Saturday, February 23, 2008

Thinking Out Loud To Yourself--So Your Child Learns How

We learn to communicate with someone who listens--with mom or dad or someone who responds as though what we have to say is powerful, important and interesting.

Then, finding it useful and enjoyable to have a conversational partner, we move an imaginary one into our heads and our favorite conversational partner becomes ...well ...ourselves. From then on, the person we talk to the most is our mysterious other self.

This private speech is as important as it is strange. When we are telling ourselves that we need to get ten things done before noon and rattling off the list mentally--is it because we don't know the list? If we know it already, which we must or how could we say it to ourselves, why do we have to say it to ourselves? It turns out that we don't know things in a conscious and motivating way until we tell ourselves, and the whole list probably will not get done unless we keep reminding ourselves. We learn by talking things over with ourselves. We understand better by talking to ourselves. We feel less lonely because we talk to ourselves. We get things done because we talk to ourselves. This private speech is built, though, on a social construct. It is an internal conversation that we have and we learn conversation first with others before we learn it as an internal mental function--at least in most cases. Children who have difficulty with all things social, that is children with autism spectrum disorders, often have difficulty developing a functional private speech system because it does not come natural to talk things over with anyone--even oneself.

Often parents and others seem to believe that children with autism have typical ideas and thoughts and feelings about the world and that they understand what they want to say but just have trouble putting these ideas into words and saying the words out loud. Oh! If only this were the case! Children with autism can be very intelligent in mechanical ways, musical ways, numerical ways, spatial ways, artistic ways--but as hard as it is to imagine for those of us who are neurologically oriented 90% of the time to the social world, children with autism are often unable to install an imaginary conversational partner into their minds. Then, all the things that they need to think through with words, tell themselves to do with words, console themselves through with words--all these things are never said and never thought.

There is a period where many children with autism do start the process of installing an imaginary other--and we can tell because like all children, they start this process by talking out loud to themselves. This is exciting to see. But, listening in, as we can, we realize that the range and complexity of their private talk is impoverished--in other words, they don't use private speech for as many cognitive or emotional purposes as other children do.

The intervention for this is to think out loud. Model and demonstrate talking to yourself. Gradually, you model slightly more complex self-talk as you see your child catching on. You teach this skill by demonstrating the skill in ways that will be interesting and potentially useful to your child. Visual supports are helpful--draw pictures, write stories, demonstrate with dolls, stop video movies and make explicit that people are thinking things with words in their heads and using language to do this. By all means, teach your child what a talking bubble and what a thinking bubble are and use these to explain how you think about things even when you don't say them out loud. This process of teaching thinking about things to yourself is one that spans years and can't be put on a treatment plan and achieved in a few months.

Here are some ways that we use private speech and that you can model for your child.

We play with words--imitating phrases that catch our fancy, trying on accents, singing songs, creating rhymes and rhythms. My name is Mary, I'm a Fairy, not too hairy, I love Larry! We don't need a reason for making car sounds, or nonsense words--we just like them.

We express and regulate ourselves emotionally with words. Just breathe! we might say after a near miss on the freeway. Yikes! is my favorite word for when small things go wrong and nearly all the children that come and play with me say Yikes! before long.

We coach ourselves through things that have several steps or are difficult. Ok! Be careful as you do this we say as we set the top block on a wobbly stack of blocks. I hope you are seeing here how play is the cradle for developing self-talk. Like so many other things, though, a child with autism will not necessarily learn self-talk in play without a model for doing so.

Narrating imaginative play and taking roles within imaginative play are both learned in pretend play but serve us well through life as we imagine future scenarios large and small and play them out, taking all the important roles so that when we get to the real job interview, the real discussion group at the community club, the real funeral for our step-brother's wife--we can figure out what to say. We often need to get on the floor and play with children to teach them how to shift back and forth between play narrator and actor in the imaginary world we co-create.

Reading and thinking through stories and information in books is another kind of private talk that we can do out loud to teach our children how to understand a book. This book has Dora on the front. I bet it will be a story about Dora. These words by her mouth have bigger letters--maybe that means she is yelling these words. Dora had a good time at the library. I wonder if we should go to the library like Dora?

You will need to use language that is at the right level for your child so that your child can understand what you are doing when you model private speech. Use language that is only slightly more complex than your child's language level. Like so many important parts of teaching a child with autism--you as a parent are in the very best position to teach this skill. If you could read my thought bubble right now, it would say Parents get all the best jobs!

Here is a link to a recent study:

Private Speech and executive functioning among high-functioning children with autistic spectrum disorders.


Beth Up North said...

Great essay! Our son is exactly at the point where he is starting to talk to himself (he's 4 1/2). It has driven me a little nuts that he repeats so much and I was going to ask what I could do about it. Now I have the answer.
Thank you!

Beth Up North said...

I am now on to day 1 of the new "Thinking out loud to yourself" program. My son was not able to repeat nearly as much this morning as we got ready for school, because I was filling up all that previous space. I guess I just assumed he was filling that space with his own thoughts like I was. I have been advised to talk all the time for Alex, and thought I was doing okay. Now I realize I did not understood the concept fully before this post. Thanks again Tahirah!

Tahirih said...

Beth, I am not sure you want to talk all the time since you are modeling talking all the time and you probably don't want you son to talk all the time. But it is good that you are modeling things in the morning like "hmm, blue shirt or red shirt? I choose red shirt because it looks nice with black pants." or "I am still tired but I will not lay down--I need to get ready this morning! There are therapies that just talk constantly to kids--and it is interesting to think about why this might or might not be a good thing. But generally I leave some silence between the talk because I believe that the child is more able to comprehend what I say and not just decide to tune me out like background music.

Beth Up North said...

Oh good, room for temperance. It will take a bit to get the process refined, but looks like I am on my way. I will watch for being tuned out.
Thanks again Tahirih