Developing Looking and Attention Skills For Children With Communication Difficulties
How Babies Learn To Communicate From Adult Carers
I have just finished doing some training in the development of speech, language and communication skills with some wonderful nursery practitioners near Brighton. We spent a lot of time talking about the skills a child needs in order to be an effective communicator, and how to help them develop these.
Instinctive Strategies For Developing Looking And Attention Skills
These skills are instinctive to many children. They develop easily and we scaffold them without fully realising how important our input is, or how good we are at supporting our children. We are hard- wired to communicate, so much of the support that we give to our children to help develop these skills is innate and comes naturally to us. For example, when we interact with an infant, we:
- Put our face near theirs instinctively. This helps the child learn about facial expression, emotion, tone of voice and interactions.
- Wait for them to say something, to make a noise, and we interpret this as being a sign they want to communicate with us. We interpret it as being meaningful, and we repeat it back to the child as if we were having a conversation with them. By repeating back what the child says, we let them know we are listening and we are interested.
- Use a sing-song voice, which helps them focus and listen.
- Follow the child’s lead – we wait for them to say something and then we respond. We don’t try to direct them.
- Develop early turn-taking by waiting for the child to say something and then responding.
We use simple language, single words that are linked to things in the infant’s immediate environment (things that they can see). For example, if we see the child is looking at a teddy, when the child looks at us we say, “Teddy!” These are the first steps in helping them to understand language.
We repeat routines in play and games, e.g. nursery rhymes, action rhymes, simple interactions with toys. This helps them anticipate and predict what is going to happen, and to learn the meaning of words. This helps develop interactions.
We do all of this this naturally. Wow! We do all this without thinking. Wow!
How To Develop Looking and Attention Skills For Children With Speech, Language, and Communication Difficulties
The process of developing communication skills is not so easy for all children and for all carers. The strategies described above that we use so naturally might not get a response from children with communication difficulties. They might not seem to help the child develop. This can be very, very hard for parents.
When I have my NHS hat on and I am working with a consultant in the Joint Social Communication Clinic, I hear so many parents say that they no longer try to play with their child or try to interact with them, as all their attempts have failed and they do not know what to do. Think back to when you were a child and other children left you out of games, wouldn’t let you play, ran away from you. Remember what that feels like. The confusion, the hurt. That is how many carers feel when they do not get the response that they want so much from their child.
The strategies above can still be effective with children with speech, language and communication difficulties, but they have to become conscious, not just instinctive. You have to work at using them and supporting the child. It is not enough for it to be something that we naturally do.
The Importance of Looking
On the training course, we talked about the importance of looking to let people know you are talking to them, to get your needs and wants met. We also talked about how easy it is to fill in the gaps, to assume that the child looked at you, when they might not have done. For example, a child might want a drink and say this aloud, verbalise what they are thinking: “Juice!” They are not asking for a drink. They are not directing “Juice!” to another person. They are simply saying what they want out loud. We know they want a juice instinctively, not because the child has asked for one. We love them and do want them to suffer, so we give the juice without thinking.. By doing this, the child does not learn that when they want something, they need to let another person know that they want it, and to do that they need to look at the person, even if it is for a couple of seconds.
On the training course, some of the lovely ladies said that they went back to their nursery and watched themselves very closely to see if they were filling in the gaps, and they said that they realised they were. This is natural, it is hard not to do it.
Practical Activities To Help Children Develop Looking Skills
This is a hard skill to teach, but we can give children reasons to look at us.
Strategies To Try At Snack Time
Offer a choice of two things at snack time, e.g. “Apple or banana?” Hold up the two things he has to make a choice between. Give him the one he wants when he looks at you, if he says, “Apple,” but does not look at you, don’t give it to him. Prompt him by saying, “Apple! You want apple!” but don’t give it until he looks up at you. He only needs to look at you for a second, and then you can give the apple to him. This is to show him that he needs to look when he asks for things, that looking is important for communication.
- Give him time to look, don’t give it to him too quickly. If he gets very agitated, give it to him; we want to avoid distress, and you can try again later.
- Start by doing this at snack time, and then do it with toys and in games, e.g. if you are playing with pretend food, offer him a choice of items: “Do you want carrot or peas?” If he is playing with transport toys: “Do you want car or lorry?”
Strategies To Try At Play Time
- Position yourself so that your child can see your face easily and make eye contact easily when they are playing, e.g. face to face on the floor, opposite them at a small table.
- Watch what they are doing and wait for them to direct language at you, i.e. wait for them to look at you when they say something. You might have to wait a while. Don’t be scared of the silence!
- When they look at you and say something, e.g. “Car crash!” repeat it back to show you are listening and interested. I always give a really big smile and sound enthusiastic to show that I am really, really interested, and to show the child that showing things to another person can be fun.
When we do this, we reward the child for looking at us and involving us in their play, and hopefully, this makes them want to show us things again. Repeating back what the child says does not put any pressure on the child, it is not directing the child in any way. We are reducing pressures, to encourage the child to look at us and interact with us.
These two strategies are very natural. They don’t require any planning, you don’t have to make any resources and the play strategy mirrors what we do instinctively with a child. The difference is we are doing it consciously now, with a clear rationale and purpose.
A Looking Game To Try
Tell the child to look at you. You look down, so that he can’t make eye contact with you. Have a motivating toy, e.g. bubbles, a balloon you can blow up and let go so that it flies round the room. Sing a made up tune, “Are you looking at me? Are you looking at me? Are you looking at me?” etc. then suddenly look up and look at the child, if he is looking at you and you make eye contact, he gets a go blowing bubbles or letting the balloon go. If he wasn’t looking, he doesn’t get a go.
To make it more challenging: play this with the child and another child so that you won’t always be looking at him, you will look at the other child, too so the child will have to wait longer to have a turn. Aim to play this in a small group.
When children get this game, they love it!
I hope these help. You can download the practical strategies above as a PDF file, and also these Strategy Cards for Encouraging Early Interaction Skills. You might also like to read the next blog post, More Strategies for Developing Looking and Attention Skills.