Ideas about the causes and treatments of Communication Deficits vary tremendously across professions and even from one professional to another within a given profession. Some authorities believe it is a good practice to teach a child to point to a picture, rather than use his voice, even when the child can speak. This practice teaches the child to communicate and can be a springboard to verbal communication; however, it could also create a reliance on the use of pictures instead of speech. Although it is advantageous to show a child that any means of communication is better than not communicating at all, it is important to relentlessly seek to reinforce speaking if the use of speech is a desired means of consistent communication. Although the approaches to the treatment of communication deficits vary tremendously, several intervention principles are common in addressing communication deficits from a behavioral perspective:
Identification of physical barriers to speech production is necessary. Children who have hearing deficits often display speech deficits – if they can’t hear speech, they really can’t figure out how to produce it or refine it for clarity.
The use of ancillary communication devices or methods (the Picture Exchange Communication System (PECS) methodology, devices to simulate speech) may be helpful and expedient. However, if the child is capable of making any speech sounds, it is probably possible to teach the child to make those sounds more consistently and intentionally, with a wider range of sounds, as a means of communicating. This is the foundation for most training in “verbal behavior” skills.
The training of communication skills can be approached just like any other behavioral training process. It starts at a basic level, takes small steps that build on success, and has a developmental plan to guide the process. Obtaining advice from a speech pathologist is invaluable in terms of creating the “developmental plan” for a given child’s communication behavioral training program.
Training in communication skills can be approached from the perspective of teaching the child to become more tolerant of age-appropriate performance expectations. Speech is a normal performance expectation for any child over the age of 1 year, so a mental health professional can assist any child over the age of 1 in acquiring speech skills by addressing the child’s behavior (escape, avoidance) in response to attempts to teach the child age-appropriate communication skills. The treatment provider is not teaching the child how to speak, which is a “life skill.” Rather, the treatment provider is behaviorally intervening to help the child tolerate the age-appropriate expectation of learning how to speak.