When a child is not conscious of other people, he/she tends to have difficulties in learning language, and also does not speak out. As he/she does not have much interest in others, his/her ability to receive the message seems to be weak. Most commonly messages are sent with "language", and when we say "language" as a communication tool, it is not only verbal information but also includes other elements such as body movement, hand movement, facial expression and tone and strength of the voice, because all of above work together to deliver the message.

There is a study that explored what elements determine the impression of speech. According to the research, the contents of the words only influenced 6 % of the impression, whereas paralanguages e.g. voice, determine 32 % and the facial expression 60%. In other words, when we are in conversation we use the speaker's facial expression as our guidance to determine the impression of the speech.

Now how does it mean to the children who have difficulties in language development? For the child who is at the stage of "becoming a little person", it is important to talk to them with emotions and let him/her watch your facial expressions. Without them, your message in your speech may not be received.

Here is story of a little boy who has just come into "the Age of Good and Bad", when parents start teaching him seriously about Good and Bad, and when the child starts to understand them.

●The boy called Yutaka who understands the word "No" but does not stop what he is doing.

Yutaka is a four-year old boy. When he was smaller, he was diagnosed to have an autistic character, but now his perseverative behavior becomes moderated and he can understand quite a lot of what adults are saying, and he can even speak out sometimes.

When I first met him in the psychotherapy room in the clinic, I induced him to come to the desk with a miniature car, as he loved cars. He then worked on one or two tasks. However, he easily got bored and said, "Don't like." or "Clean." (cleaning up) to let it be known that he wanted to quit the tasks. If we kept on asking him to work, saying "Just a little more." or "You can clean up when you finish this", he would think up other things such as "Pee" to persist with his idea. At that stage he was given a task to work with blocks, but he could not understand what "copying the example" means and made whatever he liked. But as he attended more classes, he started to understand about following the example and became able to create what we asked him to.

His mother told us that she had not asked him to continue when he disliked something. But after our guidance she changed to say "No is no." decisively, and he stopped misbehaving when he was told "No". However, it often did not last long, and when she was not watchful, he reached out for the thing that he had been told not to touch. "Is there a possibility that he still doesn't understand what NO means?" the mother asked.

What is the developmental stage that Yutaka is in? He came up with various words to insist on his idea, so he has ability to think. However, if he only adheres to his own intention and desire, his thinking ability would not be used for living in the community. As he grows older, he might be called as a selfish child. It is necessary for him to train himself to modify his intention and desire to the needs of adults and children around him. He started to understand "Good and Bad", so now is the time to encourage him to practice it in real life.

We should also remember that if a child gets bored easily at tasks or becomes mischievous even after he/she was told "No.", there are 2 areas to consider. One is that he/she is not patient enough and is unable to keep up with one thing, and the other is that he/she might have an impairment with his/her memory.

●Guidance Point

(1) Use certain patterns or words that imply rules.
We present a child with certain "words" first, then use them in practice so that he/she can understand the meanings, e.g. "You can finish it when you do ….." or "When you do ….., I will do ….". Especially when he/she tries to touch undesirable thing like an electric plug, we will ask, "Do you touch a plug, or you don't?" and induce the answer "I don't." from the child to make sure he/she really doesn't.

(2) Extending memory span
We give a child some tasks so that he/she can remember what he/she heard for a longer period. Here are some examples; we speak two words and ask the child to repeat them, or we display some picture cards and ask him/her to pick up two cards that relate to the teacher's words, or we ask him/her to repeat the short words to other people, or we ask him/her to bring back something that is placed at some distance away. If a child cannot remember the words for a certain period, then various talks from adults would be forgotten and would not make sense in the child's mind.

■From the monthly journal "The Developmental Education"
Mamiko Hitotsumatsu, Speech-Language-Hearing Therapist
The Association of Remedial Teaching for People with Developmental Handicaps