learn: to pronounce speech sounds and syllables with ease; repeat after an adult, including repeating speech sounds; correctly understand the meaning of the word.

The strategies above enable the child to receive this training. Of course, these are just examples of possible methods, and many children will need an individual therapy program to learn their first words. However, it is important to remember that this training should be diversified and include different methods and approaches.

How to teach a non-speaking child with autism to repeat sounds and words?

6/16/16

Several strategies for developing basic speaking skills in children with autism

Source: BCOTB.com
Author: Catherine Ganem

When teaching children with autism to speak, one of the first and most important skills is vocal imitation. Echo or vocal imitation is a type of speech where the speaker repeats the words of another speaker. For example, when a child says "bye" after his mother says "bye". It is obvious why vocal imitation is so important: if a child can repeat other people's words, then this will facilitate further learning in requests, naming objects and answering questions.

The first step in learning vocal imitation is choosing a reward that is valuable to the child. It can be an edible reward, favorite toys, or some kind of action (for example, tickling).
Next, the child's existing repertoire should be assessed. How often does the child make any sounds, babble? Can he spontaneously make different sounds, or does he repeat the same speech sounds over and over again? What sounds did the child make in the past? Write it all down ahead of time to help you determine a strategy or strategies for furthering your child's education.

One or more of the following strategies can then be selected:

1. Stimulus-Stimulus Combination

Purpose: To form a link or association of speech sounds with a strong reward so that speech sounds themselves become rewards in the future and something pleasant for the child.

Practice: Choose speech sounds that the child has already made in the past, or those sounds that are easiest to pronounce (“ba”, “mmm”, etc. ). Extend the encouragement to the child and say the desired sound. If the child makes or tries to make a sound, immediately reward him. If there are no sounds, then give him encouragement after a pause of one second. Remember, your goal now is to form an association between the sound and the reward, so the child doesn't have to say anything at all. However, if the child does repeat the sound after you, then reward him much more than when there were no sounds.

Rewards: For this program, the best rewards are those that don't have to be constantly taken back from the child. For example, it could be small bites of a child's favorite treat, or pleasurable adult activities such as tickling. It is best to avoid rewards that will have to be taken back (such as toys) unless the child has other types of rewards. Some children may become frustrated if a toy is taken away from them every five seconds.

Note: It usually takes hundreds of trials for a child to successfully imitate the sound of speech in this program. Gather data on what sounds your child is making to determine what sound should be the next target. Subsequently, from training in the "stimulus-stimulus" program, you can move on to training in requests. (See also How to Teach Your Child to Speak.)

2. Vocal play

Purpose: To combine or create an association between speech sounds and fun activities that the child prefers.

Practice: Start playing with your child or doing something they usually enjoy. While playing, as often as possible, make simple sounds and vocalizations that are usually associated with such a game (for example, "Beep-beep!", "Bang!"). If the child spontaneously repeats the sound after you or starts babbling, immediately praise him as much as possible and encourage him. However, do not ask or demand that the child say something.

Over time, the child will begin to associate funny sounds with play and will be more likely to imitate these sounds in the future.

Reward: Any game or favorite activity of the child. You can keep an extra reward (such as your child's favorite treat) handy just in case, to reward any spontaneous speech sounds.

Note: In this program, it is useful to set a timer for a certain time and count how many speech sounds the child makes so that you can track his progress.

3. Teaching requests with gestures simultaneously with words (total communication method)

Purpose: To create an association between speech sounds or words and specific rewards during teaching gesture requests.

Practice: When teaching gesture requests, always say the name of the item during each teaching step. If the child has already learned to ask with a gesture, then name the reward when you give it to the child. If the child is learning a new gesture, name the reward when prompting the child for the sign and then give the reward. Over time, the child will learn to associate the word with the reward, and this will increase the likelihood of word attempts and spontaneous verbal requests. (See also How to teach your child to ask with gestures.)

Reward: An item that the child asks for with a gesture.

4. Reward all sounds

Purpose: Reward all the sounds your child makes so that he is more likely to repeat them in the future.

Practice: Give your child encouragement and praise (Example: "Good job saying 'a'!") every time he or she makes a speech sound. This should be done throughout the day.

Reward: It is best to choose several rewards from different categories (eg different types of products, different activities, different toys). Otherwise, the child will quickly get fed up with the reward.

When the child can already imitate (or tries to imitate) basic speech sounds, other procedures can be used to form articulation and pronunciation of words. (Also see Vocal Imitation Teaching Technique and How to Help Your Child with Autism Speak More Clearly.