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"When Children Can't Speak" by: Nancy Marie Brown
(Research/Penn State, Vol. 17, no. 1 (March, 1996))
Janice Light leans over and points to an interviewer's pad. "Look
at what you're doing. You're writing to disseminate information
to other people.
"We write to make notes to remember things. We write for
lots of reasons.
"For people who have severe communication disabilities,
there's added importance. Very often they use writing as their
channel of communication. If they can't speak, and they want to
be able to tell you things, to tell you absolutely anything that
occurs to them, they need to be able to write and spell.
"And in terms of enjoying life -- look at the restrictions.
For you or me to just pick up and go somewhere, that's a fairly
easy matter. But people who have severe physical disabilities may
not be able to travel, they may not have access to buildings, so
access to knowledge -- through reading -- may give them
experiences."
According to Light, approximately one percent of American
children can't communicate through speech. The reasons are many:
congenital disabilities like cerebral palsy or autism, strokes,
degenerative diseases like muscular distrophy, birth trauma or
premature birth, or head injuries from a car accident or a fall
from some height. Parents and technicians have devised ways to
help: from homemade notebooks full of necessary handwritten
phrases ("I need oxygen") to the high-tech portable computer
systems which provide recorded or synthesized voices at the touch
of a key.
Unfortunately, "kids with severe communication disabilities
end up having literacy problems as well," Light notes. "We wanted
to backtrack and ask, What's happening at the early stages? Are
they entering school with the foundations that they should have?
We can't afford to have them be behind from the beginning," she
adds, "because everything's going to take them longer in terms of
learning."
In a study comparing families of disabled and nondisabled
kids, Light and her colleagues found that "both had lots of books
and magazines around, and lots of family members modeling reading
and writing, for functional purposes and for enjoyment.
"The differences set in when it came to access of those
materials. Children with physical disabilities are not able to
walk over and grab a book and run up to their mom or dad, grab
them, and say, 'Read to me.' These children have to wait. They're
left without a way to initiate things. Even if a book is put in
front of them, it just sits there. They can't turn the pages."
The problem is not that the parents don't try. "One of the
shocking things to us was realizing the caregiving demands,"
Light says. "Parents of nondisabled kids, for example, reported
that their kids spent about 90 minutes a day eating -- a minimum
amount of time -- versus more than three hours for parents of
disabled kids. And that's parent time, too. The parent is
involved in the feeding. And until your children are eating well,
it's hard to worry about whether they're reading or not."
When parents and children did sit down with books together,
Light saw another difference. "Parents of nondisabled kids
reported that their kids asked lots of questions about the book,
pretended to read, turned the pages. Parents of kids with
disabilities reported that their kids were more caught up in the
mechanics of turning the pages or seeing what's under the flap
and weren't as involved in asking questions about the text or
talking about the meaning of the story."
Videotaping some reading sessions, Light learned why. "We
saw parents really dominating the interactions, even when the
book was very familiar. They did almost all the speaking. Kids
might do something minimal like nodding or pointing, even though
cognitively they were capable of much more. With nondisabled
kids, once the books are familiar, they start to be the
predominant interactors. They tell you the story. Their parents
take a much more minimal role in the interaction. We didn't see
that shift happening for the disabled kids."
Wondering why, Light analyzed the "turn-exchange time" --
"the time from when I quit talking to when you start your turn" -- between parent and child. "Our normal 'turn-exchange time' is
about 2 to 3 seconds. We've found that kids with disabilities
need as much as 30 or 40 seconds -- much, much longer -- and
parents are uncomfortable with that. They have trouble waiting
for the child to get the meaning across. Yet we found that
silence is incredibly effective in getting kids to participate.
All they needed in many cases was time.
"Just think of children who can't speak. If they're asked a
question, they have to think of the answer and then figure out
how to express it and then control their body to do it. For many
of these kids that's difficult."
Light and her colleagues are currently exploring what social
skills such children might learn so that they will be given the
time they need to communicate. "People assumed that whatever a
speaking person would need to communicate effectively is what
these kids need. But there are some fundamental differences. One
of the skills we're looking at, for example, is how to put people
at ease. Most people's first reaction is discomfort. We've got
one videotape, for example, of a little boy who's involved in the
study going up to the counter at a fast-food restaurant and the
woman at the counter walking away, because she doesn't want to
deal with the situation, doesn't know what to do. Obviously,
that's something this little guy is going to confront all his
life, so he needs ways to introduce himself to her and to put her
enough at ease with him and the way he communicates that she'll
at least take his order."
Janice Light, Ph.D., is associate professor of communications
disorders in the College of Health and Human Development, 217
Moore Building, University Park, PA 16802; 814-863-2010. Her
collaborators were Alison Kelford Smith of McMaster University,
and Penn State research assistant Cathy Binger. Reported by Tina
Hay.
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