Working on Prosody and Semantics

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This client does indeed sound complex. If he is having the frequent crying and tantrums in school, then there may be additional language deficits in addition to prosody. In reality, prosody is a very small component of language, so "semantics" may be a better base from which to start. All humans, both children and adults, seek to make sense of the world around them. When individuals have difficulty communicating, predicting, and effectively using verbal language (regardless of diagnosis), tantrums and frustration may result. I would recommend working on semantics by helping this student become a more efficient and effective verbal communicator during existing routine interactions. Any target you select must be as meaningful as possible for the child.

In order to make intervention more meaningful, incorporate activities that are contextualized (in the classroom or during existing interactions) and authentic (real activities he needs to engage in communicatively). For example, work with his teacher and OT to determine scripts that may help him during a difficult part of the day, such as lunch time, transitions, centers, or recess. Help facilitate more successful interactions in these contexts with modeling, short stories, or peer buddies to improve generalization of skills. His unusual prosody may be the result of his overreliance on echolalia or strong rote memory skills during verbal interactions. Try to identify if there are patterns where he sounds more "robotic" than other times; this may indicate that he is uttering a memorized script without a lot of understanding regarding the interaction. It has been demonstrated that young children use echolalia functionally, so it will likely become more natural sounding as his linguistic development improves. Therefore, do not try to eliminate the use of echolalia, but encourage him to expand on his memorized phrases in natural exchanges. By focusing on helping him become a more effective and efficient communicator, you may see a decrease in his compensatory strategies (i.e., the crying, tantrums, and possibly the robotic voice). Due to the developmental level that you described, he is probably not capable of having a strong awareness of prosody. To reduce your own frustration and increase his success, consider working on functional aspects of semantics that will improve his competence as a communicator, rather than a splinter skill such as prosody.

Kathleen J. Abendroth is an Assistant Professor at Southeastern Louisiana University. She earned her B.A. at the University of Virginia (2002) and her Ph.D. at the University of Louisiana at Lafayette in 2008. She is a certified speech-language pathologist who previously worked in the East Baton Rouge school system with elementary students. She is a member of the American Speech Language and Hearing Association (ASHA) and the National Education Association (NEA). Her research interests include autism spectrum disorders, literacy, and language development.