Teaching Yes or No Communication

Yes or no? A simple question. Yet so hard for some children with special needs to answer.

The most effective, simple, non-verbal communication method we have used with our daughter has been teaching her how to tell us "yes" or "no" in a way that works for her. This has not been easy, since she does not shake or nod her head, does not point, has trouble with signing, and she is non verbal. What a challenge.

We figured that we could find out almost anything from asking yes or no questions. But how could we get her to tell us? I mentioned what she could not do, which made communication a challenge. But she could physically pull PECS pictures off of velcro. So we began with what she could do.

We designed a small velcro card with "Yes" and "No" squares attached to it. It was portable, needed very little explanation for use with other people (like childcare workers at church, or other therapists or teachers), and very easy and cheap to make. We chose text on a plain background, because Lilli can read. Lilli chooses and pulls the answer card off of the velcro. Others might consider colors and faces, depending on your child's needs. This is a great starting point for any child who is not showing interest or success with sign language, and for parents and teachers who do not have access to a

communication device. (On a side note, we did try cutting out pictures and words and laying them on the floor. This did not really work well with our daughter at first, perhaps because of the visual difference of looking down at the cards. Plus there is just something about velcro. Everything is trial and error.)

After months of teaching her to pull the card off, (I tell a little about the method of teaching her at the end of this post) Lilli did finally learn to point and touch a yes or no button on an ipad or iphone screen. This took us a very long time, but it was so worth the months of repetitive teaching. Now we can give her choices about many things, from what she wants to wear, to whether she likes or wants something, to if she is tired, or... just about anything. We still keep the cards around, because they are great back-up in case the device needs charging, etc.

One of our favorite apps is the "Yes No" app. Ours is called "Answers:YesNo Free" made by SimplifiedTouch Education. You can change the voice, select pictures or text, and there is a second page with a set of buttons as well, that you can design to say whatever you want. Lilli's has a child's voice saying "Yes" or "No" for her when she touches the buttons. I LOVE, love this functional app, and we use it all the time. It is so easy to pull the phone out of my pocket and ask her a quick question. She has learned to look at it and touch the buttons purposefully, to answer me. The bonus is that it is free! There is an upgrade for $1.99 which gives you more options for screens and buttons. There are many Yes or no apps, but be careful before you select and buy one. Some are only for fun, and are more like fortune telling apps where you ask a silly question and it answers "yes" or "no" for you. So make sure you are buying a functional speech yes or no app, not a fun one.

A screen shot of the Yes No app on my phone

On Lilli's ipad, she has a folder in her Proloquo2Go app with just "Yes" or "No." We use the velcro cards, the ipad, and the iphone app depending on where we are and what we are doing. The great thing about the velcro cards is they are cheap, and if you lose them, it is not the end of the world.

Sometimes it might take a long while, and it feels like a never ending game of "Twenty Questions." But at least we have a place to start. One of the biggest challenges was to teach her that she actually had a choice, since she spent the first six years of her life not really having a "say."

Important points to remember: 

1. Always keep the yes and no in the same place. We do not switch them up to "test" our daughter. This is functional communication. Think of how you speak to others in everyday conversation. Typically, I say, "Would you like this? Yes or no?" The yes comes first when I give a verbal choice. Most people put the yes first. So on the card, I always put the yes on the left. I tell everyone who uses the card to keep it that way. Sometimes Lilli will feel and grab, and not look. She assumes that the "yes" card is consistently on the left, so we keep it that way for her.

2. Use it all day long, for even the little things. This helps your child feel a sense of control in his or her life. I ask my daughter, "Would you like tomato on your sandwich?" "Would you like to wear this shirt?" "Do you want to go outside?" Non verbal children often have very little control in their lives, and they might be used to just doing what everyone tells them to do. We noticed a positive change in our daughter as we began to give her more choices in her life each day. We are teaching her that her opinion matters. As a parent, I had to learn to catch myself and anytime I would say, "Come on, Lilli, let's...." I would change it to, "Lilli, would you like to...?" and I would hold up the yes no cards for her to give her choice. Then I had to honor that choice, so I made sure I only gave her a choice when there was actually an option for her to say yes or no.

3. Word your questions clearly and carefully. Avoid double negatives. If possible, put the object in front of the child as you are asking about it.
Good example: (bowl of popcorn in front of child) "Do you want some popcorn? Yes or no?"
Bad example: (no popcorn in sight) Do you not want a snack? Don't you want popcorn?" (Huh?!)

4. Have patience! This is new! Do not be frustrated when beginning to teach your child this method. Try different ideas until you find a way that works. If your child cannot read, make the yes a green smiley face, and the no a red frown face. If the velcro is too hard for their fine motor skills, use magnets on the backs of the cards, and a small tin ( for example you might paint over the back of an old Altoid tin or find some other small magnetic surface to use. The Altoid tin would work well to keep in your purse or bag, and you could store the yes no cards inside it when not in use.)

5. Be consistent and try many times, do not give up! Remember, this might be a completely new concept to your child. It may take a little while for your child to realize how great it is to have a say! Our daughter did not get it right away. We tried consistently for many weeks until one day we realized, wow, she got it! Now, it is a part of our everyday life with her.

Tips for how to teach:

Begin with hand over hand. Model it for your child. Start with an easy choice. "Do you want to play with this toy? Yes or no?" Take your child's hand and help them point to, grab, or touch the yes and no as you slowly say them. If they do not answer, model by helping them push/select the "Yes" and say, "Yes, I want to play with this toy. Ok, yes, let's play with it." Then sit down and play with the toy with your child for a few minutes.

Model again. "Do you want to keep playing with this toy? Yes or no?" Take your child's hand and slowly touch each choice. If your child seems ready to be done with the toy, model: "No, I am all done with this toy." Select "no." Put the toy away.

Try with other activities. "Do you want a chip? Yes or no?" If your child loves chips, help them touch the yes, and then give them a chip! Food works well to teach a child to use "yes or no" in making choices.

Teaching our daughter how to "say" yes or no has been life changing for us, and I hope it helps someone else too! Please comment if this is helpful to you or if you have any other tips for using "yes" or "no." Thanks!

Our Current Communication Method

Of all of the methods we have tried with our daughter over the years (and we have tried a lot of things!), the ipad has been the most helpful so far for communicating with our daughter. I will be adding future posts with more specifics about other communication methods we use and have tried, and some of the different apps we currently use with her on her ipad. 

Just so you know where we are coming from, a little background on our current communication system...

The ipad we currently have is provided by the local public school district. Our daughter is allowed to have it at home and use it all throughout the day and evening, for everything (she is medically homebound right now and has a teacher from the school come in to give her lessons). We use the communication app “Proloquo2Go.” It is kind of like PECS pictures (PECS stands for “Picture Exchange Communication System) that talk for you when you touch them. 

I realize this might seem unheard of or "not an option" for some of you, but I will say again that my daughter goes to a public school. When teachers and administrators began to see what was happening with non verbal students using the ipad to communicate and learn, excitement began to build. The results were life changing. Doors were opened, and non verbal students were given this amazing opportunity. Typically parents feel that they would need to "fight" with the school district to provide this. But we did not fight at all. The ipad and the apps are that good. Instant success is evident. It is not impossible. It is also possible for some to receive a tablet device through a speech therapist, covered by insurance. These are all details I would love to write about in a future post.

We did love our PECS. It helped us finally have a way to begin to communicate with our daughter. PECS have their benefit, and I actually think they may be necessary to some extent to prepare certain children to use the Proloquo2Go app (as in our case). However after using PECS for many years, the ipad has made our lives much easier. We can use PECS as “back up” if the ipad is not available (charging, forgot it, someone got it wet and it is in a bag of rice– happened to us once…) but we focus almost completely on the ipad now for communication. Adding and changing “buttons” and “pages” takes seconds or minutes, compared to much more time as before with PECS.

If you have no communication system at all right now, there are many options to try. But for someone who has already been trying other methods and feeling frustrated, consider the ipad or another tablet device. Maybe you would like to try an ipad, but you are not sure about the cost of the ipad and apps. You might think that it is too expensive. If you are using PECS pictures right now with someone who is non verbal, think of all the time, energy, money, effort, and trips out to make these pictures. You might love your PECS system. It works for you. Your child understands it, uses it and things are just fine. Allow me to suggest that you take a closer look at the benefits of the ipad and different communication apps before deciding that it is just too expensive.

We were happy with PECS to a certain extent, but I struggled with every part of the process of making it happen: our bad quality color printer, finding the images we needed, not being able to afford Boardmaker and having to find other ways to get the symbols and images, making new PECS books and shopping for binders and plastic “pages,” constantly running out of ink, the trips to the office store to get them laminated, having friends and family help by cutting them all out, scouring the stores and internet for the best prices on large amounts of Velcro, and the worst: losing the PECS pictures or having them get wet or damaged after all that work. We have had PECS pictures fall in the toilet, get thrown behind furniture, get crumpled up or folded right after they were newly made, and get chewed on. They have been lost at school. Some teachers at school even used the PECS system incorrectly because they were not properly trained to use PECS. (More on that in another future post.)Tell me, is this hitting close to home with any readers?

If you take those factors into consideration, you might think it is worth it based on the trouble alone to find a way to get an ipad. We were blessed to have our school district offer to let our daughter borrow one. Even though it is not ours forever, we know that it would be well worth the effort to find a way to buy one if we should need to purchase our own in the future.

Based on our experience and knowing that others in our situation might also have limited budgets and might not be able to afford to purchase an ipad, I would encourage others to think outside the box a little. See if you can try one out – from an OT or speech therapist, a teacher at school, a friend who has one maybe. Ask family members to consider going in on a gift for the next big holiday or birthday and contribute towards an ipad. Create a special fund for the ipad savings and work toward that goal over time. It will be worth it if your loved one can use it as their “voice.”

Look for future posts about Proloquo2Go and other apps soon!

Introducing...

Dear friends,

I thought I would begin this blog by telling you a little bit about me, and why I feel passionate about helping people who are non verbal.

I have a daughter who cannot speak.  Lilli is eight. When she was four, one therapist told me she did not think Lilli could understand how to communicate using pictures. She tried one time, and the session went terribly. I remember leaving the clinic that day, feeling defeated and hopeless.

Several months later, a different therapist told me that there was no excuse for any person to NOT have a way to communicate, and that she would try everything to help Lilli to learn functional communication. She believed in Lilli. She helped Lilli to learn to use pictures to tell us things.

 The second therapist changed our lives. I have never forgotten her, or the simple hope she gave us.

Two things I have noticed over the years:

   1. There is a great need for easy-to-find, parent-friendly, affordable resources that are specifically for parents, therapists, family members, and teachers of people who are non-verbal. In my own personal search, I have felt frustrated.

   2. There are still many children and even young adults who have no way of communicating, despite the fact that there are ideas, devices, and therapies that can really help. There are even adults in this situation - perhaps from a brain injury later in life- and their families are struggling with the overwhelming situation and need simple ideas for communication with their loved ones. We need to have a place to go for these ideas.

Some parents and teachers just have no idea where to start. Some children are in classrooms with overwhelmed teachers who have limited budgets, no parent support, and few ideas for inspiration. Personal stories I have heard explain many different reasons. Some have to do with lack of funding and insurance problems. Some have to do with parents not knowing what is available for their child. Some parents are overwhelmed with the special needs of the child and do not even know where to begin. Sometimes children are passed through the grade levels and years of school without communication, and no one seems to think it is a problem at all, even when the child has no way whatsoever to tell another person what he or she wants.

The saddest reason to me is that sometimes, a person simply does not believe that a child will ever learn to communicate, so they do not even try.

 One of my greatest desires is for my daughter Lilli to be able to tell me what she wants, what she is thinking, what she loves, what she dislikes. I do not know what the future holds for her, but we are on an incredible journey trying everything we can. Along the way, I cannot help but write about what we are experiencing. I want to connect with others that are sharing similar struggles, and share ideas with each other.

I am passionate about researching ways to communicate with someone who is non-verbal. (Some people say non-vocal.)This blog is for anyone who knows someone that is non-verbal, non-vocal, or needs extra help with communicating. I want to share and provide a place for ideas and hope.

I will happily include communication ideas from those who would like to submit them. You can email me at Tellmeblog@aol.com. I welcome your comments, suggestions, experiences, ideas, or just a simple hello letting me know you stopped by. Thank you so much for visiting!

Sincerely Yours,
Jennie