Talking to Others and Talking to Ourselves

Andrew is five years old and he has been struggling unsuccessfully to hang on to words for years. Somehow a word just disintegrates in his mind even after Andrew learns a new one and that word may not be heard on his lips again for months or years . It is frustrating for him and for his family because in a situation where he was able to communicate last week, he may not be able to communicate this week.

A few months ago, we started to show Andrew how to use a special computer that can talk for him--a Springboard Lite. He was using PEC's quite well at school, and it has been a wonderful communication system for him, but his mother found it difficult to keep track of all the pictures that he needed at home and he never seemed to have the right pictures to communicate things that he really wanted to communicate anyway. Andrew was most motivated to communicate when something new and interesting happened like when he discovered a stop sign on the Oreo Cookie package. There was no way to talk about this with the PEC symbols that he had. But with the talking computer, because there are thousands of picture symbols already programed into the machine, it was possible for mom to create a page about the stop sign on the cookie package in about five minutes. On occassions like this, Andrew would be running back and forth across the room, touching the stop sign picture and flapping his hands until when his mom could hand Andrew the newly programed computer and he would then start talking with his machine right away saying something like, There is a stop sign on the Oreo Cookies. Awsome! That few minutes of programing would give Andrew something to talk about for two days.

One cool thing is that Andrew seems to be retaining words that he uses often on the talking computer. We don't know if he would truly retain these words over an extended period of time since we are not taking away the talking computer to see, but he does spontaneously speak using words that he previously only said on the talking computer. Where before Andrew might have said one word, cup, at dinner, now Andrew has at least twelve foods that he can spontaneously ask for with or without the talking computer. Andrew is doing a lot of self-therapy to learn new words since he spends time on the page about food pushing the buttons over and over even when he does not want to eat. This is true of the food page and it is true of other pages as well. Preparing him to take a train ride recently, his mom found a YouTube video clip of the train that they would be taking and Andrew and mom watched this clip a few times. Then she made him a page on his computer to talk about the upcoming train ride. Andrew pressed buttons on this page over and over in the days leading up to the train ride day. Andrew did not have his talking computer with him when he actually went on the train ride but he was able to say all the things he had practiced saying about the train ride appropriately. We are going on the train. This is fun! We are going over the bridge. I like trains.

Language is such an important human capacity and even I underestimate how important it is and need to be reminded. Andrew reminds me every week as he uses this machine better and better and for more and more purposes. Here is the story that got me teary today. Andrew has been unwilling to have a bowel movement on the toilet even though he can urinate in the toilet independently. His family has worked hard to convince Andrew that he should consider this option but to no avail. They know that Andrew does things in his own time. A few days ago, Andrew started pushing buttons on the talking machine to say You need to use the toilet. Mom did not program the computer to say this, he just found the buttons on his own to say this phrase. When mom thought he might be communicating a request to go to the bathroom, he made it clear that he did not want to go at all but he persisted in pushing those buttons over and over for two days. She wondered why he was saying this over and over but, after all, he is five. On the third day, Andrew's big brother called his mom excitedly saying, Mom, Andrew is pooping on the toilet! Andrew had independently decided to do this. Apparently he talked himself into using the toilet by telling himself to do so for two days and working up the motivation to do it on his own. He is now out of diapers.

We imagine that a child who can't communicate verbally with others is none-the-less able to communicate with himself or herself. But apparently, not so much for many children with autism. They do not have the language skills to tell others what they need, think, feel, remember, wonder, imagine, plan, wish, consider..... Nor the language skills to tell themselves what they need, think, feel, remember, wonder, imagine, plan, wish, consider....

It seems like a lot of work and money to provide a child like Andrew with a computer that is complicated for everyone to learn and costs about as much as a good used car. But giving Andrew the ability to communicate with others and communicate with himself is proving to be truly beyond price.