Functional Communication

Is your child struggling to express wants and needs?

Is your child:

  • Having trouble asking for help?
  • Demonstrating challenges with communication?
  • Crying and deliberately falling on the floor instead of asking for a cookie?
  • Using a single word like “puppy” but not “Momma, I want some milk”?
  • Talking but unable to converse back-and-forth?
  • Often responding “I don’t know” to questions like “What did you do today?” or “Who did you play with at recess?”

LET'S TALK ABOUT IT

Some children do not have age-appropriate functional communication, which is communication that is practical or serves a function in life. Someone with an extensive vocabulary may not necessarily have functional communication.

Maybe this challenge with functional communication is evident from age three, when your child throws a tantrum instead of asking for something he wants or needs. Maybe, at age eight, your child is not able to recap her day or to tell you how to play a board game. Your child may not be able to answer “why” questions.

It could be that expressions like “let’s hit the road” or “he gets under my skin” elicit a puzzled expression in your child. Some children view the world in a way that is very literal and concrete; others really do not understand how to have a conversation.

Some children monologue about a preferred topic, sharing lots of information, but forgetting to ask questions of others. Perhaps your child must be explicitly taught to express interest in things a peer enjoys, rather than having this social skill come naturally.

CLINICAL DESCRIPTION

Functional skills fall under the ‘adaptive’ area of psychology, and refer to an individual’s ability to do what he needs to do (function) within the home and the community. Functional Communication includes:

  • Expressing wants and needs succinctly
  • Following directions
  • Focusing attention on a book or lecture
  • Having a conversation with another person
  • Retelling the plot of a book or movie

Vygotsky’s social learning theory posits that social interaction underlies typical learning and development. Functional Communication is a part of this social interaction. Children learn communication skills in part from engaging with one another. Social skills and communication go hand-in-hand and are a part of adaptive behavior.

When children have challenges with what we call functional communication, it can be hard to be successful in the social aspects of school. If a child does not have a natural sense of social skills, he or she may appear disconnected or awkward in social settings.

A teacher may puzzle, “Well, he answers a direct math question in class. But if we ask about a favorite color or food, he doesn’t respond.” You may walk your child to her class each morning and hear numerous children say, “Hi,” but your child appears as if she did not hear these greetings.

She may sit silently in her seat despite desperately needing to go to the restroom, unwilling to ask her teacher for permission. Children with functional communication challenges may be very bright but seem unsure of how to communicate with others.

Clinically, we must consider that children with disabilities such as, autism, ADHD, attachment problem or an intellectual disability, often have challenges in one or more adaptive skill areas. See ‘Potential Disabilities’ section for more information about functional communication issues in children with neurodevelopmental or emotional problems.

WHAT TO DO IF YOUR CHILD HAS TROUBLE ASKING FOR HELP

Children with challenges in functional communication may have solid rote language skills; meaning that they may name items and speak well.

It can be helpful to provide opportunities for your child to work on social language and conversation. Join a club or group related to his or her interest. Help to support and nurture conversation by suggesting words or phrases.

For example, if your child is whining for a cookie or screaming and pointing to an item just out of reach, give the child the words to say. ‘Say, I want a cookie,’ or ‘Say, please help,’ you may suggest. As your child improves, you might pull back a little and offer something like “I want…” so your child needs to only say “truck” or “cookie”.

Make feeling cards for sad, happy, mad and worried with faces pictured depicting each emotion. Have your child and siblings make these faces for the camera so the faces depicted can be familiar. Allow your child to use these facial expression feeling cards to share with you how he or she is feeling.

At the end of a long day, give your child some down time before having to talk or share much. This way, he or she can regroup from the day and can relax before working on something that is hard for him or her.

To describe the school day, give your child specific questions with prompts. Have the class picture on the fridge, and use prompts like “today I played with…” or “I had lunch sitting beside…” “In math class we…” Starting with these direct statements can help your child to share more information. This strategy is sometimes referred to as ‘scripting,’ which means that you are essentially giving your child a script for social exchanges.

If this approach doesn’t help enough, look for a community social skills group with a therapist who facilitates the interaction and teaches conversation skills.

If your child continues to have difficulty, consider direct speech and language therapy with a focus on pragmatic communication. Applied Behavior Analysis or ABA therapy is an in-home therapy that uses behavioral strategies to increase pragmatic language (social language) and functional communication. This therapy may not be available under insurance coverage unless your child has a formal diagnosis.

SIMILAR SYMPTOMS

If your child is struggling with a similar problem, not directly addressed in this section, see the list below for links to information about other related symptom areas.

  • Social skills (Socializing): socializing is an adaptive skill that requires functional communication. Most children learn to interact with one another, to share toys and make friends as a part of typical development. If concerns are present, therapy may be needed to get back on track
  • Communication skills (Communicating): functional communication is a foundational skill for other forms of more advanced communication. Trouble with communication impacts a child’s ability to develop conversation skills and to engage reciprocally with peers
  • Intelligence: general intelligence is required for functional communication. Difficulties with thinking and reasoning can cause global delays that would encompass areas like communication
  • Motor challenges (Moving & Sensing): motor impairments are a component of adaptive skills, particularly in younger children. Some children who have difficulties with functional communication may also struggle to crawl and move about the environment. Being able to grasp items, turn the pages of a book, and draw and write have an impact on learning
  • Inattention (Focusing): attention is a foundational skill that impacts functional communication and may also cause challenges with receptive and expressive language

POTENTIAL DISABILITIES

Children who have significant problems in this area may have any of the following potential disabilities. *Note, this does not serve as a diagnosis in any way. See ‘Where to Go for Help’ section for professionals who can diagnose or provide a referral.

  • Intellectual Disability (Educationally Identified Disabilities- may be diagnosed clinically as well): Children with intellectual disabilities have general delays across cognitive and adaptive domains, which often includes functional communication. Children with Down syndrome or another genetic condition and children who have been exposed prenatally to drugs or alcohol may be at risk
  • ADHD: children who have challenges with attention, impulsivity and hyperactivity can have difficulties with functional communication. These skill deficits translate into “immature” behavior and lower skills in some areas like listening and following directions, carrying on reciprocal conversation, taking turns, and sharing information
  • Autism Spectrum Disorder: children with deficits in social communication and restricted interests associated with autism often have trouble with functional communication. A child with autism may use echolalia (echo what you say), script or recite TV shows and movies, or tell you 20 facts about World War II
  • Speech/Language Disabilities (Expressive or Receptive Language Disorder): children who have challenges with communication across the board will struggle with functional communication. This challenge may be related to articulation, expressive, receptive or pragmatic language
  • Attachment Disorder: children who struggle with attachment to primary caregivers have often come from inconsistent or unpredictable settings and may be late to communicate
  • Anxiety or Depression: children who have excessive worries or sadness may struggle with day-to-day functioning and may withdraw from peers or family or communicate less frequently

WHERE TO GO FOR HELP

If your child is struggling with this symptom to the point that it is getting in the way of his learning, relationships, or happiness, the following professionals could help; they may offer diagnosis, treatment, or both.

  • CLEAR Child Psychology: to obtain a customized profile of concerns for your child or to consult ‘live’ with a psychologist
  • ABA Therapist: to increase adaptive skills and improve communication. In school, treatment plans make addressing social and conversation skills easier. This therapy is often covered by insurance for Autism Spectrum Disorders but can be helpful for other diagnoses as well
  • Psychologist or Neuropsychologist: to consider a full assessment to examine possible symptoms in a mental health and/or behavioral context
  • Psychotherapist or Play Therapist: to treat emotional symptoms as needed; to work on social skills via a social skills group or CBT interventions
  • Speech Pathologist: to treat language deficits. In combination with ABA, this approach may be most effective for children with Intellectual Disability or Autism

These professionals may recommend or administer the following tests for this symptom:

  • WISC-V: a test of intellectual abilities or IQ (Psychological or School Psychological evaluation)
  • Vineland-3: a comprehensive test of adaptive skills for ages birth to 21 years that includes communication, socialization and daily living skills. Other adaptive measures include the ABAS and the SIB-R
  • TOL-2, CTMT, WCST, TOVA: tests of executive functions that may help to determine skills like planning, organizing, and attention (Neuropsychological evaluation)
  • ADOS-2: test for concerns in social communication domains including conversation and functional communication
  • Roberts, BASC-3, Clinical Interview, RCMAS, CDI-2, Human Figure Drawing: tests of emotions and mood through drawing tasks, open-ended questions, interviews, and rating scales. The BASC-3 also has adaptive domains to assess flexibility, social skills, leadership, and functional communication. (Neuropsychological or psychological evaluation)

LEARN MORE

[1] Kroncke, Willard, & Huckabee (2016). Assessment of autism spectrum disorder: Critical issues in clinical forensic and school settings. Springer, San Francisco.

[2] Bell, Nanci (2005). Talkies visualizing and verbalizing for language comprehension and expression. 

Amazon: https://www.amazon.com/Visualizing-Verbalizing-Language-Comprehension-Expression/dp/0945856512/

[3] Bernstein, Deena K. &   Tiegermann-Farber, Ellenmorris (2017). Language and Communication Disorders in Children, Third-Sixth Editions.

Amazon: https://www.amazon.com/Language-Communication-Disorders-Children-6th/dp/0205584616/

[4] Baker, Jed. (Retrieved 2017). Social skills books and resources for ASD. http://socialskillstrainingproject.com/books.html

[5] Mendler, Allen (2013). Teaching your students how to have a conversation. 

Amazon: http://www.edutopia.org/blog/teaching-your-students-conversation-allen-mendler

[6] Newman, Barbara M. & Newman, Phillip R. (2014). Development through life: A psychosocial approach. 

Amazon: https://www.amazon.com/Development-Through-Life-Psychosocial-Approach/dp/1285459962

Image Credit:
Description: Young toddler boy having a temper tantrum on white background
Stock Photo ID: # 92099139 (iStock)
By: Loveleah
Communication-between-parent-and-child
Previously Licensed: November 30, 2016
Stylized by Katie Harwood exclusively for CLEAR Child Psychology

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