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Why Does My Non-Verbal Child Need Speech Therapy?

Speech therapy is more than improving speech. It also helps non-verbal children to communicate.

When you hear the term “speech therapy,” you might imagine a therapist helping a child to address a lisp or a stutter. While improving speech fluency is one part of speech therapy, speech therapy overall aims to address any barriers that prevent children from communicating. This means that speech therapists can help non-verbal (or non-speaking) children find alternative ways of communicating, aside from verbal communication.

If your child is unable to speak, you know how frustrating it can be for them to make their wishes known, and how frustrating it can be for you not to know what they need. “I’ve never had one conversation with my child,” says Becky Ashcraft, whose 14-year-old daughter, Veronika, is autistic and non-verbal. “I don’t know what she likes. I don’t know what she wants. I don’t know where it hurts.”

Working with a speech-language pathologist (SLP) can help your child find ways to communicate, even without speaking.

What is Speech Therapy, and Who Can It Help?

Speech therapy can help children who are non-verbal due to any number of neurological disorders, such as autism, genetic disorders like Down syndrome and CDKL5, and disorders such as cerebral palsy or HIE (hypoxic-ischemic encephalopathy), often caused by traumatic brain injury.

An SLP can help your child to discover ways of communicating nonverbally using a variety of techniques and tools, called AAC (augmentative and alternative communication) devices. An SLP uses these tools to work with children to strengthen their receptive language (understanding what another person is saying) and their expressive language (putting words together to express thoughts).

If you’re concerned about your child’s communication abilities, it’s never too early to consider speech therapy. “The earlier the better,” says Jaime Van Echo, MS, CCC-SLP, associate director, Clinical Issues in Speech-Language Pathology at the American Speech-Language-Hearing Association (ASHA). “As soon as you identify that a child has some area of need, or might have an area of need, it’s always a good idea to consult with the speech-language pathologist to see what you can be doing.”

That said, it’s also never too late to start. Even older children can benefit from speech therapy. “Progress can be made at any age,” says Kjirsten Broughton, MS, CCC-SLP, co-founder of Southern Nevada Speech and Language Services.

What Types of Therapies Can Help My Non-Verbal Child?

Your SLP will match a therapy to your child based on their communication needs and what tools they’ve used in the past, if they have used tools. Broughton says some of her nonspeaking clients already have a communication device when she starts working with them. If not, she’ll assess if they’re already communicating using sign language, gestures, pointing, their eyes, or something else. For some children, their “access point,” or way to communicate, hasn’t yet been discovered. “I want to see where the child is right now, and how I can jump in and get their wants and needs met,” she says.

Sign Language

Signing gives nonspeaking children a way to express themselves without words. The SLP teaches your child a few simple signs, often taken from American Sign Language, such as “hungry,” “tired,” or “diaper.” Your child may learn to mimic the signs, sometimes developing their own interpretation of the sign, depending on their ability to use their fingers, hands, and arms. An SLP will help you identify when your child has learned a sign. It’s important to continue to use the correct version of signs, while allowing them to use their versions. Over time, their versions may improve as your child’s fine motor skills improve. Sign language can be a positive alternative to unproductive attempts at communication, such as crying and screaming.

AAC (Augmentative and Alternative Communication)

AAC is an umbrella term for a group of communication techniques and devices that SLPs and parents can teach children to use in place of speech. Children can use AAC to express simple responses (yes/no) or specific needs (food/water/sleep/play).

AAC includes low-tech options such as:

  • Facial expressions
  • Gestures
  • Pointing to letters, words, or pictures
  • Drawing
  • Writing

Or it can involve high-tech options like:

  • Buttons or switches that play simple pre-recorded messages such as, “I’m hungry” or “I want to play” when pressed.
  • A computer with a speech-generating device that the child controls by touch or eye gaze.

Learn more about AAC devices here.

What to Expect from Speech Therapy

Speech therapy includes a combination of activities to engage your child and family, as well as one-on-one training on the use of AAC, says Van Echo. Children might see an SLP one day or more each week, depending on their disorder and needs. Sessions can range from 30 minutes to an hour.

The goals are tailored to your child’s needs. For example, if your child doesn’t understand language, the SLP works on receptive language skills, like practicing the multi-step directions needed to put together LEGOs or prepare a recipe. If you don’t know what your child understands, an SLP may try to assess your child’s access point to begin the communication process.

Your SLP will start the first session with an evaluation to figure out what kinds of interventions will help your child the most. They’ll ask you questions about your child’s communication abilities, and then observe your child’s play and interaction skills. The SLP might also use a process called dynamic assessment to identify your child’s current skills and learning potential. This involves teaching a skill and then evaluating whether your child understood the skill and, over time, improved at performing it.

Every time an SLP introduces a new activity or type of therapy, they do so with consideration of the child’s trust in them. “You first have to really establish good rapport, because the child needs to trust that what you’re doing is safe,” Van Echo explains. Instead of starting a brand-new technique with a new client, she’ll introduce the concept she’s trying to teach with a tool the child has already used, to make them feel more comfortable.

Veronika Kovach on a slide at a therapy center
Credit: Becky Ashcraft | Veronika Kovach

Ashcraft’s daughter, Veronika, began speech therapy when she was around 2 ½ years old and has learned a number of techniques. One therapist taught her how to use a switch—a big button that records sounds—to indicate a “yes” or “no” answer, and she has used iPad language applications. Picture-based AAC devices, like the Exchange Communication System (PECS) and Proloquo2Go, have worked well. “If you show her two pictures, she can point to which one she wants,” says Ashcraft.

How long should you work with a speech therapist? The answer is unique to your child. “I have parents who ask me that question when we’re first starting therapy, but unfortunately, there is no way to know,” says Broughton. “Sometimes a kid might pick up a skill in one session, and sometimes it might take months.” Practicing the new techniques with your child at home can speed their progress, she adds.

How to Find a Speech Therapist

SLPs work in a variety of settings, including private practices, schools, and hospitals. You can find one in your area by searching on ASHA’s website. The directory lets you filter your search by areas of expertise and ages treated.

Another option is to get speech therapy through your child’s Individualized Education Program (IEP) at their school, or your state’s Early Intervention program. Veronika’s pediatrician referred her to an early intervention program in Indiana called First Steps, which provided a speech therapist who came to their house.

Broughton suggests doing some research online, reading reviews, and then talking to the prospective SLP before you commit. Make sure their practices align with your communication goals for your child.

How Much Does Speech Therapy Cost?

The average speech therapy session costs between $100 and $250 per session, depending on where you live and which provider you choose. Expect to pay more for the initial evaluation visit.

If your child has a neurological disorder, insurance plans or state care, like Medicaid, will usually cover the cost, and sometimes for more than one session per week. If you are planning to use insurance, you may need to get a doctor’s referral, such as from a neurologist, to have the visits covered, says Van Echo.


References and Further Reading

Disclosure: Occasionally, we include links to recommended products. When you purchase a product through a link, we may earn a small percentage of the sale, at no cost to you. These sales contribute to the operation of our site, and help to keep content free to read.

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