Speech therapy with non-verbal children

Speech and language is a major part of how we communicate and engage with others. However, some medical conditions, such as autism, stroke, brain injury or intellectual disability, prevent individuals from being able to verbally communicate in an adequate manner. Speech therapy can help to identify if using verbal communication is a realistic option for a child and generate therapy goals to maximise their speech and language skills.

What does a speech therapist do with a non-verbal or minimally-verbal child?

The primary step of any therapy usually comprises of garnering background information about the child. This generally includes learning about their personal, developmental, medical, family and social history, as well as their present functioning ability. When working with children, parents, other family members, health professionals or educators involved in the child’s life are commonly utilised to gain this information. The speech therapist then assesses whether speaking is a practical option for the child, usually done by engaging the child to make fundamental sounds and saying basic words. For a child who can generate sounds to communicate their needs, the therapist will customarily guide therapy to grow these skills.

What if my child is completely non-verbal?

If a child is not showing signs of having the ability to speak and produce sounds, therapy becomes directed towards finding different ways for the child to communicate with others. This can include:
– Using body language and gestures
– Sign language
– Using visual aids such as picture cards or boards, or object symbols
– Using an electronic gadget or computer to type the message
– Using specialised augmentative and voice-output devices
Trial and error is often required to determine what methods of alternative communication the child is most comfortable using. Therapy then usually involves teaching the child how to relay common directions or actions that they will need throughout the day, such as how to communicate that they want to eat or use the bathroom. The child is also usually taught how to model emotions (e.g. by using pictures) such as happy, sad, tired or angry. Gradually, the therapist will then move onto teaching the child how to understand and follow more complex directions, or activities involving multiple steps. Parents and carers are frequently heavily involved in therapy to learn how to better communicate with the child, and they can also provide insight into the child’s daily routine. Once the child has developed basic imitation skills, therapy can move towards teaching them fundamental turn-taking, sharing and making requests. These exercises usually involve another child or adult interacting with the child with each person taking turns holding the object. The child is then taught how to convey “my turn”, and the amount of time they have without the object is continuously increased.

Can speech therapy help with selective mutism?

Selective mutism is a disorder where a child does not verbally communicate in particular situations where they are expected to but exhibits speech behaviour in other settings. While the condition is categorised as a psychiatric disorder, it is also a communication disorder, and speech therapy often has its role to play in helping the child and their family. While psychotherapy (often involving family interventions) is essential to determine the psychological needs and concerns of the child, speech therapy can help to make behaviour modifications by enhancing practical communication in the environments where the child is not speaking. For instance, if a child communicates at home but not at school, the therapist can work with teachers to develop techniques to engage the child more (e.g. by modifying the environment or providing visual aids).