As a speech/language pathologist, I have a strong belief that every student has a
basic right to a communication system. I have learned that if a student does not have
a constructive way to communicate he/she will still communicate through behavior.
I have worked with severe students who were able to develop a communication
system with minimal skills in movement and vocalizations. For example, four years
ago, I walked into a home to do homebound speech therapy for a student who was
too medically fragile to attend school. She was not ambulatory, had low vision, was
non-verbal, and no use of her hands and limited movement of her arms which was
a slight up and down motion. She was on oxygen and G-Tube fed. Her cognitive
level was evaluated at the severe level and she vocalized with a basic open and shut
mouth movement and a tongue thrust forward along with a sound. My first thought
was, “OK, where do I begin?” I began with the belief that every student has a right
to a communication system including this young lady. I began with a toy that made
sounds along with flashing lights which was an object that her family said she loved.
I stood by her, turned the light on then off. I simply said, “If you want more, point
to it with your eyes.” I assumed that she had no idea what I meant, but I waited for
her eyes to land on the toy and then said, “I want the light.” I turned the light on as
if she had made the request. This simple cause and effect process allowed me to
help this student understand that her movements had the power to communicate.
We progressed from eye pointing to vocalizations. I would say to her, “If you want
more, tell me yes.” With this request, my expectation was a vocalization not an
actual word. I’m not gonna lie, I did a lot of waiting for both of these strategies
before I got a consistent response. The point here is that I got a consistent response.
I got that response when this student learned two things. First she learned that
there was a connection between her responses and getting what she wanted. She
discovered the power of communication. Second, she learned that she could trust
me to wait for her request or choice.
Today this student is in high school and we’re reading chapter books, current
events and we’ve done lessons in science and math. I have discovered that she
loves science and girly things. She answers questions about the stories and news
we read. She chooses between two answers with a short processing time between
the possible answers presented. The percentage of correct answers lets me know
that she is listening and understanding more about the material presented than I
ever imagined. She recently laughed out loud during one of our sessions for the
first time. I was reading a scene about some mean girls doing something devilish
to another character in the story. The laugh was appropriately timed. I believe she
understood exactly what was going on.
This student now has the ability to answer questions and make choices. These
skills have opened up a new world of communication that takes her beyond the
confines of her home and her disability. She has demonstrated to her family,
her therapists and her nurses that she is capable of taking advantage of more
age appropriate information and activities. She plays board games, selects music
and decides who gets what Valentine card. If a student like this can develop a
communication system, so can others with less challenges.