should have had to look for a book to give us clues. As it was, there must be, of course, many tricks that speech therapists know that he did not hit upon. We presumed in this, as we presumed in most other things where we did not seek professional help. But Elly could have been reached, at this time, only by a most unusual speech therapist; she was already good friends with her father. She could sit by him at bedtime, bathed, warm, and snug, and accept his fingers in her mouth. Eventually — perhaps even this year — Elly will be able to benefit from professionally administered speech therapy. In the meantime, her father and she make good progress.
Not remarkably good; in this, as in other things, what Elly learns in one context is only slowly extended into another. Her new clarity seemed less for use than for display. In the framework of the game, marshmallows were a worthwhile compensation for the effort required. But that effort was more than she cared to expend for the doubtful rewards of communication. Yet as months passed the effects of the marshmallow game did begin to rub off on to ordinary speech; at her seventh-birthday visit the psychiatrist remarked he could understand ninety percent of what she said. (At five, when he first saw her, she said little and he had been able to understand nothing. ) We can count on simple intitial consonants now, and many final ones. Sometimes we even get one in the middle. One day, I think, pronunciation will no longer be a major bar to her intelligibility.
Yet pronunciation, however important it might be to Elly’s contact with others, was a matter of detail. It affected single sounds, or sounds in combination. But in our work with Elly, behind every approach to a specific problem lay a decision which would affect not isolated words and word groups but everything we said. How should we speak to Elly if we wanted her to believe in the possibility of mutual communication? If some of what Elly said was still unintelligible to us, we could not forget that most of what we said was unintelligible to her. We must consider our own speech as well as hers.
We could tell when Elly understood us and when she did not. If she did, she acted appropriately or jumped up and down in enthusiasm. Incomprehension brought indifference or a clearly inappropriate response. Of course we had in the back of our minds the stories everyone knows, of children who had seemed to hear nothing and yet were found to have recorded everything; the social worker at the Institute had suggested that Elly might understand far more than she let on. Even then this had seemed improbable, much as we would have liked to believe it. In the years since, we have watched for evidence of hidden comprehension and found none. It has been only in the past year that we have seen her pick up anything out of conversation not pointed directly at her, even its general subject. As she sits with us at dinner, as she moves among the children on the playground, she is still surrounded by a foreign tongue. Like a tourist in his first weeks abroad, she can understand what she expects to hear, if it is unambiguous, is clearly addressed to her, and falls largely within her own vocabulary. We all know the difference between our hotel French and the French the waiters speak to each other. I have heard Elly as she imitates me on the telephone. Giggling she says ‘Tah. Te tah. Pah pee pee pee pah.’ The syllables suggest how meaningless to her is the sound of most speech.
Of course we did not want our speech to be meaningless to our daughter; that she should regard speech as at least potentially intelligible was our overriding concern. It was this that led us to a decision that many people will find questionable. We decided that if we wanted Elly to believe that speech had meaning, we must speak to her in her own language.
Of course this was in fact no great decision, only a verbalization of what we had been doing for years, what most parents do intuitively as they talk to their babies and toddlers. Using short, familiar sentence patterns, they speak to them in words they can understand. They do not think about the subtle process by which words build into speech; they do not have to. Automatically, with no one’s conscious attention, the vocabulary and sentence patterns of the child’s speech come to approach the range and complexity of the parents’. Gradually the parents drop their unconscious simplifications, and somewhere between three and five it turns out that everybody is now talking English. But when Elly was five we were at the beginning of this process, not the end of it. Elly was not talking English, she was mouthing words. We had the choice of confronting her with sentence patterns of normal complexity and length and hoping she would come to understand them, or confining ourselves to those she was reasonably likely to find intelligible. We chose the latter course.
We talked pidgin, but we talked it with a difference. Though we wanted Elly to understand, we did not want to imprison her within a primitive language, but to help her move towards more refined and complex structures of meaning. This meant that our pidgin must be one step ahead of hers. But not much more than one; nothing we had seen of Elly had led us to believe in her capacity for any great leaps forward.
To give details of how we spoke to Elly is impossible here, but the general approach can be conveyed. It has been rather as if one applied the familiar method of the Dick-Jane-Sally readers to speech. The influential creators of Dick and Jane do not introduce new words in clusters, but one at a time. The new word is introduced in several contexts, it is repeated ad nauseam. No step in comprehension is omitted, even if it seems obvious, and to a verbally gifted child is obvious. Stages the average adult would skip over have been identified and incorporated into a programme that gradually leads the child to feel at home with a large number of printed words. The inventors of Dick and Jane know that many children will learn ‘go’ without being able to extrapolate to ‘goes’ and ‘going’, that ‘can’t’ and ‘cannot’ will seem to them totally different words. As it was in their reading, so it was in Elly’s speech.
I learned much from Dick and Jane. When talking to Elly I tried not to burden a sentence with more than one word I knew to be unfamiliar. I was prepared to repeat the sentence again and again; autistic children do not find repetition nauseating and their parents cannot afford to. I tried to remember to use the word or phrase soon after, in another simple context, and to use it the next day and the day after that.
I spoke to her in her own vocabulary and I used her syntax as well. I tried to use it in a more civilized form — but only slightly more civilized. The gap between ‘Elly go store?’ and ‘Elly, I’m going to the store now to get the eggs, do you want to come with me?’ is fifteen words and several constructions wide. I could not, I thought, bridge it all at once, so what I actually said was a compromise, and a compromise nearer to her terms than mine. [26]
We had at first expected that once she began to talk, Elly would begin to pick up language like a normal child. And she did pick up words — especially nouns — that we had not taught her. She was much slower to pick up constructions — so slow that at length we began to take a more active part in the process. In addition to speaking ourselves so she could understand us, we began to find ways to nudge her own expression ahead — not merely to speak simply to her, but deliberately to feed her new patterns of communication that she would find usable if she knew them. We did not begin this until her seventh year. We were for a long time primarily word-conscious, and it was not for some time that we thought of conveying whole statements by repetition, as one would teach a word. A few of these were superficially sophisticated, like the arithmetical sentences with ‘plus’ and ‘equals’ mentioned earlier in this chapter. Most, however, express simple ways of coping with the world — less simple, though, to Elly than the relations of arithmetic. ‘Don’t forget the —.’ ‘Don’t be sad, be happy.’ ‘Come back another day.’ ‘Oh, we made a mistake.’ ‘Never mind.’ Ideally we would have imagined what patterns she needed to deal with her experience and provided them. If I were writing a handbook for parents of autistic children that is what I would counsel them to do. But in fact we were seldom so conscious or so clever. Only recently have we addressed ourselves consciously to the problem of giving her the words to handle recurrent situations in her experience. It has worked well enough so that we wish we had had the wit to think of it earlier. Better than anything else, it has enabled us to cope with the situations of frustration and anxiety that occur when everything doesn’t go according to plan. Uncertainty exists, and we cannot protect her from it always. It is progress indeed when words can be not only a tool but a shield. This summer I developed the pattern ‘Sometimes buy candy, sometimes
