I had a very exciting session with a non-verbal client this week. He demonstrated to me that he was consciously beginning to learn how to use his voice when he wanted. After last week’s blog about signs of speech, I thought a depiction of this would be appropriate.
Frankie is an eight year old non-verbal autistic child. I had worked with Frankie for about two months when he was five. In that time, we were able to demonstrate that Frankie understood what was said to him and could respond appropriately on his own without speech. We used his stims of turning the lights on and off and opening and closing the door. We took these actions, put them to a tune with words, gave the stim a direction and made a game of this. As we were playing the game, he opened the door and saw his mother sitting outside. He put his fingers to his lips, (motioning shh) pointed to the piano, and then closed the door. His neurologist, whom I had never met nor corresponded with, saw Frankie towards the end of our therapy together and was able to confirm that Frankie understood and could respond. Frankie moved onto a new school and three years later our paths crossed once more. We began Music Therapy sessions again.
Currently, Frankie has demonstrated that he is easily able to control his breath by blowing and sounding a recorder upon hearing the words “your turn.” As we were playing our “your turn, my turn” tune with the recorder, when it was once again my turn, I sang “ahh” on three notes . I then handed Frankie the toy microphone and said “your turn” . Frankie did understand what I meant but was unsure on how to go about this. He put his mouth to the microphone – but nothing came out. He tried what he could already do; he blew (in the same manner he blows into a recorder). I continued the music without pause and went back to my turn. I repeated the same process, except this time as I sang “ahh,” I put his hand on my throat to feel the sound. As I handed him the microphone, still unsure how to do this, sound accidentally came out. I did not alter, pause, or lengthen the music. I kept it going, back and forth, your turn, my turn. Each time he tried to get his voice out, he accidentally achieved this goal, but was still uncertain as to how he did. Keeping the music going did not give him time for any anxiety when this did not immediately happen as he attempted. Each time Frankie took his turn, the voice came out sooner and lasted longer. Each time Frankie smiled at his accomplishment. The concentrated look on Frankie’s face led me to believe that this was a very conscious act, however, allowing the music to continue keeping the flow continuous and left little time for frustration or disappointment when the voice did not immediately come.
After we ended the session, as I took Frankie to his mother and told her what had happened, Frankie stood there smiling proudly. Immediately after I was finished speaking, Frankie proudly used his voice with a long string of babble. It is my belief that Frankie had something purposeful he was telling us but just has not gained enough control to clarify. The look of pride on his face was all we needed that day.