© David Sponder, L.E.P., BCBA, Floortime Advanced
Executive Director, Sponderworks Children’s Services

Note to Professionals: The techniques described below can be found in just about any well-established Applied Behavior Analytic technique using a natural language paradigm (e.g., Verbal Behavior; Natural Environment Teaching; Pivotal Response Teaching), as well as any relationship-based or developmental therapy. The following techniques are often used by Language/Speech Therapists.

Technique 1: Speaking to Your Child in Ways that Maximize Communication

Adults are not always aware of a child’s true capacities for understanding their language, which can lead to conflict. Without knowing it, adults use words that refer to concepts the child does not yet have. This leads to miscommunication when children do not really grasp the concepts the way adults may think they do.  Children act on the information in the way they understand it – if they understand it.  This can lead to frustration on both sides. Adults may assume that children understand, but choose not to listen or to cooperate. And children may form expectations based on their immature understanding of what adults say.

For example, adults often give instructions to children with references to:

  • When: Communicating about “when” is probably the most frequent source of confusion, especially since concepts related to time, sequence and duration emerge later in development.

A little girl asks repeatedly to go to McDonalds. Her mother tells her, “Sure, honey. We’re going to McDonalds after we go buy some shoes.” Everything seems fine until they drive past a McDonalds and her daughter starts screaming. “We’re not going to McDonalds first. We’re buying shoes first, and after we buy shoes, then we go to McDonalds.

Mom tries to be clear. She tries to give her daughter the information. But what her daughter seemed to hear was “McDonalds” and maybe “first.”  All of that further explanation served only to aggravate her as she did not understand it, but was smart enough to know that it meant – No.

Children may easily misunderstand references to…

    • time (“In a few minutes…” “In 5 minutes…” “In a minute“)
    • day (“Today” “Tonight” “tomorrow” “on Friday” “next Thursday” “in February“)
    • sequence (“first” “next,” “then” “before,” “after” “when we…”” after we…,”)
    • context dependent such as, “soon,” “later” or “in a while
    • amount (more; less; one; one more; a lot; too much” big, bigger, biggest/small, smaller, smallest)
    • spatial/location (“over there” when the child has difficulty following pointing; prepositional terms; left/right, etc.
    • Logic:” Adults understand the difference for instance, between “cookies or cake” and “cookies and cake.
    • Perspective, Agreement/Disagreement” (He sees/hears/knows; Can Mommy be a daughter at the same time? Can Daddy like chocolate better than strawberry and Mommy like strawberry better. Which one is better?)
    • Inclusion/Exclusion” (something “will” or “will not/won’t…” “does” or “does not/doesn’t” “can” or “cannot/can’t,” etc.)

These are just a few examples. Children begin to understand language concepts related to what they can see and touch (things and actions). Their language reflects their thinking. Tests on young children show that they don’t use or understand these terms because they don’t have the mental concepts to understand them either.

Concrete thinking” refers to understanding only what one can see or experience, and usually relates to real objects and known actions and experiences. At the most concrete level, the child can only make specific associations between a word and an object or an action. The child may understand “bottle” to mean only his personal milk bottle, and recognize no connection between that and any other bottle. As children’s thinking matures, they draw more connections to form concepts and can understand references to categories (fruit; clothes), generalities instead of specifics (go to “the store” without any specific store in mind), and references to events that occur in other places or at other times. “Abstract thinking” requires “inferring” and hypothesizing and thinking about things that perhaps cannot be seen directly, such as concepts of “fairness” what is “good” or “better” etc.

Our cautions against speaking over children’s developmental heads notwithstanding, we also note that there are lower levels of abstract thinking that many children can understand. So what we’ve done is to provide a developmental ladder from very concrete to what we call, “Lower Level Abstractions” that a given child may or may not understand.

Matching a Child’s Developmental Language Level

“Matching developmental language level” refers to a therapeutic manner of speaking to your child that is at a level [of abstraction]that he or she can actually understand. It also requires knowing the [next] level of language in which to teach (called the “zone of proximal development”).  In general, this will consist of references to “labels” of things (tangible items), actions (observable events), and easily identifiable feelings (observable changes in facial expressions, body language and tone).

Elements of matching developmental language:

  • Adults discriminate concrete [tangible] labels vs. concepts. Concretions: singular and tangible items such as a cup, TV, Mommy, banana.  Concepts: things that have common attributes such as color, shape, function, class, etc, i.e. red things, big things, square [shaped things]; animals, etc.

For instance, a banana is a concretion whereas fruit is a concept.
A penny is a concretion whereas money is a concept.

  • Adults discriminate concretions and concepts from “Lower Level Abstractions” (i.e. good/bad, nighttime/daytime; directions such as up/down; prepositions, pronouns, etc.).

For instance, a bed is a concretion, bedtime is a concept, and sleepy is a LLA.

A bowl of cereal is a concretion, breakfast is a concept, and delicious is a LLA.

Technique 2:  Rephrasing What Your Child Says: “Language Recasting” or the “Language Recast”

You can use “Language Recasting” to increase and elaborate your child’s utterances. The way you respond in turn to your child’s utterances contains their words and ideas, but in a more correct form.  Adult reflections – or recasts, echo the child’s intentions or sentiments in correct form, without having to correct the child overtly. This keeps the communication flowing, and instead of feeling corrected, the child continues to feel heard. This is how children learn to refine their grammar and learn multiple meanings for words – they hear more competent speakers say the same things – only better.

The typical language learner somehow recognizes that the adult’s version is more correct, imitates it, and it then begins to use it in their own. As they begin to use it elsewhere, they are able to learn from the feedback they get whether or not their usage is correct.

Studies that compared rates of language learning in groups of children whose parents recasted used language more frequently and initiated more often, as opposed to children whose parents used more overt or direct ways of teaching such as correcting or teaching specific language lessons or scripts.  This was true for typical language learners, as well as those with autism and other disorders of communication.

One of the best advantages of the language recasting technique is that no matter who the learner is, it doesn’t discourage or shame the child by pointing out “the problem” with her language. The adult’s emphasis remains on the child’s ideas. Repeating what the child says, albeit in more correct form, shows the child that her message is indeed important, no matter how she communicates it.

When a child’s verbal expressions are too short, grammatically incorrect, incomplete or poorly articulated, instead of overtly correcting the statement (e.g., “Say it right;”) or telling the child that what they’re saying it wrong (“…that’s not how you say it – how do you say it?”), the adult rephrases without correcting.  This is so the child can hear the correct form, without risking feeling ashamed or embarrassed about how they say things. The more a parent overtly criticizes the way a child says something – the more [well-meaning] corrective feedback and emphasis on form, the less motivating conversing will be for the child. Language recasting is a way of providing corrective feedback in a non-offensive way.

Finally, it provides a more correct model for the child to imitate.  Recasting is something that adults do for typical language learners – without being aware of it.  Here are some examples:

 Child’s
original utterance
 Adult
recast
 Child
imitates
 “Go store”  “Let’s go to the store”  “…go to the store”
“Want up” “I want to get up” “…want get up”
 “No cereal.”  “I don’t want cereal”  “…don’t want cereal”
 “Mine”  “That’s mine”  “…dat’s mine”
 “Kitty cat”  “Oh look – a kitty cat.”  “…look, kitty cat.”

Important Cautions on the Differences between Language Learners that understand “Points of View” and Those that Don’t

Note how the adult uses phrases that use the child’s first-person perspective, as if the adult were speaking from inside the child’s body. This isn’t needed with typical language learners, but may be a necessary scaffold for children with expressive language disorders or full blown disorders or relating and communicating.

Adults have to be cautious and aware that children that have disorders with both relating and communicating require careful modeling of perspective. Learners that do not yet know how to learn from overhearing other people talk to each other (called, eavesdropping) can be expected to have difficulty understanding the idea of changing voice-perspectives. The reason why children with autism often experience difficulty learning by eavesdropping” is that they simply do not observe, or do not know how to observe in that way in the first place, so they can’t follow the conversation well-enough to see the way the patterns are supposed to work.

Think of what a remarkable phenomenon it is to master pronoun reversal in the English language (and most other languages).  Imagine that an alien from another planet watches vide of a conversation between you and me. The alien might wonder because

I call myself, “Me.”
You also call yourself. “Me.” (Do we both have the same name?)
I call you, “You.”
You also call me, “You.” (How can both of our names be “Me” and “You” at the same time? This is really getting confusing)

Children that learn typically, actually learn this by observing others speak. This makes sense, because if the two parties above were trying to figure it out simply from talking to each other, the pattern would be very difficult indeed. This process is called a “deixis,” (another lesson – too involved to describe completely here). Suffice to say that in lieu of specific instruction in deixis and teaching children with ASD to learn by eavesdropping, we have to be careful to use recasts that they can imitate directly. For instance, when asked, “How are you doing?” it is not uncommon for language learners that don’t learn typically to respond incorrectly, “You’re fine.”

Note that there are several techniques that have been developed to teach language pronoun deixis directly. They may involve clever devices such as the use of mirrors and handing objects between partners. But these are unnatural techniques compared to the logical way in which typical language learners acquire the pattern. To me, this reinforces the notion that teaching the child the correct points of reference is a better approach, as opposed to teaching with direct methods (teaching the child what to say or rules about what to say). Mirrors and transition objects can be successful methods of teaching correct pronoun use between two interfacing individuals, but they can run into serious limitations or distortions when used among multiple partners.

Technique 3:  Helping Remember Words: Intensive Language Input

This describes a therapeutic way of talking to your child that gives your child repeated experience hearing a word, before he or she is expected to use it. This technique is more natural and less restricting or impinging than massed trials, and therefore allows teaching to occur without your child becoming defensive or confused about how language is really used. We find this technique to be very effective in building vocabulary and basic grammatical development.

Elements of ILL include:

  • Using words from a focused range of vocabulary or grammatical targets – instead of a rigidly established “vocabulary list.”  For your child, this means intensifying the use and emphasis on concretions for now, then expanding to concepts and LLAs.
  • Repeating these words intensively but naturally– without prompting your child to respond.  You may look at the child expectantly and include a pause, but do not pressure or request the child to respond.  Responding will come, but perhaps not for several weeks.  We ask that parents try to be patient, although it is natural for them to want to see immediate results.We have found this technique to be much more effective in facilitating truly spontaneous and “in-context” language than more direct methods.  In most cases, we do advocate that this technique be used along with direct-teaching methods (response oriented), such as the incidental methods described below.

For example: (The adult places a cookie in a conspicuous place, but still out of reach for the child [see “Sabotage” technique below])

“Oh I see a COOKIE. How about a COOKIE. Would you like a COOKIE?  OK. Here’s a COOKIE (the adult breaks up the COOKIE into small pieces and gives the child one).  Mmmm. That looks good.  I like COOKIES too.  Want more COOKIE?  Here’s some more COOKIE.  Wow, you really like that COOKIE. (Musically) COOKIE, COOKIE, COOKIE, COOKIE, COOKIE, COOKIE, COOKIE.  I LOOOOVE COOKIES and you love COOKIES too.  I think this is a chocolate COOKIE, or maybe an Oreo COOKIE. Want more COOKIE…?”

17 repetitions so far with 1 cookie, all while talking to your child naturally, and without losing his interest.  This technique can be used whenever the adult is truly following his interest.

Technique 4:Making Your Words “Pop

In the above example, the adult should add a little more emphasis on “cookie” than the other words in the sentence.  This can be done by slowing down and putting clear stress on the word, “over-articulating” (speaking slowly and enunciating with maximum clarity, sometimes called, “over-enunciating;” using visual cues [pointing to the mouth, tongue, throat, etc.]; using creative or dramatic pauses, singing the word or using it rhythmically, using various voices or inflections in a funny way, etc.).

This is to avoid the use of telegraphic or “choppy” or “robotic” language to the child under the false belief that by removing the connecting words (articles and conjunctive words such as “it” “and” “the” etc.), that somehow you are lightening the process load (Fey, Long, & Finestack, 2003).

You can shorten a sentence without really shortening it.  Yes, perhaps the child can only process certain parts of a sentence.  For
example, it may be a while before the child understands the difference between “Open the door,” “Close the door” and “There is a door.”  (Prizant, 1983)

Instead of removing the words, you can remove the emphasis on the connectors and make the salient words pop out.  Here are some examples:

Do you want some juice?
Here’s your juice.
That’s an airplane
Put
it on the table.

Technique 5: Incidental-Engineered Opportunities

There are five kinds of incidental-engineered opportunities: incidental teaching (Halle, Alpert, & Anderson, Natural environment language assessment and intervention with serverely impaired preschoolers, 1984), the mand-model technique (Goetz & Sailor, New directions: Communication development in persons with severe disabilities., 1988), the delay procedure (Halle, Alpert, & Anderson, Natural environment language assessment and intervention with serverely impaired preschoolers, 1984), chain interruption (Goetz, Gee, & Sailor, Using a behavior chain interruption strategy to teach communication skills to students with severe disabilities, 1985), and the cloze procedure (Ingersoll & Dvortcsak, Including Parent Training in the Early Childhood Special Education Curriculum with Autism Spectrum Disorders, 2006). These can be used when teaching within natural routine tasks and other activities.

Incidental Teaching

Teaching becomes a matter of “‘making’ or ‘taking’ opportunities” for challenging, teaching and learning in the course of regular daily life.  Here, a parent waits for or sets up a challenge to encourage a particular response.  For example, a parent may encouraging more requesting by placing objects the child wants in plain sight, but out of reach. If the child speaks unclearly, or needs to work to discover a way to communicate in a given situation, the parent might “act dumb” by pretending to understand. This can encourage the child to try other ways to communicate, or it might provide an opportunity for modeling and imitation of a new way to communicate.

Communicative Temptations 

“Communicative Temptations or “Communication Temptations” are examples of how, by tweaking routine activities in certain ways, the parent can harness a child’s natural (read: emotional) motivation to communicate, and avoid naked prompting of the child to speak. I believe the  term was coined by Barry Prizant and Amy Weatherby, and various versions can be found all over the web. (The same techniques are also called “establishing operations” in Applied Behavior Analysis [ABA]. These make things [reinforcers] more desirable, making us want more than we now have. Here are a few examples:

  • Eat in front of the child without offering any to the child
  • Start a toy, let it deactivate, then hand it to the child
  • Give the four blocks to drop in a box, one at a time (or use some other action the child will repeat, such as stacking the blocks or dropping them on the floor); then immediately give the child a small animal figure to drop in the box
  • Look through a few books or magazines with the child
  • Open a jar of bubbles, blow bubbles, and then close the jar tightly and give the closed jar to the child
  • Initiate a familiar social game with the child until the child expresses pleasure, then stop the game suddenly and wait
  • Ready-Set-Go:  Once the child becomes familiar with the game – leave out “Go” and let the child say it before continuing
  • Offer the child a food item or a toy that he or she dislikes
  • Place a desired item in a clear container and place it in front of the child, then wait
  • Place the child’s hands in a cold, wet, or sticky substance, such as Jell-O, pudding, or paste
  • Roll a ball to the child.  After the child returns the ball 3 times, immediately roll a different toy to the child
  • Engage the child in putting together a puzzle. After the child has put in several pieces, offer him one that doesn’t fit
  • Engage the child in an activity with a substance that can be easily spilled (or dropped, broken, torn, etc.); suddenly spill some of the substance on the table and wait.
  • Put an object in an opaque container and shake the bag; hold up the container and wait. This can be used to teach the Pivotal Response of asking, “What’s that?
  • Give the child materials for an activity of interest that necessitates the use of an instrument for completion (e.g. a piece of paper to draw on or cut; a bowl of pudding or soup); hold the instrument out of the child’s reach
  • Give the child materials for an activity of interest that necessitates the use of an instrument for completion (e.g. crayon, scissors, wand for blowing bubbles, spoon); have a third person come over and take the instrument, go sit on a distant side of the room while holding the instrument within the child’s sight, then wait.
  • Wave and say, “Bye” to an object before removing it from the play area (or placing it back in a box). Repeat this for a second and third situation, then do nothing for the fourth object and wait
  • Hide a stuffed animal under the table. Knock, then bring out the animal. Have the animal greet the child the first time. Repeat this for second and third time, then do nothing when bringing out the animal a fourth time.
The Mand-model Technique

Here, a parent inserts a request into a child’s ongoing activity, and then prompts and/or reinforces the child’s response (Goetz and Sailor 1988). For example, while a child is playing with toy cars, his mother asks what he is doing, or asks your child to show her a red car. This, brings the child into contact with possibly unnoticed events, and helps your child generalize into the play setting behaviors he acquired elsewhere (e.g., color naming and the question-answer format). In contrast to incidental teaching, the mand-model technique involves more initiation by a parent.

The Delay/Sabotage Procedure

In a delay or sabotage procedure, a parent identifies spots in a task or interaction where a child could make a request (Halle, Baer, and Spradlin 1981). The parent participates in the interaction as usual, but at the pre-selected spot interrupts the flow for a few seconds, and waits for the child’s request. If a request is not forthcoming, the parent models one.  For instance, the parent gets the juice from the refrigerator, approaches the table, looks expectantly at the child, but waits.  Your child is expecting the parent to pour the juice, but there is now a “pregnant pause” which creates therapeutic tension.  Here the parent can simply wait for the child to speak up, or use a mand as described above.

  • Chain Interruption: In chain interruption, a parent interrupts the child engaged in a sequence, and makes a request requiring the child to insert another behavior into the sequence, thus enriching it (Hunt and Goetz 1988).  This is very similar if not the same in many instances as a Delay.  The difference is that your child must direct a parent action.For instance, while your child is watching a video, the parent can stand in front of your child, blocking his view.  Naturally, the child becomes a little (“therapeutically” of course) – upset.  Playing dumb and using the ILL technique, the parent wonders aloud, “Do you want me to MOVE?  MOVE? You want me to MOVE?  OK.  I’ll MOVE.”Of course, this blockhead parent never learns and does it again 5 minutes later.This time she uses the mand technique “Do you want me to MOVE?  MOVE? You want me to MOVE?  OK.  [Say] MOVE MOMMY.”  The child echoes, “MOVE MOMMY.”  Mom says, “OK, I’ll MOVE.”
  • Cloze Procedure:This can be thought of a “fill in the blank” type procedure.  It is primarily used to teach vocabulary.  Using phrases he has heard over and over, the adult says the sentence, leaving the target word out.  For instance, when getting in the car and grasping the seatbelt, the parent says, “OK, time to put on your ________” and waits for the child to say, “Seatbelt.”

Bibliography

Camarata, S., Nelson, K., & Camarata, M. (1994). Comparison of conversational recasting and imitative procedures for training
grammatical structures in children with specific language impairment. Journal of Speech and Hearing Research, 37, 1414-1423.

Fey, M., Long, S., & Finestack, L. (2003). Ten Principles of Grammar Facilitation for Children with Specific Language Impairments. American Journal of Speech-Language Pathology, 12(1), 3.

Goetz, L., & Sailor, W. (1988). New directions: Communication development in persons with severe disabilities. Topics in
Language Disorders, 4
, 41-54.

Goetz, L., Gee, ,. K., & Sailor, W. (1985). Using a behavior chain interruption strategy to teach communication skills to students
with severe disabilities. Journal of the Association for Persons with Severe Handicaps, 10, 21-30.

Halle, J., Alpert, C., & Anderson, S. (1984). Natural environment language assessment and intervention with serverely impaired
preschoolers. Topics in Early Childhood Special Education, 4(2), 36-56.

Halle, J., Baer, D., & Spradlin, J. (1981). Teachers’ generalized use of delay as a stimulus control procedure to increase language
use in handicapped children. Journal of Applied Behavioral Analysis, 14, 389-409.

Ingersoll, B., & Dvortcsak, A. (2006, Spring). Including Parent Training in the Early Childhood Special Education Curriculum with Autism Spectrum Disorders. Journal of Positive Behavior Interventions, 8(2).

Ingersoll, B., Dvortcsak, A., Whalen, C., & Sikora, D. (2005). The effect of a developmental, social-pragmatic language intervention
on expressive language skills in young children with autism spectrum disorders. Focus on Autism and Other Developmental Disabilities, 20, 213-222.

Kaiser, A., Hancock, T., & Nietfeld, J. (2000). The effects of parent implemented enhanced milieu teaching on the social communication of children who have autism. Early Education and Development, 11, 423-446.

Nelson, K., Camarata, S., Welsh, J., Butkovsky, L., & Camarata, M. (1996, August). Effects of Imitative and Conversational Recasting Treatment on the Acquisition of Grammar in Children with Specific Language Impairment and Younger Language-Normal Children. Journal of Speech and Hearing Research, 39, 850-859.

Prizant, B. (1983, August). Language Acquisition and Communicative Behavior In Autism: Toward an Understanding of the
“Whole” of It. 48, 296-307.

Prizant, B., & Whetherby, A. (2000). Communication intervention issues for children with autism spectrum disorders. In B. Prizant, & A. Whetherby (Eds.), Autism Spectrum Disorders: A transactional developmental perspective (pp. 193-224). Baltimore, MD: Paul H. Brookes.

Fig. A comparison between analytic and gestalt modes in language acquisition and use

from Prizant (1983)

Analytic mode

 

Gestalt Mode

Basic units of language are single words.

Basic Units

Basic units of language may be words, multiword utterances, phrases, and/or clauses, and all possibilities may co-occur as units during one period of time.
Early language acquisition involves movement from single words to two and three-words utterances encoding early semantic functions and relations.

Early

Early language acquisition involves acquisition of multiword utterances functioning as single units. May involve utterances which appear grammatically sophisticated.
Further growth in language is achieved through acquisition of grammatical morphemes and functions allowing for noun phrase and verb phrase elaboration.

Growth

Further growth in language involves analysis and segmentation of unanalyzed chunks into constituent components and/or movement to analytic mode.
Language is productive and generative from early stages of acquisition with rule induction allowing for increased complexity.

Increased Complexity

Language is relatively inflexible in early stages with limited generative use.
Increased complexity is achieved through recombinations of prefabricated patterns and further movement to an analytic mode.
Language use is generalized to relevant objects and events after short periods of situationally specific usage.

Generalization

Language use may remain specific to situational contexts for extended periods.
Analytic Processors may be more focused on internal structure (semantic and/or grammatical relationships) and referential use of utterances..

Focus

Gestalt processors may be more focused on intonation and use of language in the structure of social interaction

Recasting and direct teaching approaches are particularly suited for children at risk or with minor speech and language delays. A recast occurs when the adult expands or modifies a child’s utterance by adding new syntactic or semantic information.

Camarata SM, Nelson KE, Camarata MN. Comparison of conversational-recasting and imitative procedures for training grammatical structures in children with specific language impairment. Journal of Speech and Hearing Research 1994;37(6):1414-1423.