Program: Vocal Imitation

We all remember playing Simon Says as a child, which is at its core a game of imitation on demand. Someone does an action, and everyone else is supposed to do the same action as long as "Simon Says" was stated first. Imitation skills are so important because the ability to imitate will lead into being able to play/socially interact, learn sign language, be prompted, or just "learn to learn".

Vocal imitation is a program designed to teach a child to vocally imitate on demand. "On demand" is a key distinction. Many kids I begin working with are already babbling or have a few words. However these children cannot produce a sound or word on request. They sing songs all day, but if asked to sing a specific song or say a specific word, they don't do it.

Vocal imitation is one of the first few programs I write to start working on language, because young babies learn language by imitating the sounds they hear. From there, parents will talk to the baby/toddler and say things like "SAY Mama.....Dada....". That is a common part of teaching a young child to talk.

The ultimate goal of teaching vocal imitation is so the child will learn imitation skills, to get the child's language under instructional control, and to be able to prompt the child. If a child cannot imitate on request their language won't be very useful to them, in terms of other people being able to understand what they want or need. In order to teach the child new and novel labels/words they need to be able to imitate you.

Research supported methods for teaching language to children with Autism include Echoics (this is a Verbal Behavior term for vocal imitation),  stimulus-stimulus pairing, alternative means of communication such as PECS, and shaping. Example of stimulus-stimulus pairing: the child says "Buh" while looking at some bubbles, and you hand the child some bubbles. You reinforce language (even approximations of language) to pair the language with the item. Example of shaping: the child is taught to say "Buh", then "Buh-ll", and finally "Bubbles" in order to receive access to the bubbles. You make the language requirement progressively more difficult over time.

The first step in teaching vocal imitation using  Echoics, would be to teach the child to repeat or echo words/sounds on demand. The therapist would say to the child (with no stimuli present) "Say ball" and the child should respond "Ball". When I write a vocal imitation program for a client, typically I start with simple sounds that come easily off the lips ("Ba"), then more complex sounds, simple words ("Up"), complex words ("Hospital"), and eventually numbers, sentences, and short phrases (such as, "Ready, Set, Go"). There is definitely a hierarchy when writing a vocal imitation program. Depending on the child's current verbal abilities, you want to start where they are and build from there. So if the child is only able to babble, you wouldn't start asking them to say complex words like "Helicopter".
Also, it can be very helpful to consult with a Speech Therapist to find out where to begin when selecting sounds or words. Certain sounds and words develop quicker than others and are easier for children to produce. If you do not have access to a Speech Therapist, then do some research on child development and look at what sounds develop first, and in what order. There is a massive volume of research on baby babble, speech production, and first words.

Some common questions/problems I get asked about in regards to teaching Echoics are:

  1. The child is imitating the entire phrase, not just the target word. If the therapist says "Say ball" the child responds "Say ball". This is a very common problem. I usually fix this by going to a 0 second prompt where once I give the SD  I immediately give the child the correct answer. This would look like: "Say ball. Ball (speak over the child if necessary)". The child should respond "Ball". Another tip is to drop the word "Say" and just say to the child "BALL". Then look expectantly at the child. They should echo you and say "ball".
  2. The child is imitating the echoic, but their articulation is very poor. Instead of "cup" the child says "up". Instead of "zebra" the child says "ee-a". Decide in advance before you begin teaching vocal imitation if you are focusing on vocal production, articulation, or both. I usually go with what the parents want to do. Some parents feel they just want to get the child talking and we can clean up the words later. Other parents feel they don't want the child to "learn" the word incorrectly. Decide this upfront, and either work on articulation with the child or reinforce them for saying the word at all and then fix the pronunciation later. This doesn't have to be an issue if the parents/caregivers are okay with using Shaping techniques. Shaping is an ABA strategy where you reinforce successively closer responses until you get the actual response you want. So if a child can currently say "ah" and I am teaching the word "apple", then in the beginning I will reinforce "ah". Then I will only reinforce "ah-pa", and eventually only "apple". Shaping is a gradual process, where you slowly increase the difficulty of the demand to get the child closer and closer to the terminal goal.
  3. The child isn't imitating at all. This is also a common problem. Its not unusual for an Echoics program to take some time before the child starts responding. Do not get discouraged or frustrated if you have been teaching Echoics for a while with limited progress. There could be a myriad of adjustments and tweaks that need to happen with how this is taught, reinforcement used, consistency of teaching, etc. There is no way I could know what needs to be changed without knowing your child, so I recommend you discuss this with the therapy provider and create an action plan to modify the Echoics program. If you are able to, also consult with a Speech Language Pathologist to design speech and articulation interventions.

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