Let's Talk About .... Key Word Signing

I have previously published a post on the various methods that L uses and has used to communicate with us. In that post I very briefly discussed Key Word Signing. In the last few months I have been brushing up on my Key Word Signing and O has been doing weekly videos on different signs so I wanted to dedicate a blog post purely to the subject. In this post I will mostly be referring to children when using Key Word Signing but keep in mind that many adults also use Key Word Signing to communicate.

So what is Key Word Signing?

Key Word Signing or Makaton (as it is also known) is one way in which people who have difficulties with spoken communication skills can develop their language skills and communicate their needs, thoughts and opinions with those around them. Key Word Signing can be used to encourage and support the verbal language development in children, and adults, who have communication difficulties as well as in those whose communication skills are still developing - babies and young children.

Key word signing or Makaton is a simplified version of Australian Sign Language (Auslan) and as the name suggests, the actual signs just represent a core vocabulary of specially selected words that have been deemed most appropriate for children who have verbal language difficulties to to learn and use.

Key Word Signing is considered a manual form of communication in that a child uses their hands and fingers to form the signs and natural gestures. Those who use and teach Key Word Signing in Australia gratefully acknowledges the Australian Deaf Community for the use of the Auslan signs. Key Word Signing is a form of Augmentative and Alternative Communication (ACC) as it is a communication method other than speech.

When signing the word, you also need to speak the word so that the child begins to make the connection between the two. Signs are used for the words in the message that holds the most important information, rather than signing the entire sentence. For example, if you were to ask a child to “wash their hands,” you would use the key word signs of “wash” and “hands.” When using Key Word Signing, you should also use other visual strategies such as body language and facial expressions to convey the message that you want.

Why use Key Word Signing?

Verbal speech is the most efficient and effective way for children to communicate but some children may not develop verbal speech due to many reasons. However they can still learn to express their needs, thoughts and opinions through the use of Key Word Signing.

Key Word Signing isn't intended to replace the need for speech, it is used to assist the development of speech. Key Word Signing can also supplement or support a child's speech if they are not able to articulate themselves clearly. For example, they may not be able to say the word “water,” but may be able to sign the gesture for “drink.”

Key Word Signing can alleviate a child's frustration at not being to express their needs, thoughts and opinions. It is important to remember that Key Word Signing alone may not be sufficient enough meet the communication needs of an individual. It may need to be used in conjunction with visual cues, visual communication boards and other communication devices.

L picked up key word signing from a very young age and it was truly wonderful to see his frustration at being unable to communicate ease a little. At first L picked up the signs for please, more, finished, eat and drink. He would never say the word but the signing action was very clear.

The hand gestures used in Key Word Signing often look like what they mean, for example the signs for eat and drink. Gestures often last longer in space and time than spoken words, so a child has more time to process the visual signs that they can see. The hand gestures used in Key Word Signing can also slow down and simplify the speech of the speaker, which again allows a longer processing time for the child. The use of Key Word Signing will also slow down the child's speech so spoken words may come out more easily and slowly.

The Key Word Signing gestures are often easier to produce than speech for a child whose verbal speech is still developing. The gestures used can aid a child in adding extra information to their speech attempts.

Who can Key word Signing be used for?

Key Word Signing can be used with and taught to anyone whose verbal communication skills are still developing. I have used Key Word Signing with children who have additional needs, children for whom English is their second language and for babies whose communication skills are very much still developing and have had great success with all groups. Key Word Signing is a very effective communication form and it really does alleviate a child's frustration at being unable to communicate.

It is super important to note that the use of Key Word Signing will not stop a child from talking, so long as you always talk at the same as you sign. And remember that Key Word Signing was initially developed to support the development of speech, not to replace the need for speech.

What are the important Principles when using and

learning Key Word Signing?

When using Key Word Signing there are some important principles that you, as the speaker and the teacher, need to remember....

• First up, get the child's visual attention. You will need the child to be looking in your direction so that they can see what you are signing. Key Word Signing really does rely on the speaker and the listener to be at least looking in each others direction for it to be effective.
• Always speak the words that you are signing so that the child begins to make the connection between the Key Word Signs and speech. And when you are speaking, ensure that you are speaking in grammatically correct sentences.
• When a child is using Key Word Signing to communicate their needs, opinions and thoughts, acknowledge all of their attempts at the signs. Even if their attempt is not 100% correct, acknowledge their attempt. Communication can be tricky at the best of time so if the child makes an attempt to use a sign, acknowledge their attempt.
• When you are using Key Word Signing, place your vocal emphasis on the key words that you want to convey. For example when asking a child to wash their hands, emphasis "L, wash your hands please."
• When using Key Word Signing, use the normal facial expressions and body language that you would use when communicating verbally with a child whose verbal speech has developed. This will assist the child in developing an understanding of the non-verbal communication skills.
• Children are most likely to learn the Key Word Signs that are meaningful or useful to them in their daily lives. They will most likely learn a key word sign a lot more quickly if they have repeated opportunities to see it being used and practice it themselves. As mentioned earlier, L picked up the key word signs for "finished, more, please, eat, drink, play, book" long before he learnt other key word signs. These were the signs that were used every day and as such were easier for him to learn.

What are the building blocks skills that are necessary
when learning Key Word Signing?

When teaching Key Word Signing to children, there are some building blocks that the child should first have, or be developing, in order to assist them in key word signing. If these skills are still developing in the child, then they may find it difficult to perform the signs. This doesn't mean that the child is unable to develop the ability to learn Key Word Sign, it may just take them a little longer to effectively communicate their needs, thoughts and opinions through key word signing. You may also need to work on these building block skills at the same time as teaching Key Word Signing.

• Fine Motor Skills - All of the Key Word Signs are done through the use of finger and hand signs and gestures. If a child's fine motor skills and coordination are still developing they may struggle to correctly sign the signs. But as mentioned above, acknowledge their approximate attempts to use the signs. This is important in building up their confidence that they can do it and reassuring them that they are capable learners.
• Imitation - At first a child may simply copy or imitate what someone else is signing in order to produce the signs themselves. This means that you as the teacher need to produce the signs correctly.
• Receptive (understanding) language skills - If a child's receptive language skills are still developing, they may not fully grasp what you are asking them or talking to them about. As time goes on, a child will begin to develop and build on their receptive language skills through the use of Key Word Signing as they will need to comprehend what is being signed (and said) to them. One thing that you as the speaker can do, is remain calm. If the child is taking time to understand what you are asking, remember that it could be because they are still mentally processing what you are asking.
• Expressive language skills - A child may struggle to express themselves through the use of Key Word Signing if their expressive language skills are still developing. This skill will develop as they practice the signs in real life experiences. Again it is important for you as the speaker to remain calm when engaging with the child.
• Tactile sensitivities -  Initially a child may resist learning Key Word Signing especially if they have a tactile sensitivity. It can be helpful to assist a child to manipulate their fingers and hands to produce the signs. If they have tactile sensitivities, think sensory processing difficulties, they may resist you holding their hands.
• Working Memory - A child may have difficulty in retaining Key Word Signs if their working memory is still developing. Working memory is the ability to retain and manipulate the information involved in language comprehension and learning new information, and the ability to update this information as changes occur.
• Planning and sequencing - This is the ability to plan what signs the individual wants to use and to sequence the signs in the order needed. L struggled with this skill for a long time but the more we used Key Word Signing with him, the better he became at remembering what signs he wanted to use and in which order. Again, ensure that you acknowledge the child's attempts to use the signs.

What can you do to help a child in learning key word signing?

Looking at the building block skills mentioned above that are needed to effectively use Key Word Signing, there are many, many activities that you can do with the child to build upon the skills that they already have.

During play we would use Key word Signs that were related to the game or activity that L was engaged in. We would also use Key Word Signs and encourage L to use them too, during every day daily routines. The more we used the signs, the more receptive L was to using them. We would incorporate fine motor activities in L's play so we could assist him in developing his fine motor control. We also used visual timetables and visual communication boards with L at home. If we were unsure at what he was signing, we would use one of these visual cues to assist us and L in understanding what it was that he was attempting to communicate. We encouraged L's carers to also use Key Word Signing with him as the more practice he had in using the signs, the less frustrated he became at communicating his needs, opinions and thoughts.

When reading books, we used to sign the key concepts that were in the story. We would ask questions using Key Word Signing about the illustrations in books in regards to "where" particular objects were in the pictures. This not only assisted L in learning these signs but also assisted in developing his receptive and expressive communication skills. We would sing songs and nursery rhymes using Key Word Signing. One of L's favourite nursery rhymes was Twinkle Twinkle Little Star.

And lastly, as I have mentioned several times in this post, remain calm. Communication can be incredibly difficult when you are struggling to put your thoughts together as to what you want to say, let alone if you have difficulty verbally articulating yourself. Acknowledge all attempts that your child makes in using Key Word Signing as this will boost their confidence.

How does one communicate when the world can be confusing?

Up until his third birthday L spoke a grand total of roughly 20 words. A typically developing three year old, should have a repertoire of roughly 200 words. L was missing quite a number of words from his repertoire.

Whenever we mentioned this to L's child care Educators or to medical professionals, they would defute what we saw with "no look, L can say more than that, watch, L say ...." and he would be able to repeat the word to them.

However the words that they were getting him to repeat were not a part of his everyday vocabulary.

So how does one communicate when the world can be a very confusing place?

Children with ASD generally find other ways of communicating their needs and wants. They have their own unique way of communicating and L was no exception.

Through L's autism diagnosis we were able to identify the many ways in which L was communicating with us and others, at the time we just did not know that they were all autism spectrum disorder traits.

So I thought that I would write a post detailing the many ways in which L used to, and still does at times, communicate his needs and wants.

Key Word Signing

Key word signing or Makaton is a simplified version of Sign Language and as the name suggests, the actual signs just represent words. When signing the word, you also need to speak the word so that the child begins to make the connection between the two. Key word signing isn't intended to replace the need for speech, it is used to assist the development of speech.

L picked up key word signing from a very young age and it was truly wonderful to see his frustration at being unable to communicate ease a little. At first L picked up the signs for please, more, finished, eat and drink. He would never say the word but the signing action was very clear.

I have used key word signing for children with special needs, children for whom English is their second language and for babies and have had great success with all groups. Key word signing is a very effective communication form and it really does alleviate a child's frustration at being unable to communicate.

Non-Verbal communication.

From an early age L also used a series of sounds, grunts and random hand gestures. He would point at a direction that he wanted to go in or at an object that he wanted. The sounds and grunts that he used, while they did not resemble words at all, they all had a meaning. O became an expert at being able to interpret L's communication form for us!

In the ASD world, non-verbal does not mean quiet!

Echolalia

Quite often if we or anyone else asked L a question such as "where are your shoes," L would answer with "Where are your shoes? Dunno."

But again L would never repeat the words voluntarily. They were only ever repeated after hearing a statement or being asked a question.

Echolalia describes the act of a child or individual repeating verbatim what you have said or asked prior to answering the question or carrying on the conversation. In effect, echolalia is the repetition of the speech of others and it is generally a consistent trait among individuals diagnosed with Autism.

Echolalia is a very normal way of learning to communicate and most children at some stage in their development use this form of communication to learn to speak. If you listen to babies babbling, it is usually done in a rhythmic way. A baby will mimic the cadence of their parents or carers speech. As their speech continues to develop, a young child will copy sounds, words and sentences that they hear adults and other children say.

So echolalia can be described as an attempt to communicate to others, to learn new language and to practice new found skills.

Most children tend to grow out of using echolalia speech, individuals on the spectrum generally do not. L was still using echolalia speech well after turning three years of age and he still uses it occasionally.

Another reason that has been explained to us for L using echolalia was to give him time to process what he had so that he could retrieve a memory on how to answer the question.

Mimicking the speech of others.

Another form of echolalia is mimicking what others say. When L was asked as a toddler to say a specific word, he was merely mimicking exactly what he heard.

L could say other words by simply copying what he heard. His speech wasn't very clear but he could repeat the word.

However the word that he repeated was never said voluntarily.

Scripted Speech

Scripted speech is another form of echolalia but it describes the act of repeating verbatim phrases or words that an individual has heard from interactions with other people or from television shows or movies often during completely random moments or for children during play.

Scripted speech is a facet of autism that fascinates me and it is something that both L and O do on a regular basis to this day. Quite often L and O will repeat entire sections of movie or television shows while they are playing and usually in the accent that they heard it in. Quite often the scripted speech will be during completely random moments! The accents that they both come out with are astounding!

What O and L repeat never changes from one play experience to another and it seems to be an ongoing action. I'm not sure that either L or O will outgrow this form of communication.

What? What did you say?

Quite often when you ask L or O a question or ask them to do something, they will respond with "what?" or "what did you say?" or "can you repeat that please?"

Quite often individuals with autism struggle with processing what they have been asked and as such it can take them a little longer to respond.

When L and O initially respond with "what" or "what did you say," we simply repeat exactly we have said. Quite often L and O are then able to respond appropriately to our request.

By answering with "what," they are processing what we have said and again retrieving a memory on how to respond. It's not that they are being rude, they just need a little extra processing time.

Communication Boards.

L has also used basic communication boards to communicate his needs and wants. A communication board consists of different symbols that represent a variety of words and/or phrases.

The communication boards do not replace the need for speech, again they are used to assist in the development of speech. While pointing to the symbol or picture, it is recommended that the word be said as well so that the child begins to make a connection between the symbols and the words that they represent.

There are many others ways in which individuals can communicate, these are just a few that L and O have used or still use.

So the next time that you are struggling to communicate with a child and they are responding in a way that you do not understand or seems frustrating to you, take a  step back and look at the bigger picture.

Is the child not communicating effectively or are we looking at their communication form from the wrong angle?

A perfect winters day for a playground adventure!

If you have been following my blog, then you've probably gathered or heard by now that Tuesday is my day off of paid work. A typical Tuesday for me usually consists with running the little superheroes to and from school, therapy sessions and specialist or funding appointments. Tuesday is normally a very busy day with barely enough time to stop!

Well not the Tuesday just gone.

For a change there weren't any appointments or therapy sessions to attend and as it was still the school holidays, I wanted to do something fun with my little superheroes.

When we woke, it was the perfect winters day for a playground adventure - rain was forecast for the afternoon but the sun was shining, the wind was low and what is a little rain between friends anyway! When I mentioned to the little superheroes what I had in mind, they both leapt into action. I haven't seen them get ready that fast in a long time!

First up was a new playground, well new for us anyway, called Livvi's Place Playground in Whiteman Edge. It was established last year as a joint initiative between Stockland and the Touched by Olivia Foundation. The play area was designed as an all abilities play space with features especially designed for those children with special needs, in particular Autism Spectrum Disorder, physical, visual, hearing and mobility impairments. Although obviously it is open to any families wanting to enjoy the space. I'd been wanting to visit the play space for some time with my little superheroes and we'd just never got around to going.

When we first moved to Perth in 2010, I made a conscious effort to take O to a different playground in the Perth area each week. There are literally hundreds of play areas to visit, some small and some very large, but all are great fun. We've yet to find a playground that isn't fun. We've had many a playground adventure!

I'm a big believer in letting children play outside, either in the backyard or in a playground. There are so many benefits that can be gained from just playing.

Play really is a fundamental part of childhood and if you have ever read the United Nations Convention on the Rights of the Child, you will know that it states that "it is a child's right to enjoy play and leisure!"

Aside from having fun, children learn so much through the simple act of play!

There's the hand-eye coordination, hand-foot coordination, the development of fine motor and gross motor skills. Children learn to problem solve and take calculated risks.

Then there is the social aspect of play - children learn the art of playing and socialising with other children, they can practise turn taking and sharing. This in turn assists in the development of their communication skills!

Mmm, play is beginning to sound like a therapy session, isn't it!

Without realising, both my little superheroes were participating in a spur of the moment unofficial therapy session. And they both had a ball! 

There was lots of climbing, spinning, sand play and sliding. Livvi's place really does have it all and the play equipment was accessible for children (and adults) of all ages and skill levels.

There was an abundance of sensory equipment as well which was fantastic to see. L spent a lot of time on the spinning equipment. This kid just does not get dizzy, ever!

The twirly slide was also very popular. Both O and L went DOWN and UP the slide numerous times! There was lots of "yee haaing" and "woo-hooing" to be heard!

After roughly an hour of play, they both tired of the area and wanted to go somewhere else. So it was onto one of our favourite play spaces, Woodbridge Riverside Park. Now considering that rain was forecast for the afternoon, I was hoping that the park would be relatively clear of other people. I was completely wrong.

Woodbridge Riverside Park, or the pirate park as my little superheroes know it as, is a fantastic play space. It has a flying fox, a sunken pirate ship, climbing equipment and a lot of natural play areas and it is a very popular play space for families.

Unfortunately for us, there were loads of people enjoying the area and the busyness of the area became too much for both O and L. We weren't there for long before they were both begging to go somewhere else.

While this wasn't a great thing to hear them asking to go somewhere else, it did mean that they were both recognising the signs of anxiety within themselves. This is a good thing!

One of the aspects of this park that I just love, apart from the fact that it has an on-site coffee shop, is that scattered throughout the park are keyword signs. It really is an inclusive play area. We are already familiar with these signs as we regularly use them with L when he struggles to verbally communicate with us. L's face really does light up when he sees the signs that he recognises and can use.

Before we left the Pirate Park, O and L were fortunate to spot and collect a painted rock. Throughout the month of April we participated in the #autismrocks project. The idea behind the project was that people would decorate small rocks with autism awareness messages and they would then leave these decorated rocks in public places for people to find.

The #autismrocks project was based on a similar idea, I just can not recall where the idea originated. Well since then, the idea of leaving painted rocks in public spaces has really taken off and it is now popping up all over the world. Here in Western Australia there are a huge number of people who participate and while we have left a lot of decorated rocks in play areas, we had yet to find a rock.

You should have seen my little superheroes faces when they realised what they had found. L guarded the rock with his life and I am sorry to say that their first rock is probably never going to be re-hidden! The idea is that when you find a decorated rock, you re-hide it for others to find. Not this little gem though! L has not let it out of his sight!

After finding their very first rock, both O and L were keen to find some more rocks, but at a different park!

So off we went -  a dual adventure, playground and rock hunting!

We located a new park that was completely devoid of other people, albeit it was a little wet at that stage. O and L had so much fun, there was lots of squeals of joy as they found rock after rock.

They both re-hid several rocks and I currently have two in my car to re-hide at another park at some stage. I had to bribe them back into the car with the promise of buying them lunch, chicken nuggets and cheeseburgers of course!!

O was stoked to find out the next day that some of the rocks had been painted and hidden by one of her school friends!

And that was my Tuesday, so much more fun than sitting in a car or at specialist and funding appointments. Although I'm not sure what is more tiring, a typical Tuesday or running around like a head less chook on a playground (and rock hunting) adventure.

I know which one I'd prefer to do on a regular basis! Bring on the next school holidays!