Vacationing at Lakeside 2016: Augmented Communication and Pointing
When Nathaniel was fourteen months old, our then speech therapist asked if he was pointing at things. She expressed the importance of pointing and joint attention in language development and stressed that these were precursors for further language growth. She advised that I should place Nathaniel, who was still new at sitting up, in the middle of the room with everything desirable out of reach. "Unless Nathaniel points to the object, do not let him have it. No toys until he points to them."
Nathaniel was perfectly content to sit quietly for full days without toys.
Our therapy sessions through this season were riddle with frustration. For the therapist and me. I have previously documented our attempts at using pictures and a two-button recordable mid-tech device. Following up on therapy homework, our family modeled pointing for months; Nathaniel never seemed to catch an interest in mimicking our efforts. He participated in the joint attention when we instigated, but he did not instigate. In the end, we moved on. To a new speech therapist and new techniques. Pointing fell lower on our priority list; we did and continue to do it naturally as all parents do with children, but not with the intent we once did. Not with expectation that if we pointed x more times every day, he would be pointing by the end of the week.
Our recent focus for speech therapy homework has been to solidify the motor plan for fifty (mostly) core words on Nathaniel's device through rote drill and to model two word combinations using those fifty as a springboard. In recent weeks, we have focused on drilling two word combinations. Nathaniel has started voluntarily offering his own two- and three-word phrases, frequently with words we have not drilled which tells me he knows where a lot more than fifty words are located on his device. Simultaneously, Nathaniel is pointing. A lot.
We are on vacation this week on Lake Erie. My childhood home is a summer Chautauqua. I wrote extensively about growing up as a year around resident in this setting when we were here last year. I invite you to read Vacationing in Lakeside 2015 - Part 1 for more details of the experience. Walks to the dock to watch the sunset are a nightly occurrence every year. Last Saturday, our first night, Nathaniel pointed at a sailboat and used his talker to say SHIP. An ocean freighter was at the Marblehead limestone quarry loading dock, so I clarified with pointing and the talker that THAT was a SHIP and THAT was a SAILBOAT. His cousin piped up, also pointing, that the motorboat racing past was a BOAT. Nathaniel studied his transportation page intently as we opened these new-to-him words.
Nathaniel's gestures are both deictic and representational now. Interestingly, the later tends to emerge after two-word utterances and the former emerges in partnership with spoken speech (point to banana and say "eat") at the same time as two-word utterances in typically developing children. Perhaps Nathaniel skipped the entire early phase of pointing because it was not practical. Since he could not make any noise, how would he of gained the attention of a communication partner so that his pointing was seen? Perhaps this is another example of how applying the language development of typical developing children to those who need AAC can cripple the AAC user. For Nathaniel, it was only after being given the opportunity (through his high-tech voice generative device) to gain our attention, that he seemed to understand value and purpose of pointing.
I saw this at dinner last night. Nathaniel was vacation fun exhausted. He has vetoed a nap many days, and he was ready for bed as the family ate supper. There were nine at the table. The chatter was constant; the laughter hearty. Everyone had something to tell of their day. Nathaniel quietly looked around the table, directly at each sibling, cousin, aunt and uncle, and waved bye-bye. Nobody noticed him. So he said GIVE BED NIGHT-NIGHT with his device. Everyone stopped and turned his way. He looked from person to person around the table again and waved bye-bye, and in so doing, offered a personal "good-night" to everyone. Gesturing alone, without his device to earn him the attention of communication partners, was worthless.
Vacation has allowed a reuniting week with Josiah. He has spent that last eight weeks in Wisconsin doing an internship with my brother's photography company. Not many vacationers have multiple professional photographers every step of the way. We have enjoyed both the time with family and their amazing skills with a camera. We have Ben's girlfriend along with us too. Our pre-teen niece is enjoying the presence of another female situated age-wise between herself and the mother - grandmother aged women. As every year, Lakeside weeks reconnects us to each other and grounds us again with the peace that only the lake and home can offer.