Developing Language and Communication Skills for Kids with Autism While Social Distancing

Speech Pathologist Jessica Bosley Shares How to Safely Build Social Interactions During the COVID-19 Pandemic

Sheltering at home, quarantining, social distancing and mask-wearing were new concepts to almost everyone on Earth until about a year ago. Adults continue to cope with them – physically, mentally and emotionally – so it should come as no surprise that this struggle is multiplied for children. Now factor in communication and behavioral challenges such as speech delays and autism spectrum disorder (ASD) … how can a young person experiencing these continue to build their skills at such a crucial developmental age?

Through our interdisciplinary autism therapy programs, we have continued to help children develop their language and social skills, both in the center through one-on-one therapy, as well as via telehealth sessions. Hopebridge Speech-Language Pathologist (SLP) Jessica Bosley from our Lexington, Kentucky center is one of our in-house heroes who managed to shift gears and adapt to the new world around us, all while keeping up the progress with her kiddos. We recently connected with Jessica to guide caregivers through this process and enable them with recommendations to enhance communication opportunities at home. 

SLP Jessica Bosley Answers: ‘How Can I Help my Autistic Child Continue to Build Communication During COVID-19?’

Children with communication deficits have challenges with social communication within a typical year. Adding masks and physical distance expectations this past year has made language development even more difficult for this population. Social situations can be tough for them even on a perfect day, so these new elements add yet another layer.

As parents and therapists, we now have the unique opportunity to make this environment as structured and beneficial as we can for our children. I became a parent last summer, so I know first-hand that it is easy to get caught up in our days, but there are so many chances for us to put a positive twist on the current situation.

To do that, here are some tips and takeaways from speech therapy within our centers that families can incorporate into their own daily lives to continue developing communication and social skills with their children at home.

1. Focus on communication opportunities that naturally occur every day.
   The best way to facilitate communication is to model the language and create structured play opportunities in all of the situations that naturally occur throughout the day. Incorporate them into your daily routines, such as while you are getting ready for bed, making meals, bath time and playing in the backyard. There are lots of language-rich opportunities built into these moments. Make it a point to highlight vocabulary like “go,” “up,” “more,” “less,” “want,” “stop,” “in” and “out.” Focus on these powerful core words that create a lot of punch, then carry them over throughout various activities. For instance, if you work on “in” and “out” from the bathtub, you can also implement them when getting in and out of the car and during play.
   
2. Work on environmental sounds.
   If a child is nonverbal, rather than urging them to imitate words, work on environmental sounds. Use sounds like “uh oh,” animal noises, gasps, fake yawns, “oh no,” “beep,” and “wow,” which are all naturally occurring within play. This is a great way to evoke that imitation skill without the pressure of repeating actual words. Scaling back like this helps them take on easier sound structures that build the foundation for imitating words.
   
3. Use screen-time to your advantage.
   The American Academy of Pediatrics (AAP) recommends limiting screen time during the early years, but as children spend more time indoors, screen time will naturally increase. Parents are sometimes hard on themselves over this, but it will be ok! One way to balance screen time is to incorporate language while the child is on a device or watching a show. Pause it and work on WH-questions like, “Who is that character?” “Where did they go?” and “What are they doing?” Elicit the language while they’re already engrossed in the video. Parents can also pause it to act out the scene together or make predictions as to what will happen next. If a child is motivated by screen time or already participating in it, consider making it into a structured language opportunity you can build onto rather than telling them they cannot use the device.
   
4. Provide learning opportunities through play and movement.
   Children learn best through play. Chalk, bubbles and freeze dance are all fun ways to engage kids while also creating chances for social activity. When bodies are in motion, it is a great way for kids to become more comfortable within themselves. Use these play times to go back to core words like “go” and “stop.” Sometimes when kids are really engrossed in play, it may not seem like it is structured, but it is often when we get the most participation from them.
   
5. Utilize technology resources that allow us to feel close to people without being with them physically.
   Using Facetime, Zoom and other conversational applications with grandparents, friends and cousins offers a chance to practice communication. A lot of children I work with get on Facetime with grandparents to show them a new sound they can make or practice language with an unfamiliar listener they don’t see every day. This provides the opportunity to get feedback from another adult or peer who is listening. I also like the natural communication consequences that come with it. It’s a perfect time to show that social language can happen in a different way and that it’s ok to embrace and practice it. For example, if the person on the other end can’t hear or see your child, they may need to speak louder or pick up their face toward the screen. I noticed this when our centers had to move to teletherapy for a short period, and as adults, we have to deal with these situations on our Zoom meetings all the time! (“Can you hear me now?” “Your microphone is on mute.”) This practice can also be translated to skills that are outside and non-technical.
   
6. Encourage siblings to engage in social interaction.
   Brothers and sisters are wonderful for practicing social interactions. They will naturally communicate with each other a lot, which helps in setting up your child with another peer or similar-aged child. Listening to how they communicate can also strengthen their own skills, even if they are not yet verbal.

Tools and Games that Elicit Speech and Communication 

Beyond the tips that I shared for drawing out language, there are a few tools and games I used during virtual therapy or here at the center that work well and easily carry over for parents at home.

Even during speech therapy, movement is important! Anything that gets the body in motion will elicit language. I love the freeze dance. If your child has a wiggly body, this is a great opportunity to get them to move around and then incorporate words like “stop,” “go,” “up” and “down.” YouTube has workout videos for kids, but if you’re a Peloton family like we are, check out the “Fit Family” classes that are fun for kids and adults. Taking a walk also promotes communication opportunities.

Some of my favorite teletherapy activities are show-and-tell and scavenger hunts, and they can work well at home. Say something like, “Go into your room and find something that is red.” The child is hearing that receptive language piece and has to follow directions to find something and bring it back. If they are able, encourage them to talk to you, too. Bonus: it incorporates movement again!

All of these games can be used to develop language, but my go-to within therapy is using literacy and books. It is easy to create a theme around books and they keep children engaged, plus, early literacy skills are incredibly important. The most effective books I’ve found are repetitive stories because they are predictable. They decrease the cognitive demand needed for comprehension, as well as increase engagement and language, which allows them to focus on the book. Brown Bear, Brown Bear is a great one that kids pick up on quickly because the language repeats over and over and builds upon itself. Five Little Monkeys, Chicka Chicka Boom Boom and Pete the Cat books are also good choices. These books create a welcoming environment for children to show off what they know and may otherwise have a tough time paying attention or have cognitive challenges. Lead them in with a phrase and let them fill it in to give them the chance to be independent.

Feel free to use what you have within your home. Toys, blocks, mirrors, boxes, shaving cream, plastic cups—the list of options is never-ending. Anything that can be built, filled or played with can lead to communication, so there is no need to get more toys. Create language opportunities within whatever they are interested in playing with or doing because it will be more motivating for them.

How Does Hopebridge Approach Social Interactions During the Pandemic?

At Hopebridge, we provide medically necessary therapy for many children with autism and other developmental delays. In tandem with the COVID-safe procedures we have in place, we are able to provide a space and services that allow us to work with children to provide and strengthen language and social opportunities.

One thing that sets us apart from schools and many other therapy options is that every child has an adult with them at all times. This enables us to create social environments in which we can constantly monitor for safety. Our team members are actively engaged in therapy but are also standing by to sanitize, distance, separate and teach social behaviors, such as to cover their mouths when sneezing or coughing, throughout these interactions. Always having an adult nearby makes a world of difference.

Another benefit of our multidisciplinary autism services at Hopebridge is the collaboration within our centers. Our behavior analysts, occupational therapists and speech therapists work together to create and send information and materials home to implement, then get feedback from parents as to whether they are working.

Parent training is another key element of Hopebridge’s personalized programs. During the pandemic, we moved to holding trainings via Zoom so families do not need to come inside the clinic. This is another perk of technology that we may not have used prior to the coronavirus.

While they are not used by every child, the implementation of effective and functional Augmentative and Alternative Communication (AAC) devices is something that has become increasingly important to us at Hopebridge since the beginning of the pandemic. Options include sign language, Picture Exchange Communication System (PECS), pre-programmed buttons and high-tech AAC devices. If a child is nonverbal or struggles with verbal communication, we work to not only find a proper device that meets their needs, but also that the vocabulary is appropriate for their communication level and within their home setting. For instance, if a family eats spaghetti every Thursday night or the family dog is really important, we want them to be able to communicate that. This is more significant now than ever.

As a speech pathologist, the act of wearing masks has completely changed how I approach articulation therapy and language therapy. Even the imitation piece is now missing the visual element. To do this effectively yet safely, I’ve begun using videos of myself or using picture cards to show how the sound looks. Then, I show my kids their own face in a mirror or place them in front of an iPad camera so they can see themselves. They now use their own faces for modeling and feedback whereas before, we were dependent upon them looking at me and my mouth. Instead of solely feeling it, they’re seeing it. This has created more independence and immediate reinforcement. As a clinician, it’s been a game-changer, and I have already witnessed one child who exploded in their speech sound production, in part thanks to this new tactic.

Learn More About How Hopebridge Can Help

In addition to sharing her tips for parents and providing an insider’s look at how we approach this within the centers, Jessica also wants to remind families to notice the flexibility in kids.

“This time has allowed us to view the flexibility of people, especially within the autism community. These kids have had to adapt and learn boundaries with masks and social distancing. They are growing and changing with the times,” Jessica told us. “While the reason and process was unwanted, of course, it has been a surprising perk to realize how much growth people can have under pressure.”

If developing language and communication skills is a concern for your child, don’t hesitate to contact us. Hopebridge combines complementary services like speech therapy, occupational therapy and applied behavior analysis (ABA therapy) to help children with autism reach their greatest potentials. To find out more or arrange an evaluation at one of our centers across the country, please fill out our easy online form.

*Informed consent was obtained from the participants in this article. This information should not be captured and reused without express permission from Hopebridge, LLC.