Several years ago I had the privilege of writing part of a chapter in a communication, behavior, and functional skills assessment and curriculum tool titled Essential for Living. My goal when developing my contribution was to figure out how practitioners and parents, with little to no knowledge about speech and language development or therapy, could determine on their own appropriate communication goals for a given learner. And then once goals were determined, a clear path for achieving them. Numerous drafts finally resulted in “The Profiles.” The Profiles are six common profiles of learners with speech and language impairments. Every learner fits into a profile. Each profile comes with a behavioral description, an overarching goal, suggestions for achieving the goal, and instructions for allocating resources towards meeting the goal. Today, I want to talk about my favorite profile, Profile 3.
Profile 3 is the profile that describes learners that rarely, if ever, repeat on command. That is, if I say to a learner in this category, “Say dog,” the learner is likely to stare at me blankly. However, once in a while- and it could be once an hour, once per day or once per week- the learner says a word, perhaps even the word “dog!” But when the parent or other listener tries to evoke the word again, most of the time, maybe all of the time, the desperate parent is met with silence. Often, I hear Profile 3 learners say the names of letters or numbers. Sometimes this occurs in the context of a puzzle, maybe in the context of a specific educational video, but the hallmark of these “pop out words” are that they are understandable but highly inconsistent.
Seeking out Profile 3 Learners
I’m always on the lookout for Profile 3 learners. When I meet with parents to discuss their children’s speech and language, I’m always hoping the parent will say to me, “My child doesn’t talk, but once in a while I hear a word.” When I hear this description from a parent, I have to resist jumping out of my seat with excitement. You see, it’s these learners that frequently make incredible progress very quickly. The progress demonstrated seems almost miraculous. But really, it’s all about knowing the right goal for the learner. The goal for a Profile 3 is to teach him or her to REPEAT. That’s it. That’s the goal that should take overarching precedence among all others. The speech is there. But there’s no way to target language development if all language is only produced on the child’s own terms. In typical development, children learn language through repetition.
But since the child doesn’t repeat, how can this goal be achieved?
This is where my behavior analysis training takes the wheel. The key is finding a reinforcer. Not just something the child likes, but something that changes the child’s behavior. Also, the item must be something that can be provided immediately following a pop out word or a repetition. One second later works; three seconds later is too long! Therefore, you must always be prepared. Whatever you plan to deliver to the child, it needs to be readily accessible. I often joke that I’m single-handedly bringing the fanny pack back in style! And I’ll be honest, if the child is motivated by food, that’s probably your best bet. Also, whatever item you choose cannot be given to the child at any other time. So if you do pick an edible item, don’t choose anything that’s that’s essential for nutrition. And because the real prize is repetition and not spontaneous language initially, it’s following random repetitions that the biggest celebrations should occur!
Once repetitions become reliable, as a clinician, I have control over the expansion of the child’s language. Behavior analysis has nifty tricks for transferring repetitions into spontaneous language, so repetition is just a stop-over goal on the journey towards abundant, functional, spontaneous language. Most incredible is that Profile 3 learners often have had years of speech-language therapy with minimal results. And understandably, they also typically have frustrated and confused parents. I’m shocked that more practitioners do not know to identify the potential within a Profile 3 learner or recognize that it’s the behavior of repetition that is the core deficit. There is perhaps no greater example of the synergistic power of the fusion of speech-language therapy and ABA therapy than the progress that can be demonstrated by a Profile 3 learner!
Check out the video below for more information about Profile 3, my favorite speech-language profile!