A 4 1/2-year-old in my class, Peter, has so much trouble letting us know what he needs. We have to guess what he wants, what makes him happy, and what makes him upset. How can we help him?
There are many possible reasons for this difficulty. One to consider is how far the child has progressed in his ability to interact, communicate, and think. Ask yourself:
Can the child focus on and attend to others? Focusing and attending are essential in order to discover what others are trying to communicate and what's required in order to communicate back.
How well does the child relate to others? Is this a warm child who enjoys interacting with peers and adults? Without the capacity to relate, there may be little desire to communicate.
How purposeful is the child? Can he exchange signals of any kind, such as pointing or responding to a teacher or a peer who is pointing out or showing him something? In other words, does he engage in communicative "gestures"? These may be as simple as smiling in response to another's smile, taking someone by the hand to show them something, or vocalizing and making sounds in response to the sounds of others. Without this basic level of communication, it's hard for a child to participate in any type of two-way communication.
Also think about the specific ways he uses his senses including seeing, hearing, smelling, and using his own movement patterns to process information he receives.
Determine Communication Levels
How does the child build on the fundamentals of attending, relating, engaging, and using ideas? Is he able to use words to indicate things that he wants or doesn't want? Is he able to understand the words of others? Can the child understand what the teachers saying to him when giving simple directions? Does the child respond with a "No" or a "Yes," or "I want this one," or "Not now"?
At the next level, we see children who are not only using simple words and phrases but are often using whole sentences and are logical. They're able to answer questions, such as "Wheres the car?" "It's over there." And, "Who do you want to play with?" "I want to play with Sally." They can even answer why questions. For example, the child says, "I want to go outside."? The teacher asks, "Why?" The child can say, "Because the sun is out and I want to play."
For a child who has a communication problem or challenge, the first goal of the teacher is to observe which level of communication the child has achieved.
Evaluate the Problem
A child may have use of some words, and be able to indicate what he wants, but not understand what you're saying. When you ask him where he wants to take his truck, he looks at you blankly, or gives you an answer that seems random. For a child, for example, who can show you what he wants, but does not persist, you can challenge him to be more persistent about showing you things and help that child do what we call "opening and closing more circles of communication." Instead of just three to four exchanges, get him involved in 10 or 20 exchanges. The more circles of communication (back and forth communication) we get, the stronger a communicator he'll become.
The same goes for using words. The more we help the child with one or two words, assist in expanding it to three or four words, and use those words in many back and forth interactions, the better.
Be attuned to any particular challenges. Is the child having trouble because he does not understand what you're saying, or is it because he can't figure out what your gestures mean? Maybe he can't process what he sees very well. There may be many reasons that the child has trouble in mastering these levels of communication.
It may also be the case that the child is over- or undersensitive to sound or sight or other sensations. For the child who is undersensitive, your words may not even register with him. The child who is over-sensitive may be so overwhelmed by your words that he can't organize a response.
Patterns of Communication
There are four areas that may contribute to the communication challenge:
  • Does he comprehend what he hears? 
  • How does he organize a vocal response that we commonly call words?
  • Is the child able to gesture with smiles or smirks or with vocalization? Is he over- or underreactive in his responses?
  • Can the child organize as well as comprehend what he sees?
If we simply observe these things, we'll get a pretty good picture of the childs communication pattern.
Strategies for Teachers
We can start helping the child with communication difficulties right away by:
  • Offering practice, such as helping him answer w questions like why and where.
  • Keep communication fairly simple, but highly energetic and compelling, if you notice that the child has difficulty comprehending what you're saying.
  • Be highly energetic and animated for the child who is very underreactive to things such as touch and sound.
  • Be extra soothing for the child who's overreactive to touch and sound. He may require the help of an occupational therapist to work on sensory processing.
  • Show more animation in your gestures to a child with visual-spatial problems.
  • Have a hearing evaluation if there is a question about how quickly he understands and responds to what you're saying.
  • Check out the motor system of a child who's not responding.
  • Have a pediatric neurological consultation. If you're concerned about medical contributions or neurological contributions, such as a seizure disorder, its always a good idea to make sure there has been a recent pediatric evaluation.
It's very important for teachers and parents to work together on this, so they can compare notes on what's going on at home and at school. At school, a teacher or teacher's assistant needs to work with the child to help him communicate with other children, and at home he needs even more play dates than other children do.