Answered by child psychologists Rebecca Hallenthal and Megan Norris from the Child Development Center at the National Children's Hospital and Ohio State University.

Thank you for your question. Many people with autism find it difficult to master conversational skills. This can be annoying and frustrating for both people on the autism spectrum and their conversation partners.

If possible, this topic should be discussed with the child's behavioral therapist, speech therapist and/or speech pathologist. Ideally, you will work with them to develop a personalized plan for teaching these skills to your son. nine0003

In the meantime, here are some strategies you can try at home. They follow a three-step approach that is often used for various behavioral difficulties:

1. Assessing the problem (in other words, identifying the person's difficulties and strengths).

2. Learning new skills with extensive support.

3. Practice new skills in real life.

You can start by gathering information about what your son is doing during the conversation and what is causing him difficulty. For example:

— Does he feel better when the conversation is focused on his favorite subject, but shows no interest in other subjects?

- He manages to start a conversation, but he does not listen to what they answer?

Does he look at his partner when he speaks? What about when the other person speaks?

Does he respond on a topic when another person asks for his opinion, or otherwise tries to engage him in a discussion?

Making a list of strengths and skills to work on will help you set clear goals for your son and give him the specific feedback he needs. nine0003

Practice speaking skills

For example, your son seems to enjoy talking to other people. This is definitely a strong point. At the same time, it seems that it is difficult for him if he is not the one who speaks. To improve his listening and response skills, try to practice with a third person so that you can prompt your son for possible comments and questions about what the other person is saying.

For example:

Friend: "I watched the new Avengers movie."

You, addressing your son: “What can I ask [name of friend] about the film or what he thinks about it?”

Be sure to praise your son for any effort he makes, both for asking the question and for listening to the answer. At the same time, be patient and be prepared to take small steps towards success.

For example, agree with a conversation partner that at first all his remarks will be very short. If your son can successfully listen to his answer, then praise him. Then, you can prompt him that in return he can share his own thoughts about this (if he saw it) or another similar film. nine0003

In addition to praise, consider a separate reward system. It can be some small treat or tokens (stickers or other badges). When a child collects a certain number of tokens, he will immediately be able to “cash out” them and get some favorite toy or access to his favorite pastime. You know better what exactly can motivate your son. Use the token board or stickers on the chart to motivate your child and reward them for every little success they make during their conversation practice. nine0003

Applying visual cues

Many people on the autism spectrum perform best when they have visual cues. There are several ways you can use them to teach turn-based conversation skills.

One such strategy is called "talking stick". This is the item that your son and his conversation partner will pass to each other. The general rule is this - only the one who holds the wand can speak, the interlocutor without a wand must be silent. This way, your son will have a visual cue as to who should be speaking now. nine0003

Another strategy is to print or draw "listen" and "speak" signs. During practice conversations, hold one or another sign so that your son can see it. This will be a clue about when it is his turn to speak and when to wait and listen to the other person.

Using pre-prepared conversation topics and questions

Another way to practice different conversation skills (take turns speaking, answering questions, developing the other person's thoughts) is to write down several conversation topics or questions on separate pieces of paper and put them in a vase . These can be topics about sports, school or family. Example questions might include: “What do you want to be when you grow up?” “What is your favorite movie?” “What is your favorite memory of when you were little?” nine0078 Take the leaves out of the vase one by one and say something on the topic or answer a question that comes to you.

Keep your answers very short at first. So you will have the opportunity to praise and reward your son for listening to you even for a short time. As he gets better at listening to you and waiting his turn, try to make your answers to questions longer and longer.

We often do this exercise in conjunction with talking stick or listen/speak signs. nine0003

Review of video recordings

Another strategy that has proven effective for some families is to videotape a child's conversation with another person. Watch the video together and, in an effort to be as supportive as possible, talk about what went well and what still needs to be improved.

This will help you and your son identify next goals for improvement, such as asking clarifying questions or ending conversations properly.

Many of the children we work with enjoy watching themselves on video. nine0003

A similar approach is to watch a video of two people talking together, such as a clip from a movie or TV show. After that, talk about what these people did right or wrong. We call this video modeling and it's especially effective if your son loves to watch TV. You can even find pre-made social skills videos on YouTube.

Remember to praise your son as much as possible for his efforts and give him lots of positive attention. Emphasize his willingness to work on those skills, not just what he "succeeded." Do not forget to point out to him what he did well, for example, when he listened to the interlocutor or waited for his turn in the conversation (at least a few seconds) or made a comment on the topic of the conversation. nine0003

We hope that the information on our website will be useful or interesting for you. You can support people with autism in Russia and contribute to the work of the Foundation by clicking on the "Help" button.

Communication and Speech, Asperger's Syndrome

How to teach an autistic child to repeat words • Autism is

Today we'll talk about how to achieve vocal imitation (echo control) to help your child start talking - or say more, if the child already speaks from time to time. I constantly see the same problem that parents and specialists complain about - words or parts of words "skip" in children from time to time, but no effort can induce the child to speak more. So here I will talk about five techniques that can improve vocal imitation skills in a child with autism. nine0003

As I said before, there are what I call "slip words". From time to time the child says a word. For some children, words slip every day, while for others slip words occur no more than once a week or a month. Sometimes autism regresses, as happened with my son Lucas - he initially spoke words, but then he lost them, and for a long time I did not understand how we can return them. Over the past twenty years, I have gained experience in procedures that really help children start talking - some start talking in just a few hours, for others the process can take weeks. nine0003

Just recently, a grandmother who studied with me posted a video in which her grandson said the word "apple" for the first time. Two weeks before, he had been completely non-verbal. It was hard for me to believe it myself. But this is not a sprint, but a marathon, not all children start talking so quickly.

Very often parents get stuck in developing speech with their children due to the lack of "echo control". Let me explain a little to you what this term means. Echo control means that when I say something - a sound, a word or a phrase - you repeat after me exactly what I just said. For example, if I say "apple", then you will say "apple", or at least "yab", or other similar sounds. That is, it is the repetition of other people's words, like an echo. nine0003

When I talk about "echo control", some people who have had bad experiences with behavioral therapy react negatively because they think it's something about "control" over other people. But in reality, this is just a speech imitation, and this is a natural stage in the development of speech - young children learn to speak in this way. Children listen, repeat, and then learn to use words in everyday situations on their own. Our children with autism or autism speech regression may have skipped this step, in which case we should start working with them on vocal imitation as early as possible. In my experience, if a child develops vocal imitation, then it's like a "dam break" - after that, you can already teach more and more speech skills. nine0003

In 2010, I started working as a behavioral analyst for an early intervention organization with children from infancy to three years of age. It was there that I gained my main experience and began to apply the procedures that I now recommend to parents for practicing at home. Many of the procedures that I talk about in this article are directly related to this period of work with very young children who did not speak at all or spoke very little. nine0003

I got permission to talk about some of my clients at the time, like Daniel, Mia, and Kurt, who hadn't had vocal imitation for months. Daniel got echo control in more than a year. However, using different procedures can often achieve echo control much faster. So let's talk about five techniques for developing vocal imitation.

Shoebox and other multiple control programs

I use what we call "multiple control procedures" with my current clients. For example, the shoe box program. What does this program look like? You take out a large shoe box. Cut a slot in the lid. Take a set of photos of important family members, pets, favorite toys, favorite food - anything that is rewarding or plays an important role in the child's life. You can even use two photos for the same item. You cannot use photos on your phone. It is necessary to print standard, large photos. Each photo should contain only one person or one object. For example, it could be a photo of mom and a photo of a bike, but not a photo of mom on a bike, as this would create confusion. nine0003

You then sit diagonally across from the child so that you can be seen clearly and that you can physically help the child slide the photo into the slot in the box. You take one photo, raise it, say its name. Usually you say it up to three times, slowly but animatedly and with emotion: "Mom ... mom ... mom ..." Say only the name of the photo, nothing more. As you say this, you bring the photo closer to the child and the box. You can bring it to your mouth: "mom ...", even closer: "mom ...", and then pass it to the child: "mom." This is called "stimulus-stimulus combination". nine0003

Some children may get upset because you hold the photo for too long and it annoys them. In this case, do everything faster. Say "mom" and put the photo in the box. The child should not cry during the lesson, and in general it is better to avoid it if possible. Classes should be fun and relaxed.

You can use the same program with a wide variety of materials. For example, you can collect the Potato Head toy with your child, naming the different parts of the body that you give to the child. Or you can collect "insert" puzzles, where each insert depicts something - name a part of the puzzle and pass it to the child. Or you can do it with the parts of the toy that you need to launch it or start the game. nine0003

Such programs are called "multiple control programs". If a child says "apple" when you hold a picture of an apple, then this is partly a request because he wants to get a picture from you and put it in a box. It is also a naming or "tact-reaction" because he sees a picture of an apple. It is also a repetition or "echo response" because you say "apple" when you hold the picture.

At the same time, you teach your child to sit at the table, listen to you speak, sit still for a long time and put something in a box. But it is important that the center of such a program is a request - in this case, you are much more likely to get the child to repeat the word. It is important to engage in such programs with a child for at least 15 minutes every day. nine0003

In the old days, "echo control" was done differently - the child sat in front of the therapist, who said: "Say the ball, say the ball." This does not work. You can't force a child to say "ball." A child cannot be forced to say anything at all. Even if the child said "ball" a couple of seconds ago, even if he said "ball" thirty times yesterday, you cannot make him say "ball" as you wish.

Therefore, in early intervention programs, we kind of enter "from the back door. " We work with what is important for the child. We act unobtrusively. We try to play with the child and make this activity fun. We make the situation as pleasant as possible. And since the program is somehow connected with requests, it is easier for us to achieve hundreds of responses. nine0003

Even if a child never repeats other people's words - and some children never do - it is still important to engage in such programs with him. Some children need 15-20 minutes of practice every day, and they listen to "apple, apple, apple" and put the pictures in the box. But they never say "apple".

And this is where strategy number two can come in handy. We want to diversify the program. Because maybe the kids are just used to listening, then they put the photo in the box, and that's how they get rewarded. nine0003

A lot of very young children or older children, but at an earlier level of development, love games and toys on the principle of "cause and effect". They sit, wait, take a photo, put it in a box. If vocal imitation does not appear, then we need to think about how we can mix everything up. Maybe we don't need to say the word three times. Maybe we should say it once or four times.

Here is one trick that worked for my former client, Mia. I couldn't get vocal imitation out of her for months. But then we started showing her a picture of an apple, saying "apple", then covering up the picture, saying "apple" again. Covering up the picture helped Mia say the word because she wanted to see the picture. nine0003

Another idea is to put pictures in a bag or bag, this can be used with Potato Head and Inserts. You can put them in a bag, open it, name what is there, but not show the item. Then the child can repeat the word. If he does not say anything, then you show him the object, and then hide it again. Try to be playful - a little fun sabotage - maybe this will encourage the child to speak.

An important early program is matching the same pictures or objects. Remember how I said to prepare two pictures of one person or object? For example, two photos of mom, two photos of dad, two photos of a juice box or something else that the child likes. Some of them may be identical. Try putting two or three photos on the table at the same time. Hold up a photo of your mom. Say "mom, mom, mom." Then you can help the child by showing that the photo should be put on the same picture. nine0003

The third technique is to take turns singing the song. Over twenty years ago, before Lucas was diagnosed, I knew nothing about applied behavior analysis and knew very little about autism. And so my husband says, "Look at this." He starts singing a song from the cartoon: "What a beautiful...", and then Lucas says: "Day!" My husband continues: “I can’t work ...”, Lucas says: “Laziness!” And I was stunned. Because he does not say these words when I ask him. My husband, unknowingly, was working with him to develop "intraverbal responses. " However, we both knew nothing about this for a long time. nine0003

But you don't even need to know what it is. We'll just sing the child's favorite song and then leave one word unsung. For example: "burn-burn ...", child: "clear." But if the child does not say anything, then instead of singing further, it is better to start again: "burn-burn ...". Take a break, maintain a fun atmosphere, you can try to do this with a variety of songs. You can use props. For example, a child likes a song about ducklings, and you show him a picture of ducklings. nine0003

If a child has no vocal imitation at all, it can be difficult to get such a reaction, but sometimes children, like Lucas, start adding the right word to a song before they have vocal imitation. And then you can use that to move on to vocal imitation. In any case, it's worth a try.

Tip number four is something I rarely talk about, and in vain. This is a great strategy that you should definitely try. It's called video modeling, and it's an evidence-based tool that we can use to teach speech and play skills. I had a client, Kurt, he was one of the first kids I worked with. We worked together for several months, but I could not achieve echo control. We had both "Potato head", and "shoe box", and "liners". And Kurt spoke up to ten words in two hours, and it was "eyes", "nose" and "mouth" because we were playing Potato Head. nine0003

I decided to teach him gestures because if you can't quickly get vocal imitation, you should immediately move on to gestures or another way that the child can ask for what he wants. I asked the therapist I taught to film me teaching Kurt the first three or five gestures. Kurt stood up and began to look at me with interest in the therapist's video. And then I thought that video modeling could be applied.

Now I'm embarrassed to think of a ten-word-in-two-hour chart that hasn't changed in weeks or months because I needed to type the gestures much sooner. But I was just starting to work and only honed my methods. At least he spoke a little and was willing to cooperate. Previously, he had aggression and self-aggression. We worked on a variety of behaviors, but not on speech. nine0003

I asked the therapist to make two videos of me. At the first, I said "head", "shoulders", "knees", "fingers", I spoke clearly and very slowly. In another video, I said "eyes", "ears", "nose", "glasses", "hello". I pointed to my own body parts in accordance with the words.

I asked my mother to do me a favor and upload these two videos to Kurt's tablet. I had to leave for two or three weeks. When I returned, as soon as I entered, Kurt began to say "eyes, nose, mouth, glasses, hello." And I'm like, "My God, I completely forgot about that video." He spoke the words in the exact order that I did. nine0003

That day, instead of ten words in two hours, I got a hundred words in two hours, and after that we couldn't keep up. What's more, we've included video modeling in all of Kurt's other programs. For example, we said "where's the banana" and pointed the camera at our hands. He wasn't even in the room. After that, we pointed at the banana in front of the camera. That's all he saw.

We asked my mother to show different pictures and say "cup", "car" and other words that we worked on. She raised a picture, for example, with a cat, said "cat", and we filmed it. He began to speak thanks to this video modeling. nine0003

If the strategies above do not help you achieve vocal imitation, then the next, fifth step is additional testing of skills and additional study of possible strategies, regardless of whether you are a specialist or a parent. This is not superfluous, even if you have echo control with a child.

I recommend that the VB-MAPP be administered to all children below four years of age, whether they speak words or not. Or it could be another standardized language development test. nine0003

There are many much more complex behavioral strategies that you may need to help your young child with autism not only develop language, but correct problem behaviors, teach self-care, and be independent enough to learn school subjects in the future.

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