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From Chapter 7, SCRIPTS FOR CHILDREN WHO SAY WORDS OR PHRASES

Gary

When Gary was enrolled in the Early Intervention Program, he had no speech and he seldom babbled. Because he smiled when rocking on the seesaw or when pushed in the chair swing, his instructors frequently provided these activities and they soon noticed that when the seesaw or the swing stopped, he sometimes vocalized. These observations were important because they suggested procedures to increase babbling. Many opportunities to swing and rock on the seesaw were interspersed with other learning activities, and swinging and rocking were often intentionally interrupted. His teachers stopped, waited, and looked expectantly at him, and when he vocalized they quickly resumed the activity. In less than a month, these procedures produced increases in Gary's babbling, and his instructors that the sounds "ee" and "buh" were frequent, although he did not imitate these sounds when they were modeled by others.

In verbal-imitation sessions, Gary's instructors modeled the sounds "ee" and "buh" and rewarded his efforts to approximate their models by providing favorite toys and snacks. Initially, they helped him imitate by gently pushing the corners of his mouth into a "smile" position when they modeled "ee," and by gently holding his lips together and quickly releasing them when he attempted to say "buh"; these manual prompts were discontinued when his imitation skills improved. As soon as adults could readily distinguish Gary's production of "ee" from his production of "buh," a third sound ("ah") was introduced. It was selected not only because it was occasionally heard when he babbled, but also because it was possible to use a manual prompt (applying gentle, downward pressure to his chin) to help him open his mouth to correctly imitate sound.

Now it was time to make Gary's speech sound meaningful. His teachers observed his choices of toys, activities, and snacks, and after reviewing his preferences they decided that "ee" would represent the word eat, "buh" would be used an approximation to bubbles, and "ah" would be accepted as the word "on" (which would mean "turn on the videotape"). After these decisions were made, his first scripts were recorded on audio cards, and pictures of snacks, bubbles, and TV were attached to the relevant cards.

But before Gary was ready to say the three scripts, some additional teaching was necessary: An instructor manually guided him to play a card by running it through the card reader and waited for him to imitate the target word, and was not surprised when he did it. In subsequent discrete-trail sessions, his instructors manually guided him to play the audiotaped scripts "eat," "bubbles," "on," then quickly modeled the target sounds that he could say ("ee," "buh," and "ah"), and rewarded his imitative responses. Next, while continuing to use graduated guidance to help Gary play the audiotaped scripts, the instructors gradually decreased their voice volume until they no longer vocalized the target sounds, and he began to make those sounds after the audio cards were played. Now, he was ready for his first experience with scripts.

Gary learned to remove the cards from his activity schedule, move to the card reader that was located on the same little desk, play an audiotaped word, approach and orient toward a nearby conversation partner, and approximate the word on the audiotape. When he played the script "eat" and approached an adult and said "ee," the adult smiled, enthusiastically confirmed, "Eat," put him on her lap, and offered one of his preferred snacks. When he played the script "bubbles" and said "buh," his conversation partner took his hand and said "bubbles," and quickly blew bubbles that he attempted to catch. And when he played the script "on," and said the approximation "ah," his interaction partner said "on," put him on her lap and turned on his favorite videotape.

Gary's imitation of the audiotaped scripts became increasingly accurate. After several weeks of practice, he surprised and delighted his interaction partner by playing a script, approaching her, and saying something that sounded very much like "bubbles."

Initiating Conversation with a Word or Phrase

When children with autism learn to say words, our expectations change. Now they must not only go to the card reader and play an audiotaped script, but they must also say the script (or an approximation of the script). A toddler who has learned to say a few words has scripts such as "up," "go," and "pop"; when he says these words to his mother, she confirms these initiations with one or two words ("up high," "go out," "lollipop"), picks him up and tosses him in the air, or helps him go out to the back yard for a quick walk or a chasing game, or helps him lick a lollipop. Other examples of one-word scripts are "book," "swing," "ride" (trike, wagon, or piggy back): "play" (with a favorite toy): and "TV," "car," "ball," "tickle," and "cup." Scripts are selected because a youngster can say the target words, which, although they may not be perfectly articulated, are understood by those who know him. And as noted earlier, scripts are also chosen because the objects or activities they represent are preferred by the child.

When children learn to say phrases, they may have scripts such as "want up," "play horsie," or "tickle me." Other scripts enlist adults' assistance; for example, a card with the audiotaped script "help me" may be accompanied by a picture of a special toy that is kept on a high shelf, beyond a little girl's reach. She plays the audiotaped script, approaches an adult, and repeats "help me," and her interaction partner makes a brief reply ("Sure, I'll help") and obtains the requested toy. Or the audiotaped script "open please" is paired with a picture of a favorite snack in a transparent plastic jar with a tightly closed lid, so that saying the script "open please" results in the reply, "I'll open it," and assistance in opening the container. Of course, if children do not say the scripts, behavioral rehearsals are conducted until the target responses are independently displayed.

Both parents and professionals often make very accurate observations about the words children do and do not understand. When a girl learns to say one-word scripts, her father may decide to make small, careful changes in his responses. For example, when she approaches him and says "ride," instead of merely confirming by saying "ride," he may say "ride trike," or "go ride trike." But it is important not to ask questions ("Where's your trike?" or "What do you want to ride?"), and not to give directions ("Go find your coat," "Come with me"). Questions and directions transform the activity from conversation to instruction, and defeat the purposes of scripts and script-fading procedures.

When a child masters one or two sets of three scripts, you may decide to add one or two new scripts to each set, and then to again rotate the scripts across different positions in the activity schedule. Next, you may move the card reader farther from the youngster's activity schedule, and then increase the distance between the card reader and the conversation partner. These changes must be gradual; if the conversation partner moves three additional feet from the card reader and the child does not say the scripts, the conversation partner returns to her original location. When the youngster again correctly says the script, the distance between card reader and conversation partner is increased in small increments (perhaps one foot at a time) after one or two sessions in which the youngster correctly says the scripts.