What Is Working Now?

All behavior is communicative. For those who cannot speak, we can look at their gestures, sign approximations, facial expressions, and body language to discern the meaning of what they are attempting to communicate.

The particular behaviors that may convey communicative intent will depend on a number of factors, including the cognitive and physical abilities of the individual. Someone with a complex body may rely more on eye movements and facial expressions. If the person is an emergent communicator, the listener may need to infer what they want or need based on the behaviors they see. These behaviors may be produced without communicative intent. For example, someone cries and we observe that they have slipped down in their wheelchair. We can infer discomfort.

Others who cannot communicate with spoken words may still have learned to use some combination of behaviors and gestures to communicate with intent. They know what they want to say and are working hard to get that message across to their communication partner. Their gestures may convey a specific meaning, but they are still not using language. There is no use of grammar to link these behaviors/gestures together into a phrase or sentence. They cannot easily communicate the time and sequence of events, or communicate about events outside of their immediate context.

People with a hearing impairment or autism may have a history of being taught to use signs from American Sign Language (ASL). Many factors will influence how well someone is able to use signs. In many cases, gross and fine motor impairments may cause difficulties with an exact imitation of the signs. Cognitive and linguistic development may influence their ability to combine signs to form a phrase or a sentence. In such cases, many individuals will use sign approximations. These signs may look somewhat similar to the signs from which they are derived. These signs stem from a true language, but their use is lacking the grammatical markers of ASL, which are often conveyed using facial expressions and the space around the signer.

Others will create their own signs, which used in context, convey a specific meaning. They have associated these “home signs” with particular contexts and have learned to use them with consistency. These will only be understood by familiar communication partners.

One consistent factor about the above populations is that the user is limited to being understood by their most familiar communication partners. Outside of this circle of caregivers, communication breaks down. Even within this circle, communication is not sufficient to convey a wide range of likes, dislikes, emotional states. The individual may easily be misunderstood. When communication works, it can be considered functional. It may prevent the use of “negative behaviors” to transmit meaning.

What can we do to facilitate the use of this functional, but non-symbolic, communication? There are many tools that can be used to document communication so that it may be understood by a wider range of partners. We can create a communication dictionary. This may be paper-based. It may take the form of a series of statements in a chart.