Mary Beth Stark joins us this week from Atlanta where she has been a speech and language pathologist for over 40 years at Floortime Atlanta and is a DIR/Floortime Expert Training Leader. She recently wrote a piece in the newsletter for the Interdisciplinary Council on Development and Learning (ICDL) on pre-linguistics as pre-social abilities and that is our topic this week. Please enjoy our podcast below.

Pre-Linguistics are Pre-Social Abilities with Mary Beth Stark

by Affect Autism

Good communication

Mary Beth’s article in the newsletter was entitled Pre-Linguistics: It puts the social in Social Problem-Solving, so I began by asking her how she defines pre-linguistics. She said that they are skills that kids have to have before they start to use language: joint attention, shared attention, initiation, contingent response, and closing circles, to name a few. Good communication is when a person has an idea, can convey it to somebody else, and that person understands what they’re saying, while then the person receiving the message can turn around and say something back, and so on being on the same topic and reciprocal with one another, taking turns initiating and responding, Mary Beth says.

The communication is over when both people are done, not when just one person is done. So it’s not just the ability to talk, but to be heard and to hear what other people are saying, Mary Beth continues. It’s reciprocity that allows a child to pay attention to the other person. It’s reciprocity to know when another person looks bored. It’s reciprocity to understand that you have to listen as well as respond. There’s a lot of pre-linguistic skills that are used in reciprocity that help one become a better communicator going forward.

Pre-linguistic competencies

Below is the chart Mary Beth shared demonstrating the pre-linguistic competencies that are demonstrated with each corresponding Functional Emotional Developmental Capacity (FEDC) in the DIR Model. The first capacity that neurotypical babies develop is that of regulation where they are calm and attentive, sharing attention with some eye gaze with their primary caregiver(s). When they are calm, attentive and interested they next become engaged. When they’re engaged they can hold eye gaze and show facial expressions and emotions in their face.

You can see a range of affect whether they are happy, upset, starting to get concerned, or being nervous. This makes a big deal when you develop because if you don’t have the range of affect, and you get really upset when you’re older, Mary Beth explains, it becomes difficult to get out of that state and think. So a baby can start to have a variety of emotions, and be able to deal with them. Next, the child gets into a reciprocal back-and-forth with an emotional caregiver through eye gaze and observing, even though they aren’t talking yet. They are watching what the adult does and can sometimes imitate vocal noises, and can start to respond consistently.

Here, the child starts initiating an interaction. They will cry when they are upset, with the intention of getting somebody’s attention. This is really when communication starts because they are doing it to achieve a certain effect, Mary Beth says, such as someone will come feed me or change my diaper. They will use whatever they can to get those interactions going at this stage. What’s important here, Mary Beth explains, is that they might use their legs kicking or arms flailing to indicate communication, make noises, or use eye contact.

As the child gets practice with this back-and-forth communication, they can stay in the interaction for awhile and enjoy it. The learning how to communicate happens in this reciprocity: in the watching, listening, seeing how other people react, and figuring out how they can initiate. It’s such an important skill that isn’t given enough attention, Mary Beth tells us, because as important as it is for new communicators, there are many verbal children she works with who are not good at reciprocity. 

How to facilitate these competencies

I asked Mary Beth, what about those older kids? How do we guide this development in them when we ourselves don’t remember learning these capacities that happened so automatically for us as a baby and how do we not impose our way of communicating on them if theirs is different? Sensorimotor, emotional, language, and cognitive development happens simultaneously in neurotypical children. But if your sensory system is not developed, it’s going to affect these other systems, so you need to look at each child’s sensory profile, Mary Beth says.

Once you know the sensory profile, Mary Beth says her goal is to relate to the child by following what interests them. When you do this, you can respond to the child’s intent, not to the child’s words or actions, per se. Mary Beth gave us a nice example of doing this with one of her clients. It’s through this joint interest that Mary Beth is able to challenge and help that child interact and help that child think differently about interaction, she says. 

When kids are verbal, people expect a certain level of thinking and understanding, which has nothing to do with their intelligence. But most people assume they understand that two people are going to be in an interaction until both people are satisfied, but for some of our kids, the interaction is over when they are done. It’s then difficult for them to identify a social problem. They know when they have a problem–when they don’t get what they want, or they want to do something longer, or someone keeps asking them a question and they don’t like it. They find it difficult to see when someone else has a problem.

Kids should be reinforced when they say words, especially if they are starting to use language. But we skip the social part of that. We think that the words are the magical part and that once they have words, they’ll understand all this foundational stuff, but that’s not the case. Many kids use words, and words become magic. This is how I get stuff. I memorize these things and I use these words and that will get me things, and it does take you pretty far. But when you use language that way, it’s very hard to think at a level higher than “I want…” or “I don’t like…”.

Mary Beth Stark

The back-and-forth, the watching somebody’s reaction, and realizing that people don’t think the way I think–which you get through reciprocity and watching–that’s how you think higher and higher and higher, Mary Beth explains. If we could just focus on these pre-social skills by just playing with our kids and forgetting about words, that’s how it starts. Playing hide-and-seek running past your child and pretending you don’t see them while they giggle–that’s where language gets started and how words get meaning. That’s the magic. It’s in the pre-linguistic, relationship, affect part.

The real struggle for parents

I gave an example of slowing down and stretching out an interaction of a child wanting a toy on a shelf into a 20-minute play session using anticipation and affect like Mary Beth described, but explained how some parents are uncomfortable doing that because it feels like we are teasing our child. However, I point out that we are not being mean, but rather being playful and silly to the child’s enjoyment. I shared that many parents do feel like we are walking on egg shells around our children and we really just want to keep the peace and give them what they want to avoid a huge tantrum that could disrupt the rest of the day for everyone.

Mary Beth says that sometimes you just give them the toy. But when you do Floortime and make it a bit more difficult, it’s not just that you’re having the interaction last longer, but in that situation the child gets the opportunity to learn patience and to realize that they’re uncomfortable with this and don’t like it, but the motivation of being in the interaction and knowing or hoping what’s going to come will allow them to build up their discomfort muscle. There’s a lot to be learned from the challenge, she says. I pointed out that Dr. Greenspan called it frustration tolerance and that you work on it when there is time and willingness, not in the heat of the moment or when you have some place to go. Mary Beth adds that it also helps build the emotional range.

Reciprocity leads to theory of mind, thinking, and communicating

Mary Beth and I went through a few more examples of working on this reciprocity with older kids. In terms of children who are non speaking, Mary Beth said that often motor challenges get in the way of them showing they can communicate. Again, it’s about forming the relationship with them, figuring out how their individual neurological system works so she can become a better listener and interactor with them, or so she knows how long she has to wait if she gives them a direction. The pre-linguistic skills are important whether you’re verbal or not. There is a feeling you get with somebody when they get you, Mary Beth shares. Working on the pre-linguistics is what’s going to help our children say what they want or need three times before someone gets them.

I brought up that we want to learn the ‘why’ behind a behaviour and how our son has been playfully screaming loudly. Punishing him every time he screams by taking away something he likes or doing something he doesn’t like as a response only backfired. Mary Beth says we are adults and that would work for adults, but kids don’t think like adults so that doesn’t work. Instead, she said, using the pre-linguistic interactions will do wonders for his later communication. By playfully going back-and-forth about the screaming and setting limits such as me saying he can only scream when we are stopped at the red light helps him later on–even if we have to do this many, many times before he gets it.

Mary Beth says that young children learn by doing: by interacting with it, by smelling it, by feeling it, whereas we as adults can learn a new language by sitting at a table looking at words, saying and imitating. A little kid can’t learn language by someone telling them what to say, Mary Beth points out. They have to learn it and feel it and know how it works, and that’s where the pre-linguistics come in.

Thank you to Mary Beth for taking the time to chat with us about this important topic. If you have any related questions, comments, or experiences, please feel to put them in the Comments section below. Also please consider sharing this post on Facebook or Twitter if you found it informative and helpful.

Until next time… here’s to affecting autism through playful interactions!

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