We focused on Pamela using more elaborate language to redirect my attention. While she writes or types in complete sentences when narrating books, real-time interactions flow so quickly that Pamela either relies on vague language ("Over there" or "Wrong way") or nonverbals. RDI emphasizes nonverbal communication in early stages because nearly all autistic children missed the opportunity to learn it early in their development (or lost that ability). Teaching a child to talk without learning to read facial expressions and body language leads to awkward interactions. They end up ensnaring people in long monologues about their favorite topics without knowing whether they are enchanting their communication partner or boring them to tears. An autism remediation post listed you-tube clips breaking down nonverbals: introduction, body (emblems, illustrators, affect displays, regulators, adaptors), face, eyes, touch (positive touch, controlling touch, playful touch, ritualistic touch, task-related touch, touch avoidance), space (territoriality), artifacts (space decoration, appearances, clothing, color, adornment, scent), and silence.
Pamela has both autism and a severe language disorder. We never had her formally diagnosed but two SLPs who know Pamela very well (my husband Steve's sister and our RDI consultant) agree that Pamela has some form of aphasia. Five years ago, Pamela's challenges with language fit the description of syntactic aphasia perfectly (I put other definitions at the end of the post),
Difficulties in using words in the correct order and/or forms for effective communication. Certain classes of words such as prepositions, conjunctions and articles may be omitted. Example, "Car man hit" for "the man hit the car." (Teaching Language Deficient Children)RDI is not necessarily doing special activities beyond your normal day. I have been hanging laundry since last fall because our clothes smell fresher perfumed by the great outdoors and it is easier on the pocketbook. One key to framing an activity with an objective mind is how you assign roles. All week long, Pamela has been the talker and I have been the doer, as she directs my attention to line up with hers. I find these activities work for teens and are not at all babyish, even though the objective reflects the development of a two-year-old child:
- Laundry (hanging, pull off the rack, folding, putting away)
- Car navigator (telling me directions)
- Shopping (making a list, getting items, putting away)
- Cooking (getting out recipe, following recipe, cleaning up)
In the clip, I try to give Pamela many opportunities to speak specifically about where to hang the laundry in several locations (the rack, bricks, railing, and rocking chairs). We focus on prepositions and nouns in this activity. I throw in lots of variations, which does not frustrate Pamela. What we did here worked on many kinds of words and phrases dynamically and contigently without static repetitions or rote memory.
Other Forms of Aphasia
Nominal aphasia - The inability to know the appropriate names of things or to find categorical terms. For example: 1) "We went to that place (library) to check out books." 2) "Please do the door" for "open" or "close the door."
Semantic aphasia - Difficulty with word meanings. Example pen for pencil.
Pragmatic aphasia - Syntax and semantic ability may be present, but they may be used inappropriately. Example: "Your birthday is Mary 1, 1921" repeated frequently and inappropriately in time and place. Neologism are substituted for meaningful words. Example: "That man is clipping the krepies."
Expressive aphasia/Expressive language disorder - The individual is limited in the ability to express ideas through spoken words or written symbols.
Receptive aphasia/Receptive language disorder - The individual has difficulty comprehending language through spoken or written symbols.
Expressive-receptive aphasia - Difficulties with both types of language skills, comprehending and expressing ideas.
Global aphasia - All language forms are seriously affected to the degree that it is impossible to use one of the preceding categories. There may be an automatic expression or two which may not be meaningful. Example: "The puthee the puthigh" as a response to any comment or question.