Q&A with Dr. Temple Grandin: Nonverbal Autism

This month, Dr. Temple Grandin answers parents’ questions about nonverbal or nonspeaking autism.

Juju’s mom, in Queens, New York, asks, “My son is three and a half years old and autistic. He sings and has words. He can read some words but can’t functionally communicate, such as telling me he’s hungry, etc. What can I do to help him?”

Well, he’s only three, so the first thing I’ll ask a parent is, ‘Is he improving?’ The other thing I will ask about is the therapy he’s getting because I’ve learned that one hour of speech a week is not sufficient. And in some places, that’s all the child receives.

If you have that situation, you need to use that professional teacher as a coach and get some grandmothers and some volunteers to do more work with the kid because one hour of treatment is definitely not sufficient.

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I want to make sure that he is getting at least 10 hours a week of one-on-one instruction with an effective teacher. I want words, turn-taking, and skills right now, at age three.

In my program, when I was two and a half or three, there were four things we worked on, but basically, we just want to learn more words. Let’s start out with only three—learning words for favorite things. Then, let’s work on turn-taking games and basic skills like dressing and combing your hair. The child should also like to go to therapy.

Let’s look at functional communication for something he might need.

He says, “Water.” Then you’d give him the water. Then you want to say to him, “I know you know the word. Use your words.” He’s got to learn that words can have some power.

Another thing is to give him time to respond. He’s like a phone with one bar of service. It takes time to download the webpage. Give the child time to respond. Then, if you’re making progress and they like going to therapy, then you’re doing the right thing.

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Balaji from New York asks, “My eight-year-old son is autistic and nonverbal. Is it safe to allow him to sleep by himself in a room? Is it safe to let him participate in summer camps without parental or sibling support? We would like him to practice becoming more independent.”

Well, there’s a tendency for parents to overprotect. I’m seeing 16-year-olds who are fully verbal but have never gone shopping.

The first thing is how he acts when he’s with somebody else. How does he react when he’s with someone who’s not family? You see, he needs to learn how to work with somebody who’s not family before you go to something like the summer camp.

How is he getting along at school with a teacher? I would need to ask many things, and he is only eight years old. But when I was eight years old, I was fully verbal and shopping by myself with my allowance.

I think we just have to see gradually — is he going to engage in some really dangerous behavior? You see, this is where you’d have to make some judgments. The other thing is how good the camp program is. The thing to do is observe them, and then you slowly fade out.

Also, if he’s nonverbal, you’ve got to give him a way to communicate. I can remember one of the biggest frustrations when I couldn’t talk was I couldn’t express my needs. So I would scream. That’s how I expressed my needs. A child has to have a way to communicate — sign language, picture boards, something.

Also, if he’s completely nonverbal, you might want to consider teaching typing. And I’ll tell you a little secret: These individuals cannot gaze shift. For example, the keyboard is way down here on the desktop, but what I type will appear way up on the screen. The desktop won’t be helpful unless you put the keyboard on a box.

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An iPad or something similar works because the print appears next to the virtual keyboard, which is very important. I suggest getting a tablet and seeing if your son can start to learn to type some words on it. Quite a few people are nonverbal and have a good brain inside, but they will have to communicate by typing, not speaking. You have to use some judgment here. Some children might run off, and it would not be appropriate to go to the camp.

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