A team I was working on many years ago was teaching a young child with autism who had minimal language how to talk. One of the things he had learned to spontaneously request was “Oh, no!” When the therapist heard, “Oh, no!” he or she would fall down. It was a highly motivating and fun way to get him to use language. A couple of weeks after he learned this, an evaluator was coming to assess the student. The child ran up to the evaluator, and as the person was saying, “Hello I’m doctor so-and-so,” and extending a hand, the child was enthusiastically saying, “Oh, no!” When the evaluator didn’t respond correctly, the child had a major tantrum that disrupted most of the evaluation.
I think this experience can teach us some important lessons. Some obvious, but one not so obvious. Let’s start with the obvious lessons. First, I knew the evaluator was coming to see this student. There are lots of things I could have done to prepare. In particular, warn the evaluator ahead of time so the evaluation time wasn’t ruined. Second, whenever you are teaching requests, part of the procedure must be to teach the student that the requests are not always available, otherwise problem behaviors are inevitable.
But some people who have similar experiences learn what I think is the wrong lesson. Specifically, some will argue that is absolutely essential right from the beginning to ensure that the child can be understood by novel people to avoid these types of problems. I’ve heard this used as an argument against games like my student learned. I’ve heard this used as a rationale to put an immediate and major focus on articulation. I’ve heard this used as an argument against teaching sign language. A common argument against sign language is, “How will he be able to make a purchase at a store?” “How will he be able to talk with peers in class?”
These are real problems, but I don’t think we need to worry about them too much. Our goal should always be to teach skills that will meet a natural contingency, which certainly means we have to reach the point where novel people can understand. The way to do that is to teach the child to be a sophisticated communicator. If you do that, you will overcome these types of issues easily. Sometimes, it may be possible and beneficial to start out immediately with procedures that novel people can understand (e.g., iPads, PECS, articulation training), but I doubt that means we always have to do that immediately. In my view, there isn’t sufficient research to make a definite determination for every case, and currently it requires some clinical judgment.
My student who started talking by learning to say “Oh, no” became a fairly sophisticated communicator. Whether other procedures would have achieved more, better, or faster is hard to say. But always avoiding these types of activities is a big mistake.