The Fundamentals of Communication

If you have a child or are working with a child who doesn’t speak yet, then this post is for you. I often hear comments like ‘He doesn’t have any communication’ in relation to these children when I think, in reality, what people actually mean is ‘He doesn’t speak yet’. Before we think about the Fundamentals of Communication, it’s very important that we understand that speech and communication are not the same thing.

The communication chain

The communication chain is all about getting an idea from one person’s head into another person’s so that both people end up with the same idea in their minds.

Communication is essentially about getting a thought from your head into someone else’s head. To do this, we make our thoughts into messages that other people can understand. Those messages take many different forms from gestures and facial expressions to noises like laughing or spoken words. Speech is simply one of many forms of communication that are available to human beings.

 

Communication development represented as a tower.Typically, human communication is a rich and complex thing. Communication is a skill that we typically learn and use subconsciously. Like any other complex skill, communication requires a strong foundation of basic skills to support the development of increasingly complex skills. I like to think of it like a tower, without strong and established foundations, a tower will fall down. In the same way, adult communication relies on a solid foundation of basic skills. If the basic skills don’t develop, the more advanced skills won’t either. As you can see, the first level of foundations is where the Fundamentals of Communication need to be. The most amazing thing to my mind, is the fact that we learn all of those fundamentals through simple exposure to interaction with others. No-one ever sits us down and formally teaches us these skills, we just pick it up and typically we’ve learned the Fundamentals of Communication before we say our first words at 18-24 months.

Before we look at the Fundamentals of Communication in more depth and define what they are, I think it is important to consider a couple of key stages in early communication development.

Pre-intentional Communication

Pre-intentional communication is really communicating by accident. This is what babies do in their first days of life. What happens here is the baby responds to some discomfort (maybe hunger or pain) by crying. Typically, the baby’s parent will respond by doing something to comfort the baby, perhaps feeding them or giving them a cuddle. Clearly some communication has occurred here because the parent has realised that the baby needs something. It is important to understand that at this stage the crying is simply a response to the feeling of discomfort and not a calculated attempt at communication. The fact that something happens to fix the problem is simply a happy accident.

Intentional Communication

Over time the baby starts to make the connection between crying and something positive happening. Because the parents respond to the baby’s crying by doing something to comfort him/her, the baby starts to realise that crying (cause) makes something happen (effect).  Here we have the beginnings of intentional communication. The baby now starts to cry with the specific intention of communicating the message ‘I need something’.

The Fundamentals of Communication

The Fundamentals of Communication are woven into this process of pre-intentional and intentional communication development. They are not learned in a sequence, rather they are learned alongside one another as part of the process of communication.

The Fundamentals of Communication are a set of basic communication skills that form the foundations of more advanced communication skills, including speech. If these fundamentals are missing, it is unlikely that more advanced communication can develop. Sometimes children develop most but not all of the fundamentals. When this happens, spoken communication may be achieved but it is likely to be unusual. For example, a child who fails to pay attention to others may speak at length about things that no-one else is interested in without realising that they have lost their listener’s interest. The key Fundamentals of Communication are as follows:

  • Enjoying being with another person – quite simply, communication requires you to enjoy being with other people. If you do not want to be around other people, you will have very little motivation to communicate at all.
  • Developing the ability to attend to another person – paying attention to other people is an essential learning skill. As I said earlier, we learn the fundamentals of communication and indeed all the communication skills we acquire in our preschool years through simple exposure to communication situations. To learn in this way, we have to be able to pay attention to other people, recognise that they are different from objects, take interest in what they are doing and to have a go at copying what they do.
  • Concentration and attention span – In order to learn from an activity or an interaction we have to be able to sustain attention to it. If we flit between activities too quickly, we miss learning opportunities. For communication to be successful, we have to be able to pay attention for long enough to receive and understand messages that are coming to us and to concentrate for long enough to pull together what we want to communicate ourselves. As we develop and grow, we learn to maintain attention for the full course of a conversation, sometimes over a period of days in the case of email or text conversations!
  • Learning to do sequences of activity with another person – For example, a sequence of causes and effects like [mum tickles, baby laughs, mum laughs, baby waits, mum tickles again]. This sort of play sequence reinforces cause and effect understanding as well as turn-taking. It is also fun for both parties and reinforces the idea that communicating is a satisfying and rewarding thing to do. Let’s also not forget that a spoken conversation is essentially a sequence of activities that we share with another person.
  • Taking turns in exchanges of behaviour – this is linked to the idea of completing a sequence of activities with another person. To take part in a sequence of activities, you have to be able to give and take turns. Turn taking is an essential skill for communication as all successful communication relies on one person being able to take a turn to communicate their message and their listener being able to wait until the message is finished before responding.
  • Sharing personal space – in communication, particularly in the early stages of development, we are usually seeking to form some sort of bond or relationship with another person. In order to do that, we usually need to be physically close to that other person and depending on the type of relationship, to engage in some form of physical contact. For example, family members may hug each other or friends may nudge each other to share a joke.
  • Using and understanding non-verbal communication – by non-verbal communication here, I mean things like facial expressions, eye contact and gestures. Basically the messages we send to each other without using words. We typically learn to understand these messages subconsciously and without formal teaching and they allow us to ‘mind read’ how our conversational partner is feeling so that we can modify our communication accordingly. They also influence the unwritten ‘rules’ of conversation, for example eye contact helps us to know whose turn it is in a conversation because the speaker will usually stop talking and look at the person whose turn it is next.
  • Using vocalisations with meaning – following on from that earliest stage of intentional communication is the realisation that different noises can be used to communicate different things. This understanding is essential for the development of spoken language because words are essentially unique collections of noises with specific meanings attached to them.
  • Learning to regulate and control arousal levels – self-regulation just means the ability to know if you are getting either over excited or bored and being able to do something constructive about it. It’s an essential communication skill. In very young children, overexcitement can result in overstimulation unless the child has a way to show you ‘I need a break’.
  • Cause and Effect – I mentioned this when I talked earlier about pre-intentional and intentional communication and it is simply the understanding of ‘I do something and something else happens’. Communication does not develop without some understanding of cause and effect.
  • Anticipation – developing anticipation in familiar routines is essential for communication development. It helps to build understanding & use of language as well as reinforcing the idea that communication is a rewarding and fun thing to do. The repetitive nature of anticipation routines like ’round & round the garden, like a teddy bear, one step, two step…***PAUSE***… tickle you under there!’ means that the child gets to hear the same words and see the same nonverbal communication used over and over again without it becoming boring.

Therapy to Develop the Fundamentals of Communication

So now you know about the Fundamentals of Communication, what do you do about supporting their development? Well, a speech & language therapist will be able to give you lots of guidance here. Most therapists will advocate either or both of the Hanen approach or Intensive Interaction. Hanen is an approach developed in Canada for children with delayed communication development. It is based on specially trained therapists providing training and coaching for parents to support them to get the best from their child’s communication skills. It is a very effective and popular approach which is offered by most NHS speech & language therapy teams. Go to the Hanen official website for more information.

Intensive Interaction is more specifically aimed at the population of people who have severe and complex learning difficulties however it has much in common with the Hanen approach. It encourages a very naturalistic approach to communication where the ‘teacher person’ uses their knowledge of the Fundamentals of Communication to provide a communication situation that promotes and supports their development in the ‘learner person’. Many speech & language therapists are trained to use Intensive Interaction and Isla at Blethers is trained to an advanced level which means she can not only use Intensive Interaction with clients but can deliver detailed training for parents and care staff. You can find more information about Intensive Interaction on the Intensive Interaction website or in my post called Intensive Interaction Video.

Creating A Good Environment for Communication Work

Even the most able children have difficulty focusing in some environments. If you are trying to work on communication with your child, it’s really important to bear in mind the surroundings you are working in. To get the most out of a learning experience, any child needs to have the best opportunity to concentrate easily. This might sound obvious, but the first thing to check is that the child’s basic needs are met. That means making sure that he or she is warm enough, isn’t hungry and doesn’t need the toilet. The next questions to ask yourself are:

  1. Is the child able to hear the sounds and words they are being asked to listen to?
  2. Can the child focus on the target task without being distracted by irrelevant distractions?
  3. Can the child maintain a comfortable body position without wasting too much mental effort?

How do communication difficulties affect concentration?

Many children who have communication difficulties have additional problems concentrating due to difficulty with one or more of the following factors:

  • Maintaining attention to an activity they haven’t chosen and following adult direction.
  • Auditory processing – discriminating speech from background noise and making sense of the sounds they hear. They may not be able to filter out what is important from a background of other sounds.
  • Ignoring irrelevant activity and visual stimulation around them – weak sensory processing of information coming from all of the senses can lead to problems filtering out what is relevant.
  • Maintaining a stable posture – maintaining posture is a developmental skill like any other so you can expect that children won’t be as good at it as adults are. Also, children who have co-ordination difficulties like dyspraxia or other conditions affecting movement are more likely to need support to maintain a stable posture. They will expend a significant amount of mental effort doing so if the seating they are given doesn’t provide adequate physical support in the right places.
  • Understanding language – often children who have problems understanding language have a higher tendency to ‘switch off’ when faced with a barrage of language. This is particularly noticeable in noisy, busy situations with lots of distractions.

How can we make it easier for children to pay attention?

The good news is that a few simple tweaks can make your living room, kitchen, classroom quiet area or other work area into an environment that supports concentration. Bearing in mind that we all live in the real world and you can’t always have the ideal situation, here are a few key tips that are eminently do-able:

  • Try to keep your work area as quiet as possible. Turn off the TV, turn off the computer, turn off the radio/stereo and, if you need to, close the door to the rest of the house. Turning off the TV is particularly important as it is not just a source of noise but also visual stimulation.
  • Try to remove as many distractions as you can – I know this is not always easy! Try to put any ‘fiddly’ or interesting objects out of the way and try to work away from other people. If there are a lot of pictures/posters/displays on the wall, have a think about taking some down or moving them.

    The Mobile therapy room with minimal visual displays on the wall.

    One of the best things about the Mobile Therapy Room is that it is easy to add and take away visual displays as you need to because of the Velcro and magnetic areas of wall.

  • Think about the lighting in your work area. Fluorescent lighting tubes can be a source of visual and sound stimulation because they flicker and hum when they’re on. Make sure that your area has enough light so that you can easily see the materials you are working with. If the child you’re working with wears glasses, make sure they have them on and that the lenses are clean.
  • Think about the seat your child is sitting in – try to choose one that supports their upper body well, and if possible, allows their feet to be on the floor to give them a stable base for their posture. Working at a table is often more effective than working on the floor as it provides extra support and you don’t end up with a ‘liquid child’ lolling all over the floor!

    The chairs I use when working with primary school children in the mobile therapy room.

    I use a Postura Plus chair for young children as it supports their posture well and it’s very stable so difficult to swing on.

  • Use games that your child is familiar with and keep it simple so that your child focuses on the communication task you are helping them to learn. This avoids your child having to waste mental effort learning a new or complicated game before they can engage with the communication activity.
  • Be prepared! Have all your materials ready to go before you start so that you’re not faffing about trying to find things while you’re working. For example, Ikea make a wide range of useful storage boxes which are great for keeping your resources together, easy to get out and also easily hidden if necessary!
  • Think about how many resources you present at a time. Try to have only the materials you are using for the current task on display. That’s another reason to keep all your materials in a box or a bag. You can then hide things easily when you’re not using them.
  • Think about timing – as a general rule, children find it easier to focus when they’re not tired. If a child has difficulty maintaining attention at the best of times, you will most likely find that you have more successful sessions with them earlier in the day.

This list is not exhaustive but I think that it covers the key points. Hopefully, with these few simple tips, you’ll get the best from your communication sessions. That said, no child is perfect and no strategy is perfect. There will be times when you do all of these things and your child still can’t maintain attention to what you are doing. If you’ve given it a good try and it’s still not working, I’d say abandon the activity for the time being. You can always try again later. If your session isn’t holding the child’s attention, it’s worth having a think about the activities you have presented just to check whether there’s anything you need to change to make the activity work better. Can you tweak the materials to make them more motivating for the child? Is there some extra factor impacting on their attention today like illness, a late night or excitement? Sometimes a good deal of lateral thinking is required and self-reflection is always worthwhile!