Positive Approaches Journal, Volume 9, Issue 2

Volume 9 ► Issue 2 ► 2020

Communication: Understanding the Basics, Levels, and Strategies

Erin Kline, M.Ed.

Abstract

Communication is necessary for language to occur. This article will discuss considerations that are foundational in eliciting communication. Building on these concepts, the seven levels of communication, based on an assessment tool used to determine why and how a child/individual is expressively using behaviors or other means to communicate (called the Communication Matrix), will be explained. The levels acknowledge behaviors as: rudimentary, reflexive, advanced, formalized and the many stages in between. Lastly, detailed strategies will be offered to further support and promote growth in each of the seven areas.

 

Communication and language; people often think they are one and the same. Yet that is not entirely true. One can communicate without the use of language; however, one cannot use language without communication. This article will provide clarification between the two and will focus on communication, specifically for individuals who might not yet be using formalized language. Many people place the emphasis on individuals using language, wanting to know if they are talking or signing yet, without realizing the many foundational skills that must be developed and set in place before language is established.

Communication is defined as the exchange of a message between two or more people.¹ There are four key elements that are needed for communication to happen. First, a sender is needed. This is the person who is communicating/expressing the message. Second, a receiver is needed. This is the person who the message is going to. Third, a shared topic is what the two people are communicating about. When trying to motivate communication, one of the driving forces is preferential topics. Everyone communicates about things that are important and of interest to them. Consider this: if someone is passionate about sports and that is where a bulk of their time and energy lies, when somebody approaches them wanting to talk about the prime minister of France, they might not be very inclined to engage in the discussion. However, if that same person wanted to talk about the game winning shot of last night’s championship basketball game, they would naturally be more eager and excited for that conversation. Being aware of what the person wants to give their attention to is essential. Try to avoid broad activities or objects; dig deep and get specific. Notice what they enjoy looking at, listening to, touching, smelling, and tasting/eating. Notice their preferences in toys/objects, textures, people, environments, positions/equipment, movement, vibration, etc. In order to develop and have a repertoire of likes and dislikes, there must be varied experiences, time, and repetition. Reflect on the person’s exposure and experiences in relation to objects, toys, activities, foods, people, and places. Have there been multiple exposures that will enable them to actively decide whether they liked or disliked the experience?

While this may sound basic, there are many factors to consider for an individual who may have limited access to people, places, experiences, materials, and/or objects. The following questions must be considered: What and how many experiences has the individual had? Have they had the opportunity and time to form trusting relationships and attachments with others? Does the individual feel safe and secure enough to communicate? Have they been in an environment with people that are responsive to their vocalizations, movements, and behaviors? Does the individual understand that their behavior(s) can impact those around them? At the very core of communication is cause and effect; the individual does something and someone responds. When developing communication, individuals need to be in an environment where any movements, vocalizations, or facial expressions the individual exhibits are acknowledged, and responded too. Through these consistent responses, individuals learn that their behaviors affect the people around them and, in turn, their needs are met.

When looking at why, there are a plethora of reasons that individuals communicate. The following list is not exhaustive, but includes expressing comfort or discomfort, requesting something, making choices, refusing something, requesting help or attention, showing affection, greeting others, sharing, and asking questions.²

The last of the four elements needed for communication is a mode or a means of expression. There are numerous modes that individuals can use to communicate, a few of which include facial expressions, body movements, signs, words, pictures, objects, augmentative and alternative communication (AAC) devices, and braille. When thinking about the mode or what the communication exchange looks like, it is important to first determine how the individual is communicating and what means are accessible, meaningful, and functional to them. Communication can be described as either pre-symbolic or symbolic.

Pre-Symbolic Communication

Pre-symbolic communication is when the individual engages in behaviors that are either reflexive or purposeful. Reflexive, or pre-intentional behaviors, express the state of the individual (e.g., if they are in pain, wet, or hungry) and typically develop between birth-3 months of age.² This may look like a change in posture (e.g., stiffen, relax), facial expressions (e.g., grimace, smile), vocalizations (e.g., cry, fuss, scream, coo, squeal), or body movements (e.g., head movements, turn away, lean in, kick legs, extend arms). Purposeful behaviors (similar to those listed above) are intentional, but not intentionally communicative and typically emerge between 3-8 months of age.² This means that the individual is using these behaviors to affect the other’s behavior, however, with both reflexive and intentional behaviors, it is the other person who is inferring the meaning of the individual’s behavior. An example of an intentional behavior would be when a mother rocking her child stops. The child vocalizes when the rocking movement stops. The child vocalized, which was an intentional behavior, but didn’t turn toward, touch, or look at the adult. It is the adult who interprets the vocalization to mean the child wants more rocking.

Now that the individual has developed consistent behaviors that are intentional, the next step is when communication emerges, either unconventionally or conventionally. The main component that moves an individual’s purposeful behaviors into communication is the emergence of dual orientation. To recap, communication occurs when the individual sends a message about something to someone else; there is a sender, a receiver, a shared topic, and a means of expressing. Dual orientation is when the individual understands that they must communicate a message about something to someone; it is two-fold. An example of this would be when the individual is swinging on a swing. When the movement of the swing stops, to request more they might kick their legs, arch their body back, vocalize, or smile. In addition to these intentional behaviors, the communicator must provide wait time for the individual to involve a communication partner. The individual might move their arm to touch the person pushing them or turn toward where the person is to look at them. Proximity is important. The communication partner should be right next to the individual, talking and touching her/him throughout the interaction, so they are aware someone is there, available to communicate. The communication partner should also be close enough to the individual so that they can easily reach, touch, or turn toward them. Motivating activities/toys are also crucial when encouraging communication. When dual orientation occurs, it is no longer the other person who is guessing or interpreting what the individual’s behaviors mean; the individual is now communicating.

Unconventional communication, defined as “gestures used with the intent of affecting the caregiver’s behavior,” typically emerges between 8-12 months of age.² With unconventional communication, one typically needs to know the individual or have spent time with them to know what their body movements/gestures mean. Conventional communication, common gestures that most people would be able to understand and interpret (e.g., shakes head “no” or nods head “yes,”  points at someone or something, waves or raises hand,  etc.), “used with the intent of affecting the caregiver’s behavior,” develops between 12-18 months of age.²

 

Symbolic Communication

Now that the individual understands the importance of communicating a message to another person, at the symbolic level the communicator begins using symbols (either concrete or abstract). They are generally used one at a time, not yet in combination with more than one symbol. At this point, the individual learns the concept of one-to-one correspondence; the understanding that a symbol is a representation of a specific referent (e.g., a photograph of a green spoon is a concrete representation of the actual green spoon the individual uses during breakfast). Concrete symbols, generally understood between 12-24 months, refer to symbols that “bear a clear perceptual relationship to the referent; they physically resemble the referent in appearance, sound, touch, or motion²” (e.g., a real life photograph, an object symbol, pantomiming the action, or mimicking the sound of the object). Abstract symbols, typically understood between 18-24 months of age, “bear a purely arbitrary relationship to their referents; they are not perceptually similar to them²” (e.g., a braille or written word, a manual sign, a spoken word, or an abstract 3D or 2D symbol, such as a texture, object, picture, or drawing).

Once the individual has these foundational skills (attachment/relationship with others, repertoire of preferences, intentional behaviors, a responsive communication partner, dual orientation, and one-to-one correspondence), the groundwork has been laid for language to occur. This is when the individual combines two or more symbols, according to grammatical rules or syntax, and generally happens around 24 months or age.²

Building on the various levels of communication, moving from reflexive and intentional behaviors, to the emergence of communication (whether unconventional or conventional), to then communicating using symbols (whether concrete or abstract), takes time and practice. When determining if the individual is ready for the next level, the communication partner must assess the ability to generalize, that is, making sure the individual’s responses are consistent across a variety of people, locations, and activities. To help facilitate the development and mastery of these levels, below are intervention strategies that may be beneficial for eliciting communication.

Strategies for Communication Development

Reflexive or pre-intentional behaviors

- Use a variety of active learning materials and preferred objects/textures/activities to encourage purposeful movements and active exploration

- Set up an environment that the individual has access to and is responsive to their movements, behaviors, and vocalizations

- A person familiar with the individual’s vocalizations, facial expressions or body movements immediately acknowledges and provides language in response to the child

- A responsive environment means setting up objects that respond to the child’s purposeful movements

- The individual is positioned next to dangling wind chimes or hanging beads/bells. Even the smallest of movements will generate a response; the sound of the chimes or beads/bells

- Keep a consistent and predictable routine and implement touch/sound/visual cues, so the individual can anticipate what will be happening throughout their day

Purposeful or intentional behaviors

- When the individual makes any purposeful movements, vocalizations, or facial expressions; immediately acknowledge what they did, and respond with what they may be trying to communicate

- The child is playing on the swings on the playground. When the movement stops, and they begin pushing their head/trunk back, the adult might say, “Oh, I see you pushing back, you want more swinging?” and immediately start pushing the swing again

- Give the individual the opportunity to communicate with others. Have “touch conversations” with them about things that are motivating/interesting to them. Notice what they are paying attention to, exploring, or playing with and use mutual tactile attention to let them know that their interest is shared by touching the side of their hand, as well as the item they are interacting with. Follow their lead by imitating their movements and/or playing alongside them. This communicates, "I see you playing with _____ and I’m interested in the same thing you are. Can I play too?" Provide the language for what they are doing, seeing, touching, experiencing, etc.

- Provide opportunities for the individual to engage with activities and manipulatives that encourage turn-taking with another person (joint attention and parallel play). When the individual is interested in an object/activity that a peer is involved in and they approach the peer, model how to engage in back and forth interactions. Also, provide the language for “my turn,” “your turn,” and “wait.”

Unconventional communication

- When the individual communicates using unconventional methods, honor and respond to their behaviors and then model more conventional gestures

- Use hand-under-hand signing and shape the child’s hands into the appropriate handshape for the sign³

- Set up activities that encourage dual orientation. During a preferred activity/object, pause or stop it and provide wait time for the individual to communicate a message to a communication partner

- During activities, proximity will be important; the communication partner should be next to the person, talking and maintaining physical contact with them throughout the interaction, so they are aware someone is there

Offer wait time

- When the individual vocalizes or makes body movements to show that they no longer want an item, encourage them to communicate this message to a communication partner (e.g., by pushing the object away and then looking at the person, etc.)

- Give the individual the option to make choices between preferred activities/items and non-preferred activities/items. Make sure the individual is aware of and looks at/touches both choices being presented and does not just choose the first item they see. Wait for the individual to reach for or sustain gaze with what they want. Then give them the object they picked and pair it with a concrete or abstract representation of it (e.g., photograph of what the object is or the sign or word for it)

- With choice-making, when requesting more of, or when requesting a new activity/object, in addition to the individual looking at or reaching toward the item or photo that they want, we still want them to communicate that message to a communication partner. They can involve a communication partner by reaching to touch, turning toward, or looking at the person, or by handing them the object or photo

Conventional communication

- To encourage the individual to request a new object, set up a box with a few of their preferred objects (so they can see it, but just out of reach). This allows the opportunity to communicate that they want something new/different

- To encourage the individual to request a new activity, begin pairing a meaningful object (preferably one that is used with that activity) and a photo at the beginning of the activity; this symbol will come to be a representation of that specific activity. In turn, they can touch, look at, or reach for the object or photo and then involve the communication partner

- Encourage the individual to request the attention of a communication partner. Begin by positioning within close proximity (next to, touching whenever possible) to the individual and then distancing; encouraging them to seek out the communication partner. Situations may need to be sabotaged to encourage the individual to request attention (e.g., the - activity/object doesn’t begin until they request a communication partner’s attention)

- If the individual throws an object, provide the language for what their behaviors are communicating. Model head shaking for “no” and say, “No, you don’t want the _____? Okay, we can be done.” Encourage the individual to hand the unwanted object to the communication partner (to communicate that they don’t want it) or sign/say “all done,” “no,” or “don’t want.”

- Pair cleaning up and putting the object back in its original location with the word and sign for “all done/finished.” Do this by saying, “all done with the _____,” as well as signing “all done/finished” with the individual’s hands (hand-under-hand)

- Provide opportunities within the individual’s normal routines to greet people and have others greet them at arrival and departure. Model waving hello and goodbye

Concrete/Abstract symbols

- Use concrete symbols in a calendar system to prepare the individual for transitions and refer to the symbols throughout their day³

- Give the individual the option to make choices between objects/activities while pairing the corresponding photo, object symbol, word, or sign with the object/activity prior to interacting with it (reinforcing the concept of one-to-one correspondence using concrete and abstract symbols). When the individual chooses the object or photo symbol of the object/activity that they want, encourage them to hand the symbol to the communication partner, as if communicating, “This is the activity I want to do.” In time, see if the individual can confirm the choice they made (with the object) with the corresponding photo, sign, or word

- When the individual becomes disengaged or it is obvious that they no longer want an item, encourage them to communicate this message to a communication partner, using concrete or abstract symbols. An example of this would be the individual taking the object or photo symbol of the toy or activity they are finished with and placing it in the finished box. Continue to model the signs and words for “all done” and “don’t want” and provide wait time for the individual to express this

- Create a list for “first words/signs/symbols” to share with all team members and ask for their input as well³

Language

- Plan activities that provide opportunities to practice combinations of 2-3 symbols with a variety of people in different environments (if needed, model first)³

- Teach specific grammar, syntax, and other rules of language³

- Provide access to individuals who are fluent in the individual’s specific language mode, including peers, across all environments³

Language is a form of communication, but communication does not necessarily require language. By reviewing the developmental tiers of communication, there are multiple skills that can be built upon in between purposeful movements, understanding communication, and using formalized language. Engaging in activities or with objects and people that are motivating to the individual, sets the stage for communication to be fun and rewarding for all involved.

References

1. Stremel, K. Communication interactions: it takes two. DB-LINK. 2004;1.
2. Rowland, C. Communication matrix: a communication skill assessment. Portland, OR: Design to Learn; 2004.
3. New York Deaf-Blind Collaborative (NYDBC). Communication for learners who are deaf-blind and/or have multiple disabilities; 2016.