Wednesday, October 1, 2008

Solving the Elephant Word Problem

The most effective intervention for children who use jargon or who use echolalia is to help these children understand the language you use and understand the social dynamics of each situation. Please see previous post. There are many strategies for accomplishing this but in this post, I want to talk about helping children comprehend words and word combinations. Some children talk in what sounds like meaningless gibberish but may actually be speaking in a kind of word that I have heard described as an elephant word.

An Elephant Word is something that the child thinks of as a word but which is actually a phrase or sentence that the child has heard. For example, in a preschool classroom each day at 10:00 am, the teacher says, Time to put the toys away. Then he sings a clean up song and helps the children put all the toys in boxes and on shelves. He then says Come to circle-time, sit on your carpet squares. A child with autism may begin to understand this routine and even have noted the words that the teacher says each day because the teacher tends to say this the same way every time (which is a good thing). To the child with autism, these three utterances sounded like three long, hard to pronounce words 1) timetoputyourtoysaway 2)cometocircletime and 3) sitonyourcarpetsquares. A word this long is not easy to repeat, though, and even if the child is trying to do so, it might not sound like anything intelligible. Try this six syllable word: saimnaywonkameemtak. Now close your eyes and try to repeat it. Even if I tell you that this means Let's eat applesauce for dinner, you'd have a hard time learning to say it because you don't know what part says applesauce or what part says dinner or any of the individual words. Only a passionate love for applesauce or a million repetitions (or the word in a song) could make you learn a word that big. It would be a lot easier to learn if you could hear the long string of sounds as meaningful words.

So that is the problem--the Elephant Word Problem.

Here is how I help children with autism to hear words as words.

I take the utterance apart for children and demonstrate the meaning of the words within the utterance. I might teach a child to hear sit and carpetsquare this way. Assuming the child, Amy, knows the phrase Amy's turn, I might bring her brother in to help with the game and say: David's turn. David sit on carpet square. Then, turning to Amy, I might say, Amy's turn. Amy sit on carpet square. And after I help Amy sit, I might begin to demonstrate the meaning of sit by contrasting it with stand. David's turn. Stand on carpet square. Amy's turn. Stand on carpet square. Because I know that Amy loves to play a game we call Go to Sleep/Wake up! I say David's turn. Sleep on carpet square. I would help David make this dramatic by snoring and then say Wake Up! and have David leap off the carpet square. Amy's turn. Sleep on carpet square. After this sleeping game, I need to clarify carpet square. I know Amy knows color words so I use them in the next part. All done. Bye bye red carpet square. Bye bye green carpet square. I put the carpet squares away with some procedure or another. Then, I announce, Time for blankets. David's turn. Sit on red blanket. Amy's turn. Sit on Green blanket. And so on.

This game might work with Amy but for a different child, say a child who loves trains and can think about little else, I might have to add a little presentation of train cars between each step of this game. In other words, I need to find a way to capture the child's attention or all this talking will be water off a duck's back. I don't need to break up all the sentences that Amy hears in order to help Amy hear words within sentences, but I might need to do several months of this kind of therapy in one way or another. I would certainly teach Amy's parents to break up and demonstrate the meaning of frequently used phrases so that they could help me speed up the process of breaking up Amy's Elephant words.

Note: A parent recently told me that where she sees one step between A and B in teaching her child to communicate, she often learns that there is A1, A2, A3......A9, and then B. That is true. We know there are two dozen steps or more to helping a child learn to read, but if a child does not learn to speak and use language spontaneously, we often find it hard to imagine all the steps to learning that are involved. Breaking it down into learnable parts is the challenge. You know that you have, indeed, broken the skill down far enough when a child begins to show an interest and learn.


Beth Up North said...

"sigh" Fantastic recent posts. I am just stunned by how you comprehend and are illuminating the zillions of nuances of communicating with children with autism. Six months ago I read your entire Autism Games web site and comprehended 1/4. There was just so much to take in. Now I am going back and picking up more. Thank you so much for sharing your vast knowledge and heart.
Mom of Alex who is 5

Tahirih said...

Thank You Beth, It is encouraging to hear from readers, wherever they may be but particularly nice to hear from readers up north.