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The Child with Unusual Behaviours - Repetitive Nonfunctional Speech and Talk to Self

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Repetitive Talk and Talking to Self

Repetitive talk and talking to self usually go together, and are exhibited by children with a broad range of developmental difficulties. These children usually have social difficulties as well, and tend to be resistant to change and to display repetitive motor behaviours. They may repeat: "Are we going to the Zoo? Are we going to the Zoo? as many as ten times or until someone interrupts and redirects them. They may also repeat phrases to themselves, such as, "It's ok, you are not hurt". Although just a few children display these characteristics, they require extensive input and support from school and home.

Repetitive speech patterns of children with higher cognitive abilities may get overlooked because of similarities between these children's behaviour and that of peers who are just boisterous or too active. But there is growing recognition that some children who are quite competent intellectually also engage in repetitive talk. This could help explain why recent reports have shown considerable increases in numbers of children with repetitive or nonfunctional speech in the general population. The latest studies suggest that about 1% of children and adolescents speak repetitively, although not all of them will talk to themselves or say things that don't make sense for the context.

Most children with repetitive speech also display problems in communication and are intellectually delayed. This group is more likely to be identified early, as early as the second year of life or even earlier in some cases. Once these children acquire speech, they may use it inappropriately for the context (nonfunctionally), and also will most likely talk to themselves. Such children may also reverse pronouns, e.g., use "He" for "I", and may use metaphors to communicate.

Example

  • a 5-year old boy who fell into a lake while admiring a flock of ducks. He was shocked and had to be pulled out wet and crying. Ever since then, he began to say "ducks" every time he saw a body of water. This demonstrates "nonfunctional speech".

Example

  • a 9-year-old girl's ongoing requests to "Give Jessica juice," instead of her saying: "Can I have juice?" demonstrates "pronoun reversal".

It is fairly easy for teachers to identify such children by virtue of the severity and pervasiveness of their uncommon behaviours. Identification by the parents could also be early, particularly if there is another such child in the family. Occasionally, even when they recognize that their child has problems, parents may resist acknowledging their existence,often out of fear for their child. In such cases it is the teacher who will alert the parents and school as to the child's difficulties. More recently, with considerable awareness of atypical behaviours in children, these children tend to be identified early by nursery school teachers or daycare workers, if not by the parents, and are directed to assessment and appropriate intervention strategies. The child's doctor may have also consulted with the parents about early assessment and enrichment services.

Following are various characteristics of the children who talk to themselves and use repetitive or nonfunctional speech.


  • In most cases this problem tends to appear quite early and around the second year of life.
  • There is a subgroup of children in this category who acquire speech and various other skills but lose them, to regain them a few months later. This has been referred to as the "interrupted course" of expression of the difficulties.
  • If left untreated, as many as 50% of children in the lower functioning group do in fact acquire speech, with the remainder being mute or using occasionally a single word, under conditions of great demand or stress.
  • Aside from nonfunctional speech (speech that does not make any sense for the context), many of the children may also display echolalia, i.e., repeating what they just heard (immediate echolalia) or something they heard some time previously (delayed echolalia).
  • These children may also display "neologisms", i.e., words that do not exist in the spoken language of the group to which they belong.
  • A tendency to resist change is very common in the children, regardless of level of functioning, along with the nonfunctional language use and the talking to self.
  • There is also a great likelihood that the children will be intellectually delayed. Research indicates that, left untreated, 50 % of these children will have very low intellectual ability.
  • Chances are high that the children will continue to display the nonfunctional and repetitious speech throughout their lives.However, intervention may help them adapt by enhancing their interpersonal and social skills.
  • Fine and/or gross motor control difficulties are present in most children with these characteristics as well.
  • There is a need for very extensive and intensive training for these children to modify their speech pattern and to use more functional and appropriate speech, based on expected standards, or close to that expected for their age range and cultural group norms.
  • In a few but increasing number of cases, behavioural interventions can eliminate nonfunctional speech and speaking to self, and the child learns to use language appropriately for academic, social and home living.

General Comments

Difficulty may first appear as early as birth or a little later, but definitely before the 30th month of life. Some children in this group may graduate into very competent speakers and may have a very high intellectual ability. Nevertheless, they will continue to have difficulties in the use of speech for social purposes, even if their speech is fully correct in grammar and syntax.Children in this group can manage some degree of contact with adults but, despite their grammatical competence, may have difficulty relating to peers. The day-to-day communication with other children is hard for them, and in turn peers view them as different

The children may also display peculiar body movements of a repetitious type that are quite visible to others and set them apart from other children.

Such children are also more likely to have sensory peculiarities. These may include:

  • Preference for specific pressure in their bodies
  • A tendency to feel uncomfortable with the feel of tags on their clothing against their body
  • A need to receive deep pressure in their face or other body parts

They are also likely to

  • Avoid eye contact
  • Like to see things from the corner of their eyes
  • Squint their eyes
  • Repeat TV jingles over and over
  • Repeat things they have heard even months or years ago
  • Cover their ears to loud sounds (although they may not have any objection to sounds they produce themselves, which can be quite loud.)
  • Although they can be developmentally delayed in some areas of their functioning, some of the children show competencies in other areas, with some being characterized as "savants", i.e., having exceptional abilities in some areas.
  • Almost all of these children have difficulties with psychomotor tasks, that is, tasks for which the brain has to order the body to move in specific ways. As well, the children may display some negative behaviours such as hitting objects, themselves or others.
  • In sum, these children have problems in interacting with others and problems in the use of language, particularly its use for social purposes. They resist change, and have a different way of perceiving the world thorough their senses. Frequently as well, they function below their age in cognitive tasks and may show a number of challenging behaviours.
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  • Young children may occasionally use nonfunctional speech (speech that makes no sense), since fantasy is considered characteristic of this age.The children may talk to an imaginary friend, and identify with a character on TV or an animal or fairy they have encountered in their books.
  • However, typical children will not display any of the other behaviours that accompany this self-talk. There is no self-stimulation such as jumping up and down or rocking of the body; there is an interest in others, there are no eye contact difficulties, and no sensory difficulties or resistance to change. With children who may occasionally speak without making sense but do not display any of these other concerning behaviours, teachers may just attempt to clarify what the child is referring to and make sure that the child's self talk relates to his or her rich fantasy life. There will not be further concern about this child's adaptive behaviours

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  • If children occasionally talk to themselves, show some inappropriate behaviours, avoid eye contact, and at times seem to be in a world of their own, then they need to be observed more systematically. A teacher who notices a child who engages in self-talk may also want to note whether the child relates to other children in the classroom, has issues around change in routine, and so on.
  • If, after an observation of a week or two the child appears to present some of the behaviours outlined under A is for Actions (LINK p. 1), then the parents may need to be notified and asked whether comparable behaviours occur at home.
  • If parents do not report seeing such behaviours at home, it is still necessary for the teacher to notify the School Support Team and the school principal. This follow-up is needed for several reasons. First of all, the child's behaviours may be the result of anxiety around coping with school demands. Secondly, the parents may resist accepting the fact that their child displays these behaviours, especially if the child is a firstborn. In addition, while teachers may easily notice such behaviours in the relatively demanding context of the school, it is possible that similar behaviours, especially if fleeting, may not be as evident to parents in the more relaxed context of their home. Once the School Team is notified, the members may decide that the child needs to be referred to mental health professionals with expertise in dealing with a child who presents these behaviours.

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  • If a child avoids eye contact frequently, talks to himself or herself, says things unrelated to the context, becomes very upset and may tantrum when asked to interrupt a task and engage in something else, this child needs immediate attention. The child would also likely cover his or her ears to noise, love to touch specific surfaces, engage in visual self-stimulation (such as looking at mirrors or squinting the eyes), flap his or her hands or rock to and fro. This child clearly presents a problem that requires action. The child as well is likely not to interact with peers, and appears to be in a world of his or her own. First, referral to the School Support Team would be required. The parents have to be notified so that they can refer the child to their family physician, who needs to make a further referral to a specialized assessment team or professional with expertise in this area for an assessment and clarification of the child's needs. Once assessment has taken place, the child will likely receive treatment.

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  • Typical children in this age group are unlikely to talk to themselves or to use speech that makes no sense (nonfunctional). If they had these difficulties, they would have already been identified by this age. If a child occasionally talks to himself or herself in an attempt to rehearse something they want to remember, this need not be seen as a sign of difficulty. However, they would not show self-stimulation (such as squinting eyes or rocking body), lack of interest in others, poor eye contact or sensory difficulties and resistance to change. In such cases the teacher may just attempt to clarify what the child is referring to ensure that the talk to self is not of concern.

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  • Although rare, there may be a child who uses nonfunctional speech as late as that age. If he or she also displays some of the other behaviours such as avoidance of eye contact, lack of peer interaction, resistance to change, or sensory issues, that child must be monitored since he or she is likely to require assessment and ongoing support. Data on the intensity and frequency of the problem behaviours, peer avoidance and how avoidance is expressed, as well as communication and learning difficulties will be most helpful.The teacher may be able to collect the information or may ask someone else to do so, likely someone from the school's professional support team.
  • If the data suggest that this is a problem for school, it is important that the parents be contacted to clarify whether the same behaviours are displayed at home. The teacher would also need to alert the school principal and the school's support team about the problem. If all agree, the parents can then be asked to have the child referred to the family physician who will decide to further direct the parents to a referral to a specialized mental health professional or team. The teacher may want to keep open communication lines with the parents and report same or changed behaviours over time. This will help the parent with suggested follow-up services.

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  • If nonfunctional speech and talking to self are accompanied by the behaviours outlined in A is for Actions (LINK to p. 1), the child would have to be monitored on an ongoing basis for a few weeks. Once the information suggests that the child displays not only the nonfunctional speech but also speaking to self and most of the behaviours outlined earlier, the parents have to be contacted and interviewed as to whether the child displays the same behaviours at home. Since it is most likely that this will be true, the child is clearly in need of immediate evaluation by a professional or specialized professional team to ensure that he or she are appropriately assessed and directed to the appropriate treatment necessary for the child along the lines outlined below. Parents may need to hear specific examples of concern that can be explained by lack of experience, shyness or stress.

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  • There are some youth who are intellectually quite competent or even gifted, who may talk non-functionally and even talk to themselves. It is important for the teacher to be able to determine if these behaviours are just part of the child's behaviour style. The teacher will be assisted in this by knowing what behaviours are likely to go along with non-functional speech and speaking to self, as outlined in A is for Actions (LINK to p. 1).If these behaviours are not present, then the teacher need not be concerned.

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Watch for and monitor a youth who:

  • Speaks to self or says things that do not always make sense to others
  • Shows some limited eye contact
  • Tends to see things in black and white with no gradations in between

Check whether the youth also:

  • Shows a tendency to be oblivious to the needs of others
  • May show some aggressive behaviours towards the self or others
  • May show possibly a sensory preoccupation or two
  • May show some resistance to change
  • Whose language may be grammatically competent but is having difficulties with metaphors, humor and jokes
  • Shows fine and gross motor difficulties
  • If the teacher encounters such a youth, even with only one or two of these difficulties, it is important to collect data on the youth's behaviours. If many of these behaviours are present, and they tend be of relatively high intensity and frequency, then the teacher needs to communicate with the student's home. It is likely that the parents have noticed some problems, but are unclear as to whether they need to be addressed. If the problems persist, the parents and school principal have to be notified that the youth needs to be referred for additional help. Referral could first be to the school professional support team who could then decide whether that child needs to be referred further for an assessment by a professional or team that specialize in children with these difficulties.

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  • If a youth's use of nonfunctional speech (speech that makes no sense for the context) and talking to self is well established and accompanied by all the behaviours outlined under Yellow Light (LINK p. 5), then he or she needs immediate attention, support, and specialized management efforts. The parents and principal will need to be notified and the school's professional support team mobilized to assess the youth in question. The School Team will ask the parents to refer their child to their family physician, who in turn will make a referral to a specialized professional team or professional who could further address the child's needs.

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There is a wide range of cognitive functioning amongst students who demonstrate non-functional speech, difficulty with communication, or repetitive speech. There may be a student in your class who has Aspergers Syndrome, with at least average intellectual abilities, who will likely have unusual speech patterns. These can include precocious speech on topics of their interest, not knowing how to enter or end a conversation, and not being able to perceive that others are annoyed by their interrupting or challenging the ideas or opinions of their classmates. They will often not understand humour or figurative language such as metaphors (e.g. her smile lights up the room), sarcasm (e.g. thanks a lot for wrecking my science experiment), or similes (e.g. the lake is like a sheet of glass).

There may be a student who has a language impairment identified by a speech and language pathologist, and that student may not have the ability to communicate effectively to demonstrate knowledge. By adolescence, it is likely that the gap between their academic level and their intellectual level will have widened and this gap can be detected in their use of language. They may not have the confidence to express what they know, and their understanding of information from what they read and hear may be lower than what would be expected given their age. This combination will result in poorer academic performance and social interactions.

There may also be a student who has a form of autism spectrum disorder other than Aspergers Syndrome (i.e., Autistic Disorder or Pervasive Developmental Disorder Not Otherwise Specified), and those students may talk aloud to themselves, reverse pronouns, repeat things they have heard (echolalia), and be unable to engage in a two-way conversation.

An adolescent student with obvious indicators of non-functional speech is unlikely to be developing as a typical adolescent. He or she will require some form of intervention which should be discussed amongst parents, teachers, and support staff such as psychologists and speech and language pathologists.
Watch for and monitor a youth who:
  • Speaks to self or says things that do not always make sense to others
  • Shows some limited eye contact
  • Tends to see things in black and white with no gradations in between
There are additional features which often co-exist with non-functional speech and they should also be monitored. Check whether the youth also:
  • Shows a tendency to be oblivious to the needs of others
  • Shows some aggressive behaviours towards the self or others. Sometimes the frustration of not being able to communicate effectively leads to aggression.
  • Shows a sensory preoccupation, such as liking deep pressure
  • Shows a repetitive behaviour such as hand-flapping
  • Shows some resistance to change
  • Shows fine and gross motor difficulties

If the adolescent student infrequently repeats a word or phrase, or infrequently says something that does not make sense to the discussion, these would be part of typical language and intellectual development. Back to top

If the adolescent student has a diagnosis, then it is important for all teachers to understand the diagnosis, know what to expect and know when and how to intervene.

If the student has no diagnosis and is demonstrating frequent language behaviours such as:
  • echolalia (repeating words or phrases they have heard)
  • not knowing how to enter a conversation
  • being very knowledgeable about a narrow range of topics
  • being resistant to change or to completing assigned tasks which hold no interest for them
  • answering questions in class by giving lengthy and complex answers in an apparent attempt to make themselves look intelligent
  • failing to get the gist of the discussion or the assigned reading materials
  • then these behaviours must be monitored and discussed with colleagues and parents.

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The student may have a diagnosed language impairment, intellectual disability, or autism spectrum disorder.

If they have no such diagnosis, the following behaviours would be red light, signalling the need to consult an expert:
  • frequent echolalia (repeating of words or phrases they have heard); with increased occurrences in highly challenging environments that cause confusion or disorganization, such as transitions between activities or classes, or when the child is unable to predict the behaviour or expectations of others
  • neologisms (new words)
  • talking aloud to self
  • loudly interrupting others, calling others names for their ideas or opinions which differ from theirs
  • failing courses because of not understanding the material
  • refusing to stay on topic of discussion and consistently trying to divert the topic to their own interest
  • making comments which cause teachers to ask themselves, “Where did that come from?”

Such behaviours would warrant a referral to professionals, in areas such as psychology and speech and language pathology, for further investigation.
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In the school system today there is much emphasis placed upon students who learn and present themselves differently. When students reach adolescence, it often becomes more difficult to understand and respond to their differences. This is because most adolescents are in school settings which require them to have various teachers each day and these teachers will have different expectations, teaching styles, and tolerance levels. Some adolescents will find their niche in high school and their behaviours will be mild and they will be successful. Others will require the understanding and intervention of dedicated and caring teachers. Back to top


There is considerable research on the reasons why children speak to themselves or use speech that has no relevance to the context. The following positions have been put forth: Back to top


The Genetic Hypothesis
  • Studies with identical and fraternal twins have come to the conclusion that these behaviours are hereditarily transmitted. This view holds that different genes, whose exact number is still unclear, when present in the fetus are likely to result in the appearance of the problem behaviours in the offspring. The genetic position is supported by the fact that identical twin pairs are more likely than non identical twin pairs to show the same difficulties. Many different genes in more than one location of the chromosomes are likely responsible for the problem although, to the present time, no specific gene(s) have been conclusively identified.

The Neurological Impairment Hypothesis

  • This view links use of nonfunctional speech and speaking to self, along with the other behaviours outlined in part A (LINK to p. 1), to damage that can affect different parts of the brain. Evidence bears this out, since brain-imaging techniques such as CT-Scans and MRI studies show abnormalities in the brains of children with these characteristics. Some of the parts that are thought to be involved are: the hypothalamus (a brain structure that looks like a chamber), the amygdala (two brain structures that looks like almonds), the cerebellum, the temporal lobe, and one or two other brain structures. According to this view, different children who present with these characteristics have problems with different parts of their brain. This may explain why some are more intellectually impaired while others are more socially impaired and still others are more communication impaired.
  • The developmental history of some of the children who talk to themselves or use nonfunctional speech shows that they have suffered complications prior to or at birth, or complications that show up a little later,such as viral encephalitis or very high fever. This suggests that in addition to the neurological differences that are present at conception, some of these children have sustained some form of brain damage around the birth process or very early in life.

The Theory of Mind view

  • This position accepts the possibility that children who show nonfunctional speech have suffered some form of brain damage, but attempts to explain how the damage affects social functioning. This approach views the problem in psychological terms, suggesting that children who talk to themselves or engage in nonfunctional talk do not appreciate that others have minds distinct from their own. Because of this, they talk to themselves, do not relate to peers, and generally do not engage in sharing information in a reciprocal way, though give and take.

The Inefficient Executive Control view

  • This position holds that children with various difficulties, including those with problems in attention and impulsivity, are poor at planning, organizing and guiding their behaviour. Children with nonfunctional speech or speech to self are likely to be poor at planning ahead and organizing their daily lives and activities. They cannot exclude irrelevant information from their minds since they do not have an "executive" who makes decisions as to what to think or talk about and how to prioritize different tasks.

The Lack of Central Coherence Hypothesis

  • This position argues that children with nonfunctional speech or speech to self are unlikely able to understand things in their world as complete "wholes" (as opposed to a collection of parts) the way typical children do. For example, these children can be very good at putting individual puzzle pieces together, but they do not consider the overall theme of the puzzle picture to help them. This is why, according to this view; they are very good at visual tasks that require fitting pieces mechanically without regard for a theme.

Temperament

  • It is true that, of the children who display repetitive and non-functional speech and related characteristics (LINK to A, p. 1), those with temperaments related to stronger reactions and poorer management of behaviour and emotions are more likely to be difficult. However, temperament is unrelated to the cause of the children's difficulties.

Explanations based on Environmental Stress

  • A common belief in the past was that mothers were responsible for their children's difficulties because they were unable to interact with their children in a warm and supporting way. Mothers of children with problems were thought cold and unemotional. This theory has long been debunked in view of the fact that the other children of the family who have these same parents are doing well. It would be inconceivable that the mothers would have targeted these children for lack of affection and not their other ones

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  • Problems within the family may explain the child's more difficult behaviours, but they seem insufficient to account for the broad range of the child's difficulties. However, the child's challenging behaviours may affect family functioning and intactness, which in turn may negatively affect the child.

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  • There is no evidence that exposure to traumatic events would result in the appearance of nonfunctional speech in children or a tendency to talk to self or any of the other symptoms presented under A (LINK to p. 2). Such children may present a post-traumatic stress disorder but not the characteristics outlined above.

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  • In view of the severity of the problem and its life-long implications, speaking to self or use of nonfunctional speech (speech that does not make sense for the context) are clearly due to some form of biological insult rather than environmental factors. Evidence has shown that only one approach holds promise for helping children with repetitious and nonfunctional speech to acquire skills or improve on available skills, and that is the behavioural approach. Medication may be used for symptomatic relief of some of the difficulties, but so far only the behavioural approach promises to help the children acquire new skills and eliminate some of the more difficult behaviours.

Behavioural Intervention

  • Since children who speak to themselves or do not use functional speech (speech that makes sense for the context), have a variety of difficult characteristics, efforts are made to help them acquire an appropriate repertoire of communication skills that work. In the behavioural approach, consequences that reward progress are used to try to turn the child's nonfunctional speech or self-talk into functional talk.
  • This approach aims to modify the child's verbal behaviour, along with other areas in the child's functioning. Emphasis based on modifying and correcting speech is referred to as the "Verbal Learning" approach while the one directed at more general functioning is described as the Applied Behaviour Analysis (ABA) approach. When these approaches address the problems of very young children in an intensive fashion, they are referred to as Intensive Behaviour Interventions (IBI).
  • They begin quite early, occasionally before the child reaches his or her third birthday and continue for a number of years, until the child can be graduated out of the need for the use of this costly intervention. It should be noticed that existing evidence supports the view that intervention is most effective if it starts early and is in its most intense form (IBI). Children who show promise at imitation and those who are cognitively higher functioning and have some words are more likely to benefit from intervention. However, aside from age, all children benefit from the ABA approach, particularly if it is employed by seasoned and knowledgeable professionals. 
  • This approach starts with testing the child's knowledge of a series of tasks in various areas of knowledge, e.g., receptive language (understanding), expressive language (speaking), requesting something, math. Those tasks that the child fails form part of an individualized plan in which the child is taught these skills, one-to-one, over and over until success is maintained. For example, a young girl could be tested for her knowledge of the word for milk by having three pictures in front of her on the table and asking her to give the therapist the picture for milk. If she responds correctly over a number of attempts, the child is assumed to understand the meaning of the word milk. For more examples, go to http://www.ehow.com/how_2149869_use-aba-autism-therapy.html or http://www.behavior.org/autism/.
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In Class

  • For children who may occasionally talk to themselves or use nonfunctional speech, the teacher's task is merely to help the child understand that his or her speech is not helpful in sharing with others or helping others with his or her needs.
  • Helping the child to rely exclusively on functional speech and to use speech that is governed by the principles of typical conversation should be the teacher's aim. Rewarding the child for using functional and correct speech and discouraging the use of irrelevant speech would be the approach to take with children who rarely use nonfunctional speech and use it only as a result of engaging in fantasy and their entertainment.

In the School

  • Clearly, children who rarely speak non-functionally or speak to themselves occasionally do not attract much negative attention in the schoolyard and do not create problems for others. The teacher's task is merely to ensure that these children are in fact only occasionally using nonfunctional speech. The teacher may help the child to understand why his or her nonfunctional speech is not appropriate or responded to positively by others. It is anticipated that minimal input by the teacher will rectify the problem. If the problem persists despite the teacher's efforts, then she or he need to consider acting according to the Yellow Light format (see below).

With Family

  • Families may be aware that their preschooler or school age child occasionally uses nonfunctional speech or speech to self. It is important for school and families to share knowledge about the behaviour and what should be done about it in order to ensure that the child reduces these inappropriate behaviours in the school, home and the community. If the behaviours are not easy to control, the family may seek professional input.
  • For children with developmental delay, the parents may obtain support from a developmental psychologist to ensure that they are aware of their child's level of functioning and needs. This is because engaging in nonfunctional speech may also be present in some mildly delayed children. A Speech and Language Pathologist may also be asked to provide input into the child's program.

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In Class

  • In the event that the child uses both functional and nonfunctional speech, the teacher's task would be to collect information on the child's behaviours. Teachers can intervene by redirecting the child and pointing out alternative things the child can engage in rather than self-talk or use of inappropriate talk. As well, the teacher can alert others in the school about the issue. The intervention in this case would be to ensure that the child is rewarded for using appropriate language and refraining from using non-functional speech.

In the School

  • For children who display some of the problems outlined above in the Green Light area, along with nonfunctional speech and talking to themselves, there is a need to ensure that they are identified early and referred appropriately. As well, they need to be protected from bullies in the schoolyard. These children may be assigned tasks that take them away from the presence and noise generated by other children. They may also need to be acclimatized to such things as a loud school bell or boisterous school assemblies in view of their "sensory" issues, and often unusual reactions to loud and unpredictable noise.

With Family

  • Parents who are told that their youngster engages in some self-talk or nonfunctional verbalizations may need to refer their child for a psychological assessment to be undertaken either through the school board's department of psychology or privately. Such an assessment will evaluate areas of strength and weakness and would provide suggestions as to how to best help the child.

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In Class

  • Children in this group require specialized and intensive training, in some instances extended to 40 hours per week. These children are at present not easy to help in their regular classroom. They need to attend either Centre-based or Home based programs in which therapists address the child's areas of deficit and help them acquire a variety of skills, relying on reinforcement principles. They also attempt to reduce the child's more challenging behaviours, including his or her self-talk and nonfunctional talk. The earlier the intervention, the better the reported outcomes.
  • In the event that the child cannot be appropriately placed for a period of time, the teacher can attempt to provide instruction to the child at his or her level. This could be accomplished by examining areas of ability and providing the child with appropriate educational materials related to them. For example, teachers can find that the child is good at copying designs, lacing, tracing or printing letters and numbers, and can reinforce these skills through arts and crafts in the classroom. Teachers should look for any classroom activities that contain elements present in the child's repertoire of skills, and use these opportunities to reinforce the child's strengths.

In the School

  • Children who clearly present with nonfunctional use of speech, speaking to self and all the associated difficulties of a social, communication and sensory nature, need to be supported on an ongoing basis. They require support from an Educational Assistant at least for part of the school day and occasionally the entire day.
  • If they have nothing specific and systematic planned for them, they will need to be taught in a specialized fashion, following the advice and recommendations of specialists in the developmental disabilities area. Such children will also need supports in the home and the community, and to be integrated, at least for part of the time, with typical peers so that they can learn to model age appropriate behaviours from them. As well, such children require ongoing monitoring of progress across time and supports from a variety of professionals such as psychologists, speech and language pathologists, and occupational therapists. Employing a "circle of friends" consisting of caring older children, or even peers of the child with the difficulties, may also help to protect the child from negative treatment by careless classmates or other children.

With Family

  • For those children who have always presented nonfunctional speech and speech to self, there is a need to immediately intervene to ensure that the child receives the best possible support and encouragement to overcome his or her difficulties.
  • The child would most likely require intensive behaviour interventions (IBI), particularly as a preschooler when the benefits are more likely to appear and to be enduring. The parents are also likely to need counseling and support themselves, including self-help groups of parents who have children with comparable problems, in order to cope with the additional demands imposed on them and the other family members.
  • Parents of children who use nonfunctional speech and speech to self, eye contact avoidance, lack of speech or limited use of speech, resistance to change, lack of interactions with peers and sensory issues are in stress. They need the support and understanding from the rest of the community, including their child's school. The bond between home and school will help the child's more adaptive functioning in the long run.

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In Class

  • For children who may occasionally talk to themselves or use nonfunctional speech, the teacher's task is merely to help the child understand that his or her speech is not helpful in sharing with others or helping others with his or her needs.
  • Helping the child to rely exclusively on functional speech and to use speech that is governed by the principles of typical conversation should be the teacher's aim. Rewarding the child for using functional and correct speech and discouraging the use of irrelevant speech would be the approach to take with children who rarely use nonfunctional speech and use it only as a result of engaging in fantasy and their entertainment.

In the School

  • Clearly, children who rarely speak non-functionally or speak to themselves occasionally do not attract much negative attention in the schoolyard and do not create problems for others. The teacher's task is merely to ensure that these children are in fact only occasionally using nonfunctional speech. The teacher may help the child to understand why his or her nonfunctional speech is not appropriate or responded to positively by others. It is anticipated that minimal input by the teacher will rectify the problem. If the problem persists despite the teacher's efforts, then she or he need to consider acting according to the Yellow Light format (see below).

With Family

  • Families may be aware that their preschooler or school age child occasionally uses nonfunctional speech or speech to self. It is important for school and families to share knowledge about the behaviour and what should be done about it in order to ensure that the child reduces these inappropriate behaviours in the school, home and the community. If the behaviours are not easy to control, the family may seek professional input.
  • For children with developmental delay, the parents may obtain support from a developmental psychologist to ensure that they are aware of their child's level of functioning and needs. This is because engaging in nonfunctional speech may also be present in some mildly delayed children. A Speech and Language Pathologist may also be asked to provide input into the child's program.

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In Class

  • In the event that the child uses both functional and nonfunctional speech, the teacher's task would be to collect information on the child's behaviours. Teachers can intervene by redirecting the child and pointing out alternative things the child can engage in rather than self-talk or use of inappropriate talk. As well, the teacher can alert others in the school about the issue. The intervention in this case would be to ensure that the child is rewarded for using appropriate language and refraining from using non-functional speech.

In the School

  • For children who display some of the problems outlined above in the Green Light area, along with nonfunctional speech and talking to themselves, there is a need to ensure that they are identified early and referred appropriately. As well, they need to be protected from bullies in the schoolyard. These children may be assigned tasks that take them away from the presence and noise generated by other children. They may also need to be acclimatized to such things as a loud school bell or boisterous school assemblies in view of their "sensory" issues, and often unusual reactions to loud and unpredictable noise.

With Family

  • Parents who are told that their youngster engages in some self-talk or nonfunctional verbalizations may need to refer their child for a psychological assessment to be undertaken either through the school board's department of psychology or privately. Such an assessment will evaluate areas of strength and weakness and would provide suggestions as to how to best help the child.

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In Class

  • Children in this group require specialized and intensive training, in some instances extended to 40 hours per week. These children are at present not easy to help in their regular classroom. They need to attend either Centre-based or Home based programs in which therapists address the child's areas of deficit and help them acquire a variety of skills, relying on reinforcement principles. They also attempt to reduce the child's more challenging behaviours, including his or her self-talk and nonfunctional talk. The earlier the intervention, the better the reported outcomes.
  • In the event that the child cannot be appropriately placed for a period of time, the teacher can attempt to provide instruction to the child at his or her level. This could be accomplished by examining areas of ability and providing the child with appropriate educational materials related to them. For example, teachers can find that the child is good at copying designs, lacing, tracing or printing letters and numbers, and can reinforce these skills through arts and crafts in the classroom. Teachers should look for any classroom activities that contain elements present in the child's repertoire of skills, and use these opportunities to reinforce the child's strengths.

In the School

  • Children who clearly present with nonfunctional use of speech, speaking to self and all the associated difficulties of a social, communication and sensory nature, need to be supported on an ongoing basis. They require support from an Educational Assistant at least for part of the school day and occasionally the entire day.
  • If they have nothing specific and systematic planned for them, they will need to be taught in a specialized fashion, following the advice and recommendations of specialists in the developmental disabilities area. Such children will also need supports in the home and the community, and to be integrated, at least for part of the time, with typical peers so that they can learn to model age appropriate behaviours from them. As well, such children require ongoing monitoring of progress across time and supports from a variety of professionals such as psychologists, speech and language pathologists, and occupational therapists. Employing a "circle of friends" consisting of caring older children, or even peers of the child with the difficulties, may also help to protect the child from negative treatment by careless classmates or other children.

With Family

  • For those children who have always presented nonfunctional speech and speech to self, there is a need to immediately intervene to ensure that the child receives the best possible support and encouragement to overcome his or her difficulties.
  • The child would most likely require intensive behaviour interventions (IBI), particularly as a preschooler when the benefits are more likely to appear and to be enduring. The parents are also likely to need counseling and support themselves, including self-help groups of parents who have children with comparable problems, in order to cope with the additional demands imposed on them and the other family members.
  • Parents of children who use nonfunctional speech and speech to self, eye contact avoidance, lack of speech or limited use of speech, resistance to change, lack of interactions with peers and sensory issues are in stress. They need the support and understanding from the rest of the community, including their child's school. The bond between home and school will help the child's more adaptive functioning in the long run.

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In Class

  • For children who may occasionally talk to themselves or use nonfunctional speech, the teacher's task is merely to help the child understand that his or her speech is not helpful in sharing with others or helping others with his or her needs.
  • Helping the child to rely exclusively on functional speech and to use speech that is governed by the principles of typical conversation should be the teacher's aim. Rewarding the child for using functional and correct speech and discouraging the use of irrelevant speech would be the approach to take with children who rarely use nonfunctional speech and use it only as a result of engaging in fantasy and their entertainment.

In the School

  • Clearly, children who rarely speak non-functionally or speak to themselves occasionally do not attract much negative attention in the schoolyard and do not create problems for others. The teacher's task is merely to ensure that these children are in fact only occasionally using nonfunctional speech. The teacher may help the child to understand why his or her nonfunctional speech is not appropriate or responded to positively by others. It is anticipated that minimal input by the teacher will rectify the problem. If the problem persists despite the teacher's efforts, then she or he need to consider acting according to the Yellow Light format (see below).

With Family

  • Families may be aware that their preschooler or school age child occasionally uses nonfunctional speech or speech to self. It is important for school and families to share knowledge about the behaviour and what should be done about it in order to ensure that the child reduces these inappropriate behaviours in the school, home and the community. If the behaviours are not easy to control, the family may seek professional input.
  • For children with developmental delay, the parents may obtain support from a developmental psychologist to ensure that they are aware of their child's level of functioning and needs. This is because engaging in nonfunctional speech may also be present in some mildly delayed children. A Speech and Language Pathologist may also be asked to provide input into the child's program.

Back to top


In Class

  • In the event that the child uses both functional and nonfunctional speech, the teacher's task would be to collect information on the child's behaviours. Teachers can intervene by redirecting the child and pointing out alternative things the child can engage in rather than self-talk or use of inappropriate talk. As well, the teacher can alert others in the school about the issue. The intervention in this case would be to ensure that the child is rewarded for using appropriate language and refraining from using non-functional speech.

In the School

  • For children who display some of the problems outlined above in the Green Light area, along with nonfunctional speech and talking to themselves, there is a need to ensure that they are identified early and referred appropriately. As well, they need to be protected from bullies in the schoolyard. These children may be assigned tasks that take them away from the presence and noise generated by other children. They may also need to be acclimatized to such things as a loud school bell or boisterous school assemblies in view of their "sensory" issues, and often unusual reactions to loud and unpredictable noise.

With Family

  • Parents who are told that their youngster engages in some self-talk or nonfunctional verbalizations may need to refer their child for a psychological assessment to be undertaken either through the school board's department of psychology or privately. Such an assessment will evaluate areas of strength and weakness and would provide suggestions as to how to best help the child.

Back to top


In Class

  • Children in this group require specialized and intensive training, in some instances extended to 40 hours per week. These children are at present not easy to help in their regular classroom. They need to attend either Centre-based or Home based programs in which therapists address the child's areas of deficit and help them acquire a variety of skills, relying on reinforcement principles. They also attempt to reduce the child's more challenging behaviours, including his or her self-talk and nonfunctional talk. The earlier the intervention, the better the reported outcomes.
  • In the event that the child cannot be appropriately placed for a period of time, the teacher can attempt to provide instruction to the child at his or her level. This could be accomplished by examining areas of ability and providing the child with appropriate educational materials related to them. For example, teachers can find that the child is good at copying designs, lacing, tracing or printing letters and numbers, and can reinforce these skills through arts and crafts in the classroom. Teachers should look for any classroom activities that contain elements present in the child's repertoire of skills, and use these opportunities to reinforce the child's strengths.

In the School

  • Children who clearly present with nonfunctional use of speech, speaking to self and all the associated difficulties of a social, communication and sensory nature, need to be supported on an ongoing basis. They require support from an Educational Assistant at least for part of the school day and occasionally the entire day.
  • If they have nothing specific and systematic planned for them, they will need to be taught in a specialized fashion, following the advice and recommendations of specialists in the developmental disabilities area. Such children will also need supports in the home and the community, and to be integrated, at least for part of the time, with typical peers so that they can learn to model age appropriate behaviours from them. As well, such children require ongoing monitoring of progress across time and supports from a variety of professionals such as psychologists, speech and language pathologists, and occupational therapists. Employing a "circle of friends" consisting of caring older children, or even peers of the child with the difficulties, may also help to protect the child from negative treatment by careless classmates or other children.

With Family

  • For those children who have always presented nonfunctional speech and speech to self, there is a need to immediately intervene to ensure that the child receives the best possible support and encouragement to overcome his or her difficulties.
  • The child would most likely require intensive behaviour interventions (IBI), particularly as a preschooler when the benefits are more likely to appear and to be enduring. The parents are also likely to need counseling and support themselves, including self-help groups of parents who have children with comparable problems, in order to cope with the additional demands imposed on them and the other family members.
  • Parents of children who use nonfunctional speech and speech to self, eye contact avoidance, lack of speech or limited use of speech, resistance to change, lack of interactions with peers and sensory issues are in stress. They need the support and understanding from the rest of the community, including their child's school. The bond between home and school will help the child's more adaptive functioning in the long run.

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The course to follow will depend upon the level of difficulty.

There will be adolescents who:
  • have difficulty carrying on a conversation and will require modelling and direction about when and how to converse with another person
  • have echolalia (repeating words or phrases they have heard). This will have to be discussed with a speech and language pathologist to explore why it is occurring; sometimes echolalia is functional but the function or purpose is difficult to determine.
  • do not get the gist of discussion nor the meaning of humour or figurative language and will require additional information from teachers to know what is being taught
  • do not look at the person they are speaking with and will have to be taught the social niceties of communication
  • reverse their pronouns; staff will have to model appropriate use of pronouns, correcting the student’s misuse of them
  • frequently make comments or use words that do not make sense (non-functional). If they are lower functioning intellectually this misuse of words will likely be ignored, but if they are higher functioning intellectually they will have to be taught through modelling and direct instruction that such use of words interferes with their ability to communicate effectively.
If the teacher encounters such a youth, even with only one or two of these difficulties, it is important to collect data on the youth's behaviours. If many of these behaviours are present, and they tend be of relatively high intensity and frequency, then the teacher needs to communicate with the student's home. It would be prudent to communicate with the home even if only one or two of the difficulties are noted. It is likely that the parents have noticed some problems, but are unclear as to whether they need to be addressed. If the problems persist, the parents and school principal have to be notified that the youth needs to be referred for additional help. Referral could first be to the school professional support team who could then decide whether that child needs to be referred further for an assessment by a professional or team that specialize in children/adolescents with these difficulties.




  • For students who may occasionally talk to themselves or use non-functional speech, the teacher's task is merely to help the child understand that his or her speech is not helpful in sharing with others.
  • The teacher’s aim should be to help the student rely exclusively on functional speech and use speech that is governed by the principles of typical conversation.
  • For students who rarely use nonfunctional speech, and use it only as a result of engaging in fantasy and their entertainment, the teacher should reward the student for using functional and correct speech and discourage the use of irrelevant speech.
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  • In the event that the adolescent uses both functional and nonfunctional speech, the teacher's task would be to collect information on the student’s behaviours.
  • Teachers can intervene by redirecting the student and pointing out alternative things he or she can engage in rather than self-talk or use of inappropriate talk. As well, the teacher can alert others in the school about the issue. The intervention in this case would be to ensure that the student is rewarded for using appropriate language and refraining from using non-functional speech.
  • The teacher can model appropriate speech and have the youth imitate the model. Other students in the classroom can also be helpful in modelling appropriate teen-age speech and, under the teacher’s direction, can assist the student in understanding age-appropriate speech. This could be done as part of an English class on communication or it could be done incidentally during group tasks or during leisure times. Some adolescents may not understand when to be colloquial and when to be more formal. They may not know the colloquial vocabulary or the topics of interest of their adolescent peers. They have to be taught this information.
  • The adolescent can practice new responses to conversation with guidance and encouragement. For those who have deficits with theory of mind (understanding the perspectives of others) they must be taught that being a good friend means sometimes talking about what somebody else what to talk about. They also have to be taught how to end a conversation appropriately, rather than appearing rude by abruptly leaving or carrying on the “conversation” incessantly.
  • The teacher could set up a discussion with the adolescent and purposefully make conversational errors, asking the adolescent to point out the errors. The adolescent could then be asked to suggest other ways for the adult to respond or comment. They can then be asked to model their suggestion.
  • The adolescent may need to be taught “rescue” comments. If they do not understand what is being said, they will need to learn to indicate that by saying something like, “I didn’t get that. Could you explain it again?”
  • When doing group tasks, the teacher could videotape an activity with the adolescent. Afterward, they could watch the video to identify conversational errors and successes. This might be especially useful in a drama class, since it may seem more natural to the adolescent.
  • Role-playing can be helpful in teaching the cues for conversation such as when someone gives eye contact to indicate it’s the other’s turn to speak. There is an interactive DVD titled “Mind Reading: The interactive Guide to Emotions” which may be helpful in teaching the adolescent to identify conversational cues such as facial expression and tone of voice.
  • New skills have to be practiced in real situations as well as in contrived ones. The adolescent must be given “homework” assignments to try out their new skills.
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  • Adolescents who clearly present with non-functional use of speech, speaking to self and all the associated difficulties of a social, communication and sensory nature, need to be supported on an ongoing basis. They require an individualized education plan to direct teachers’ instruction. The school support team should discuss the student, make a plan to assess for a disorder, if not already done recently, and identify needs for programming.
  • If the student has nothing specific and systematic planned for them, they will need to be taught in a specialized fashion, following the advice and recommendations of specialists in the developmental disabilities area. Such adolescents will also need supports in the home and the community, and to be integrated, at least for part of the time, with typical peers so that they can learn to model age-appropriate behaviours from them. As well, such adolescents require ongoing monitoring of progress across time, and supports from a variety of professionals such as psychologists, speech and language pathologists, and occupational therapists.
  • Employing a "circle of friends" consisting of caring older adolescents, or even peers of the youth with the difficulties, may also help to protect the adolescent from negative treatment by careless classmates or other peers.
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It would be extremely unusual for the behaviours reviewed in this section to begin in adolescence. They generally begin early in child development and continue through the student’s lifespan. The severity of the difficulties depends upon the student’s intellectual abilities and adaptive skills. There can certainly be improvements made to the communication difficulties, but it is likely that there will always be a degree of difficulty.

Those adolescents with higher functioning intellectual abilities may be aware of their communication difficulties and want to improve upon them to be more accepted socially. For others, there may not be cognitive awareness, and the approach for intervention will be based on behaviour. In those cases, adults (teachers and parents) will rely on strategies to alter the behaviours exhibited by the adolescent.
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