For parents, one of the most frequently cited first-signs of autism in their child is a complete lack of or delayed speech. While there may be earlier signs that are present such as a lack of eye contact, those signs are far more subtle and are not immediately obvious.
The reason a delay in speech is commonly observed in children with autism is that one of the core features of autism is a lack of joint attention. Typically developing infants are naturally attuned to others. This means that children get feedback and information about their world from other people. Children with autism on the other hand tend not to pay as much attention to other people. Thus, their capacity to learn a variety of skills including speech is impeded.
In the Early Start Denver Model, one of the most effective method of teaching speech is using the one-up rule (Rogers & Dawson, 2010). It is a method I have found great success with and is exceptionally simple to use.
The crux of the one-up rule is to add an extra word to the number of words that your child currently uses in any given phrase and repeat it back to your child. In other words, always add on one additional word to your child’s sentences. If your child currently possesses no words, then speak in single words. If your child uses one word, speak in two words and so on.
1. Child: (sound) + reach for cup
2. Child: Ball!
You: Big ball!
3. Child: I want crackers
You: I want crackers please
The point of the one-up rule is to meet your child at his or her current level of speech and then adding on one extra word which you are trying to teach. One common question I get from parents is “how do I know what word to teach?”. While it is a perfectly understandable question, it doesn’t really matter what word you are adding in as we ultimately want our child to understand and use a wide variety of words. What matters is the addition of the extra word. As your child picks up more words, it is important to continue adding on the extra word and also expecting that your child doesn’t “get lazy” by using less words than they are capable of.
Without being made aware of this rule, almost all parents will use far too many words (sometimes up to 10 words over their child’s current sentence length) which confuses a child and results in a child that ignores instructions given by parents (another commonly reported problem) as well as reducing a child’s ability to learn and use new language.
Billy is having a great time jumping on the exercise ball with the help of his father Joel. Billy currently speaks in single words and is saying “jump” to get his father to continue helping him jump on the ball. He has now said “jump” over five times in succession now. Joel recognises that it is now a great time to teach Billy another word to go along with “jump”.
There are many valid options such as “more (jump)”, “big”, “small”, “(jump) up”. Joel decides that he wants to teach the phrase “jump up”. Now, every time Billy says “jump”, Joel repeats “jump..up!” making sure to emphasise the “up”.
After repeating this five times, Joel now increases his expectation of Billy. When Billy says “jump”, Joel repeats “jump….”. However, instead of saying “up”, he looks at his son expectantly while also holding him still on the ball without jumping.
After a brief moment of silence, Billy says “up!” and Joel repeats back excitedly “jump up!” and resumes bouncing Billy on the ball.
After a few turns of this, Joel again increases his expectations. He wants his son to combine “jump” and “up” into a 2-word phrase. He suddenly stops bouncing Joel on the ball and looks expectantly. Billy says “jump” but Joel does not bounce him. Instead, he looks even more expectantly at Billy. After a second or so, Billy then says “up”. Joel is very excited and again repeats “jump up!”, emphasising the “up” and continues bouncing Billy on the ball.