“LET THERE BE COMMUNICATION!”

“Bacche ne bolna shuru kiya kya?” (Has your child started speaking?). This is one of the most common questions asked to the parents of toddlers. Speech is an essential part and is considered to be one of the most crucial milestones in a child’s development. Speech is one form of communication through which we express our needs, thoughts, memories and feelings. It uses phonetic combinations of sounds (vowels and consonants) to form words and sentences and is delivered verbally to communicate different intentional speech acts based on the context.

We often come across parents reporting that their child is verbal and has speech as he/she can sing, can recite poems, says all the alphabets and counts till 20, and in some cases can express their needs in words, however when it comes to interaction they shy away and seems to be not responding. In another case, the child is verbal however is not intelligible, he or she can label few things but only parents can follow what is being communicated. This is when it becomes imperative for most parents to visit a professional to help their child to build upon his/her language. Nonetheless, we must understand that speech has several other functions which we as adults utilize in our day-to-day life and so do kids, but in their own, simplified language or vocabulary.

Speech is used for providing information (referential speech), giving commands (directive speech), sharing feelings (expressive speech), seeking what other person might be feeling (phatic speech), singing songs or poems (poetic speech), seeking information (heuristic speech), talking about commitments (commissive speech), to convey an action (performative speech), to use language contextually (metalinguistic speech) and so forth. It is important to observe if our children are utilizing these functions of speech, as they play a crucial part of one’s communication profile.

Children usually develop their first words by the age of 1 to 1.5 years. Most toddlers pick up the language by observing others with repeated exposure to interactive environment and by help of modelling.  Speech is a very complicated process which involves auditory processing, language processing, and speech production. A significant half of the brain is dedicated to sensory and motor function and the remaining for complex cognitive behavior such as language processing. Children in their developmental years with their observation and exploration (auditory, sensory, tactile etc.) learn the structure of language and how it can be used effectively.

Following is a schematic representation of speech production and speech perception.

Taken from: (BOOK, Vyas, Jay, Suthar, Anilkumar, 2017/04/01, Study of Speech Recognition Technology and its Significance in Human-Machine Interface, DO  – 10.13140/RG.2.2.27403.44327)

With this we must understand that these are primary pre-requisites for a successful verbal interaction to occur between 2 people. Along with these there are other things which are equally important such as auditory attention, orientation to environment, language skills and cognitive capacities.

As illustrated above, speech is not just throat, voice, tongue and teeth. It is way beyond that and we must understand that each of those components are equally important to have a successful verbal interaction for a child or an adult. If any of the components are disturbed then it directly affects the state of understanding of the person or his/her speech. There are several conditions found in children where one or several of these components are affected. For example in a condition called misarticulation, where a  child is not intelligible in his speech as certain sounds in his repertoire are affected. This is an issue with speech formulation. Hence, we need to work to correct the production of the sounds affected. Similarly, in another condition such as Autism, wherein a child is not able to interact well with his surroundings, he might not indulge in meaningful play and he might have challenges to put forth his needs and thoughts. Here, the child might have good speech formulation, good vocal mechanism, good acoustic air, good auditory perception, good speech comprehension etc., but his level of attention, level of activity, level of awareness and orientation to the environment are restricting him/her to communicate the way we expect the child to. Hence, it becomes very important to focus on COMMUNICATION and not just speech alone.

We all communicate, not only through speech but also through our gestures, finger pointing, body postures and movement, eyes, through scripts, through text messages and mails etc. There are innumerable options. But, when it comes to a child’s communication, especially of a child who is already struggling with many other underlying conditions, we still expect him/her to communicate verbally. Yes, Speech still remains the primary mode of communication largely, but, having said that, when a child is facing challenges to communicate verbally, shouldn’t we give him/her other options to start the process of communication in his/her early years than wait for Speech to develop?

There are several ‘Alternative Augmentative Mode of Communication’ (AAC).
It is majorly divided into high-tech and low-tech devices. Low-tech modes range from writing with a pen on paper to using communication books or boards. High-tech devices are majorly electronic and/or app based which are more accessible, less cumbersome and easy-to-use. However, this needs to be initiated under proper professional guidance. It would need a proper assessment by a Speech Language Pathologist who is specialised in ‘AAC’ training, who would be able to decide the form of modules the child can start using and how and when the transition should take place.

Now, to address the major parental concerns – such as, will it demotivate my child’s speech skills ? Will he/she completely rely on those methods ? Are using these methods practical ?
Let’s start by saying that these are initial anxiety concerns… there are enough research findings stating that – Alternative Modes of Communication help children to:

• communicate right away,
• to get their anxiety levels down,
• to gain confidence,
• to be independent
• And, most importantly to bridge the gap between communication and speech (if any).

There are several studies stating that ‘Alternative Augmentative modes of Communication’ (AAC) augments or helps speech development. And, once speech is fully developed the use of AAC is reduced to the minimum in the child’s everyday routine. We, as parents need to stand for our children’s needs and enable them to gain confidence and hence gradually connect with their environment in an effective manner.

Alternative Augmentative Communication is an established mode of communication. It’s multiple forms are being used by several children and adults across the world. What we need is proper guidance from expert professionals, thus, enabling the child to communicate effectively.

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