The following excerpt is taken from Chapter Six of Pervasive Developmental Disorders: Finding a Diagnosis and Getting Help by Mitzi Waltz, copyright 1999 by O'Reilly & Associates, Inc. For book orders/information, call (800) 998-9938. Permission is granted to print and distribute this excerpt for noncommercial use as long as the above source is included. The information in this article is meant to educate and should not be used as an alternative for professional medical care.
The best approach
to working with non-verbal, barely verbal, or Apraxic children and adults is
what some speech therapists call "Total Communication." It involves
relying not only on oral language to build communication skills, but
introducing gestures, sign language, and other visual communication systems
even as you do speech therapy. A person who cannot communicate is cut off from
others, and it has been conclusively shown that visual communication systems
use the same brain circuits as oral communication does. In other words, using
visual communication may help build up these weak circuits, laying the
groundwork for oral speech. The goal of the SLP in this situation is to help
the person transition from the visual to the verbal, first by making the
connection between the two, and then by doing traditional speech work. Most
experts in helping people with communication disorders endorse the Total
Communication approach.
There is research
that teaching speech and sign language at the same time will increase the
likelihood that the child will speak.
Unfortunately, many behavior therapists teach only speech because they
feel that sign language will become a
crutch, and the child will rely on signs rather than speaking. There is no
evidence to support this notion.
Interestingly,
when a person talks or uses sign language, the same area of the brain is
activated. Thus, the procedure of teaching speech and sign language
simultaneously may, in fact, be stimulating two neurological pathways that
activate the same area of the brain.
Even Dr. Lovaas, who has long pushed a "speech-only" approach, is beginning to come around to the Total Communication point of view. If children in an intensive ABA program still have not initiated speech after a long time, he now recommends using PECS symbols or something similar to jump-start communication, according to parents.