More than words: Being nonspeaking nonverbal

At Demelza, many of the children we support are nonspeaking/nonverbal. There are lots of different reasons this could be: some children may experience delays in reaching developmental milestones, including speech and language; some may have conditions that affect their muscles or their motor skills, meaning they physically cannot speak; others may have autism or other developmental differences that manifest in difficulty processing or producing spoken language; and some children may have conditions that affect their cognitive capacity, impacting their ability to understand words and language. Speech can also be lost later in life, due to conditions such as motor neurone disease or specific cancers.

What does nonspeaking/nonverbal mean?

Put simply, nonspeaking/nonverbal people do not speak, or have minimal speech. Being nonspeaking/nonverbal doesn’t equate to a lack of intelligence or inability to communicate complex thoughts. While some nonspeaking/nonverbal people do not cognize words, many nonspeaking/nonverbal people understand speech and writing, even though they don’t speak themselves. Instead, they often use alternative methods of communication that utilise words, such as spelling boards, signing or speech generating technology.

Nonverbal is a term that is rooted in medical vocabulary, traditionally meaning a person who doesn’t use spoken language. Recently there has been pushback on this term, with some feeling that it implies a lack of cognitive function or being incapable of language. Particularly within the autistic community, nonspeaking is often the preferred term as it better reflects their lived experience, describing the way they communicate, rather than implying that they can’t.

How do nonspeaking/nonverbal children communicate?

There are a lot of ways to communicate that don’t need speech. With a little support, many nonspeaking/nonverbal children can express themselves using alternative communication systems, ensuring that they are able to make choices, share their experiences and fully participate in the world around them.

Writing/typing

If a nonspeaking/nonverbal person has full motor control, or their motor function is minimally affected, they can communicate through handwriting or typing, the same as a speaking person.

Signing

Using hand signs is common form of communication. Many children use a simplified signing system called Makaton, either as their main communication method, or to support speech. As well as nonspeaking/nonverbal children, Makaton is increasingly used by the general public to aid and develop communication. We have a number of Makaton specialists on our team who help children and their families find ways to communicate with each other.

British Sign Language (and finger spelling) is an officially recognised language that is mainly used by Deaf people or people with hearing impairments, but can be learned by anyone, and uses gestures, facial expressions and body language to communicate.

Picture Exchange Communication System (PECS)

PECS is a communication system where learners are taught to exchange pictures for the things or activities they want. It is focused on encouraging nonspeaking/nonverbal people to express their needs and nurture independent communication. Originally developed for young children with autism, it’s become more widespread and has been highly successful in supporting the development of communication skills.

Choice boards

Choice boards give nonspeaking/nonverbal children the opportunity to express themselves and empower them to make choices. The boards feature a grid system containing core vocabulary words or symbols (these can be customised to a child’s daily life) which are then pointed to, meaning nonspeaking/nonverbal children can construct sentences, share their emotions and ask for what they need.

Spelling boards

Similar to choice boards, spelling boards are a grid of letters which can be pointed at to spell out words and create sentences, allowing nonspeaking/nonverbal people to communicate directly and in their own words.

Speech generating devices

Speech generating devices are augmentative and assistive communication (AAC) systems designed to replace or support speech, which use varying interfaces, such as a keyboard, a joystick, light pointers or eye tracking, to produce an electronic voice which speaks on behalf of the nonspeaking/nonverbal person. At Demelza, our partnership with inclusive technology charity Lifelites means we can provide access to Eyegaze technology, which enables children to communicate, play and create, using just the movement of their eyes.

Expressing beyond words

Sometimes, words fail all of us. So, we offer creative therapies as an alternative to traditional talking therapies. Creative therapies give children, including those who speak, the opportunity to express themselves in ways that don’t require words. Often children don’t have the language to describe what they’re going through, so creativity gives them tools to explore their emotions without having to give them names. Instead, they can give their experiences colour, sound and texture, demonstrating what they’re feeling through shapes and noises. Creative therapies provide children with a form of communication that is cathartic, allowing children to act out their emotions and release them.

We know the children we support have their own unique voices, even if they don’t speak. No matter how they communicate, we make it our mission to understand them and their families, and enable them to live their fullest, most connected and meaningful lives.