Q: I have an 8-year-old student, in a regular second grade classroom. She can say a few words and carries a diagnosis of apraxia. She is below average in intelligence. The parents are insisting on sign language training only and are refusing other forms of augmentative communication – computer, pictures, etc. She can do up to five signs in sequence with prompting, but verbal speech is not coming along. She is failing further and further behind in academics because of the lack of communication. What are your suggestions?

I am concerned about her lack of other forms of communication for three reasons: Social, Academic, and Safety.

Socially

I would ask the parents how they plan to integrate their child into the community with sign only. This child will not be living in a signing world. When she is not with her parents, how will she communicate when she goes shopping or to a movie? How will she order in a restaurant, or talk with a post office clerk or bank teller? How will she communicate with potential new friends?

Academically

Symbol systems are not just for social communication. They also help develop cognitive skill. The ability to manipulate concepts allows one to develop cognition. The few spoken words this child says allow her to manipulate a few concepts. The signs she uses allow her to manipulate some more concepts. Pictures and written words would allow her to manipulate even more, perhaps many more, concepts. If this were my own child, I would want her to have as many ways to manipulate concepts as I she could handle so that she had maximum opportunity to develop her thinking and reasoning skills.

Safety

Finally, limiting the child to sign only may impact her safety. What if the child gets separated from the mom in a crowd at the mall or elsewhere? How will she tell another adult who she is, where she lives, or her parent’s names and phone number? A child who is minimally verbal, but whose cognitive skills are fairly high, needs to be prepared for interaction with the broader world.

Every parent has to do what they think is best for their own child, of course. But I believe that these parents do not realize how they are limiting their child’s performance by restricting her access to only one type of symbol system. Maybe these ideas will help the parents see the bigger picture. I hope they will become more interested in a multifaceted approach to alternative and augmentative communication.