How to Target Vocabulary Goals for Speech Therapy in Young Children with Autism

How should I start working on vocabulary goals for speech therapy sessions with little learners with autism?  What if they aren’t verbal yet?  Where do I even start?  You guys…I’ve been there!  I’m “there” several times throughout the school year because at the early childhood level, I have new students join my class all the time!  If you are working with 3-5 year olds, you know that evaluations are ongoing all year and you could have a new student join your class at any time.  I want to share some techniques and activities that have made my (and my paras/assistants’) lives easier when it comes to being able to target vocabulary goals for speech therapy.  

It is so important to find time to meet as a team (special education teacher, SLP, and paras) in order to talk about how to implement these strategies.  Whether you talk as a team about the prompting hierarchy for motor imitation and one step directions, like I talked about in last week’s blog, or are teaching new vocabulary to your students, being on the same page is NUMBER ONE.  Making sure you are all using the same cue/prompts will make a world of difference.  In my experience, it is equally as important to hear from our paras/assistants because when working with students, they often discover a cue or little technique that works with a specific student.  For example, my para Janet, once found that a student responded better to 3 vocabulary cards being placed in a cardholder, instead of flat on the table.  This made all the difference for that student and accelerated his learning!  He started identifying vocabulary left and right after that technique was introduced.  We were able to discuss it at our monthly meeting so she could demonstrate what worked for him and we all implemented it.  A team approach is everything!

Typically receptive understanding develops before a child is able to verbally express themselves.  This is true for vocabulary development.  Now, I say *typically*, because sometimes, with autism, language skills can be quite disordered and scattered.  Throw in a little echolalia and it may look like the expressive skills are “higher” than the child’s receptive skills.  That is why we really have to look at each student individually to know where to start.  With vocabulary goals for speech therapy in autism, I usually introduce both simultaneously.  

RECEPTIVE VOCABULARY:

When I’m starting with receptive identification of vocabulary, I want to develop a routine where my student knows what to expect.  Consistency and repetition are important for learning!  I start by probing a bit to see if they can “point to” a picture out of an array of 3 or “give me” the picture.  Sometimes at the beginning, it seems to be easier to teach children to hand you a picture vs. pointing.  I suspect that is because gestures can be difficult for autistic children.  So, when my student is just starting out and doesn’t know how to “point” or “give”, I do the following:

1. Put 3 pictures of common vocabulary pictures on the table and say “give me ____”.  If they don’t understand that instruction, you physically guide their hand to pick up the correct picture and give it to you.  At this point, you may be teaching that instruction of “give me” more than you are teaching discrimination between vocabulary.  That’s okay!  Remember, small steps can make a big difference.

2. Start fading the hand over hand cue and use a partial physical cue.  For example, touch their elbow or move their hand to the picture and let go in order to get them started.  This may take a while, but it will help you be able to fade the cues.  For some students, this can be quick and for others, it will take longer.  Every child is different.  When you are doing this, keep your eyes on the greater goal, and that is that you are doing this to teach your student to identify vocabulary.

   

3. Once your student can reach and give a picture to you, you can start to take data to see how accurate they are.  Out of a set of 10 pictures, how many are they getting correct?  This baseline data for each set is important because it will help you see the progress that is being made, whether it is fast or slow.  If they aren’t discriminating between the pictures, you can gently guide their hand to the correct one.  When they reach for a card and you can tell they are reaching for the incorrect card, guide their hand to the correct one and praise them!  Over time, this will help them learn what it is.  I also like to hold the picture up by my mouth and tell them what it is after they give it to me (e.g. “socks”! followed by the praise).

   

4. Now that your student is giving you pictures, you can continue to introduce new vocabulary as he or she is ready.  Keeping good data will let you know when they are ready!  I start with my “common toddler vocabulary” and then use theme-based vocabulary too. 

5. After my students seem to have a good grasp on “giving” or “pointing” to nouns in pictures, I move to present progressive verbs.  I keep the routine the same and place 3 pictures on the table and ask my students to “give me”, “point to”, or “touch the”.  At this point, you can start trying to use some of those other directions to see if your student can generalize.  When a student is able to identify both nouns and verbs in pictures, I move on to verb + noun phrases.  With these, I follow the same format by placing 3 pictures on the table and asking my student to identify the one I say.

   

EXPRESSIVE VOCABULARY:

1. Hold a picture (of a noun) up near your mouth/face and say “what is it?”.  If your student doesn’t expressively label the picture, and you’ve given some wait time, you should model it (e.g. “car!”).  Remember that with autism, each time you give the direction, you are starting the processing time over again, so beware of saying “what is it?” several times when you don’t get an answer right away.  If you know your students “wheels are turning” and they require a lot of wait time (aka processing time), try to count to 10 in your head to give that time for them to process and don’t give the direction again during that time.  It should be noted that if you have a student who is very echolalic, you may have to remove the “what is it” cue.  Instead, hold up the picture and see if they will label it, and if they don’t, you can just say what it is.  Take data, even if it is 0/10 for a while.  It will be fun to look back at that when you start to make some progress.  I even write on the data sheet if my student makes an initial sound because it is fun to see that develop over time too.

   

2. Another place to start would be by using small stuffed animals or miniatures to try to elicit animal sounds.  If this is more motivating and interesting for your student, start here!  Many animal sounds consist of CV and VC syllables (C= consonant and V= vowel).  These can be easier to produce for young children who are non-verbal.  For example, saying “moo” when seeing a cow is easier to produce than saying the word “cow”.  Plus, using stuffed animals and miniature toys can be extra motivating because kids usually want to hold and touch them.  I hold the toy by my mouth and say “mooo” and give some wait time. If they don’t make the animal sound, I model it and then give them the toy to hold. 

   

3. Using miniature objects can also be done when teaching common vocabulary when those objects make more sense to a student than pictures do.  Use a gallon baggie to gather sets of 10 items/toys/objects and label them “set 1”, “set 2” etc…  You can use these in the same way as I described above for labeling pictures.  I’m telling you, little learners LOVE holding small toys and objects!

4. Another little tip that may seem kind of strange, but works for me, is to use a plastic cup.  You might be thinking “Tara, what the heck are you talking about?!”, but hear me out.  I don’t even remember the first time I discovered this little hack, but it works!  If my student isn’t labeling or even imitating me when we are working on animal sounds or nouns in pictures, I grab a plastic cup and say the word into the cup, then I face the open part of the cup toward my student’s mouth.  I can’t even tell you how many times this has worked!  All of a sudden my student is imitating me!  This can also be done with an inexpensive, plastic echo microphone.  But, start with a simple plastic cup and see what happens!  It won’t work for everyone, but even if it works for one student, it is SO worth the try!

5. When you reach the point where your student is labeling a variety of nouns, you can use the free sentence starters that I have for you.  See if they can start to verbalize “It’s a” or “I see” with the target picture.   You can also move on to present progressive verbs.  Again, I keep the routine the same by holding the picture up near my face and giving the cue “what is he/she doing?”, followed by wait time.  Don’t forget to take data!

   

6. When a student is able to label both nouns and verbs in pictures, I move to having them expressively label verb + noun phrases.  I like to have one picture that has both the verb and noun on it at the same time, so I don’t have to mess around with multiple pictures.  By now, my student has already worked on present progressive verbs, so they should be saying the -ing ending.  The focus of this activity is to combine the two words into short phrases.  When your student is ready, they can use sentence starters with these to provide structure for verbalizing a longer sentence (e.g. “he is eating cookies” and “she is drinking juice”).

I hope these techniques and strategies help you address vocabulary goals for speech therapy with children with autism and other communication related disabilities!  Remember, small changes make a big difference!

PLEASE NOTE:  Teaching children to label vocabulary is not considered a precursor to utilizing an effective communication system for children who are non-verbal or have limited verbal abilities.  Each child who is not able to effectively communicate with others in their environment should have an alternative/augmentative communication put in place right away.  This can be a choice board, communication book (PECS or other), or a dedicated communication device.  I will be blogging on this topic in the future, but if you have questions in the meantime, please contact me.  It is SO important to give children a “voice” and the ability to communicate!  Vocabulary does not have to be learned prior to using a communication system.