Conventional Gestures:
Foundational to Language Development.

Most people use gestures.  We wave across the room to get another person’s attention.  We demonstrate the size of a fish we caught with both hands:  we hold up an open hand to say ‘stop’: we stretch out our open palm to say, “Give it to me”.  We use gestures instead of speech; gestures with speech; gestures to be demonstrative and to be dramatic.  We know gestures are often an important component of our successful adult communication.
How important, then, are gestures to the language development of a young child?  Recent studies have shown that the use of purposeful gestures in a pre-speech child can actually increase his/her functional language and vocabulary. Intentional gestures launch the child into purposeful communication with others. Typically, an infant begins to communicate intentionally through vocalizations, gestures and, later, words.  Developmentally, a young child often uses gestures before s/he begins to speak.  S/he may lean towards mommy or daddy and hold up arms to say, “Pick me up”.  A child might be observed holding out his/her hand while clutching and opening fingers to say “I want”.  He/she may grab your hand and take you to the desired item. When these gestures are directed towards a person and the child is oriented towards the listener or even looks up at the listener it is assumed that the child is establishing a communication partnership with another (social referencing) and is learning communication intent. The parent intuitively responds.

We use communication to serve different functions or purposes. Ten basic functions of communication are:
  • Seeking attention.
  • Greeting/farewell.
  • Requesting objects or actions.
  • Protesting.
  • Rejection (rejecting an item or wanting to cease an activity). 
  • Requesting more or continuation.
  • Requesting ‘help’.
  • Commenting.
  • Answering ‘wh’ questions.
  • Sharing past experiences.
The Functional communication skills in children with autism are most often limited to requesting immediate object, protesting, requesting more and rejection. Social functions of communication (i.e., seeking attention, greeting, commenting and conversational turn-taking) are often more difficult for children with autism to learn. . Functional communication means being able to effectively express wants, needs, and thoughts to a communication partner; be it parent, family member, teacher, doctor, or friend.
The way we communicate are considered the’ Forms’ of communication.   Forms of communication include
  • Reactive behavior -a more primitive response level which denotes responses to environment or people without true communication intent being part of the behavior.  An example would be crying or covering ears at a loud sound.
  • Non-conventional-intentional behaviors - communicative in nature, but usually successfully interpreted only by those close to the person.  An example would be throwing food on floor might mean, “I don’t like this”.
  • Conventional-intentional - the form of language that is intentional and includes gestures that are familiar to that culture.   Here we would include hand waving to say ‘hi’ or ‘bye’, a palm held up to say, “stop”.  This is the level we are developing when we teach gestures as a link to language.
  • Symbolic language - culture specific and can be words, signs, symbols, pictures or written language. Without true intent, the symbols are just a collection of words.
Two types of gestures are most often observed in a child’s early development of language.
  1.  Deictic gestures, which have the function of drawing the attention of the child’s communication partner to something in the environment, are typically observed around 10 to 12 months of age.  Such gestures are usually object based and help to establish the function of ‘requesting’ through pointing, holding things up, showing to and handing to another person. A deictic gesture also helps  the child learn vocabulary as s/he points to and waits for the parent or family member  to ‘name’ the object or picture.  Handing off and releasing an object during the ‘give for help’ gesture in anticipation of the action about to take place takes place at the transition stage of deictic gestures.  Note: during the “Give for Help” gesture, the child also references the adult and waits for a response.   
  2. Representational gestures, (sometimes called Metaphoric gestures) which appear beginning 12-14 months of age,  are more abstract and provide references and linguistic content, with meaning often being independent from the objects around the child.  Such gestures include nodding ‘yes’ or holding a fist to the ear to denote talking on the phone.  At eighteen months, half of an average child’s speech is accompanied by gestures until 2 word spoken sentences appear mid second year, when gestures tend to take second place to developing the spoken word.
Both types of gestures are important in forming structure and meaning in language.  In fact, the use of gestures actually helps children to learn to intentionally communicate to others. (Pien. 1989) In order to be considered meaningful and social, the following characteristics are observed.
  1. Gestures are directed to another person, which requires getting the attention of that person.
  2.  A child who uses a gesture meaningfully expects a response from the other person. We would see the child wait for a response.  If there is no response, the child would persist in making his request by using the same gesture or a different gesture or action until the person responds.
  3. Gestures become ritualized and abbreviated.  Initially the child acts directly upon the object in the environment. S/He grabs at the bottle, pulling it towards his/her mouth.  S/ He reaches for the cup of milk that is placed directly in front of her/him on the high chair tray.  As the child begins to realize that his/her direct actions do not always result in needs being met, s/he begins to “abbreviate” the direct action of grabbing into a gesture.  A grab becomes a whole hand point.  A whole hand point turns sideways so the index finger is leading the point.  Thus the adapted whole hand point becomes an isolated index finger point. The gesture is not going to be effective if the child does not have the attention of the parent so a vocalization is often precedes the point or is paired with the point.  If a vocalization is not used for gaining attention, less desired!
Does your pre-speech child do the following?
  1. Take you to the object he/she desires?
  2. Point to request item-first with whole hand, then with isolated finger?
  3. Does your child look at you when she points to confirm that you are ‘listening’?
  4. Does your child ‘ask’ for help by handing you an object, looking at you while he waits for help?*
  5. Does she greet by ‘waving’, say goodbye by waving, while looking at the person she waves to?
  6. Are your child’s gestures clear and readable to others?
Pairing a deictic gesture with a spoken word, “(point to) bottle” performs the function and intent of a two+ word sentence:  “want bottle”, or even more specifically, “I want THIS bottle”.  Holding a hand to the ear and saying, “daddy” might communicate, “Talk to Daddy”. When the gesture is combined with gaining your attention and following your action to make sure s/he gets that bottle or gets to talk to daddy then your child has learned a complete communication cycle:  s/he wants, uses language directed at you; you respond; s/he gets what s/he wants!  If your child points to an item, such as ‘car’ and says “dada”, you will probably say, “Yes, that is dada’s car” Unless of course it isn’t, then you would say, “No, that is not Dada’s car”; all that communication from a word and a point!
Between the ages of 12 months, when children are typically learning their first words and the age of 24 months when vocabulary begins to grow and two word combinations explode, purposeful gestures often make the difference between communication success and failure.
Children will begin to use more symbolic gesturing as they pretend to bake or pretend to brush teeth.  Words gradually increase and gestures decrease as the spoken word becomes more effective and complete. However, typically gestures never completely disappear.
One of the challenges a child with autism faces is his/her ability to interact with others in a purposeful, social, successful communicative way.  It is, in fact, one of the defining characteristics of an Autism Spectrum Disorder. Research over the past decade has identified two core communication deficits in children with autism:  (1) joint attention and (2) symbol use (Dawson et al., 1990).
A deficit in symbol use reflects difficulty learning conventional or shared meanings for symbols and is evident in deficits in using conventional gestures (gestures that are readable across people and settings in a given culture-such as wave for ‘hi’); learning conventional meanings for words; and using objects both functionally and in symbolic play. Similarly, children with autism do not compensate for their lack of verbal skills with gestures; they show limited gestural use, both in quantity and quality. They predominantly use primitive motoric gestures to communicate (i.e., leading, pulling or manipulating another’s hand). They lack the use of many conventional gestures, such as showing, waving, pointing, nodding the head and the use of symbolic gestures depicting actions (such as pantomiming).
Gestural  joint attention (e.g., showing or pointing to direct listener’s attention) has been found to be a significant predictor of language outcome thus making the teaching of functional gestures an important target for early communication intervention!
 Joint attention establishes the connection between communication partners and redirects the listener’s focus. Many gestures expect a response from the communication partner thereby establishing reciprocity (two way interactions). Gestures without purpose or a referencing are just hand movements. In fact a child may seemingly have many gestures or even signs that are nothing more than learned repetitive motor movementsIn order for gestures to be purposeful, they must be used with intent to communicate and they must be clearly directed towards a person.  A deficit in joint attention reflects a difficulty in the child’s ability to gain the attention of a communication partner and then to gaze or to point to a desired object as a request for that object.  This deficit is often observed in the child’s inability to orient and attend to the social partner; a poor gaze shift between people and objects; and the inability to share emotional states with another person.
Diane Pien from the University of Washington (1989) developed a wonderful protocol called, “Gestures the Missing Link to Language”.  During the development of her program, she looked at children with severely delayed language.  One group of children in her study were beginning to learn cause and effect, that an action makes something happen but these children were not yet ready to learn words or signs as a symbolic language system.  A second group of children had a very small vocabulary of fewer than 10 words or signs that they appeared to use non-imitatively and without prompting. But parents and professionals were puzzled as the children’s signing or spoken vocabulary never increased.  They seemed “stuck”.  When Dr. Pien examined these children more closely, she discovered that the words and signs were not used symbolically but as rote motor responses to questions or requests. This information is crucial to consider as we undertake the teaching of purposeful gestures, signs and words to our children.
The following are red flags indicating that children are using, words or signs as non-symbolic motor actions: (Pien, University of Washington, 1989) 
  1.  Frequent inappropriate use of a, word or a sign.  This would be observed if your child tends to use the same sign or word for a variety of functions even if the word is not applicable. The only correct use of the sign or word would be by chance-for instance, signing ‘more’ serving the function of gaining attention, requesting specific item, and  asking for ‘more’.
  2. Spontaneous use of signs as an almost magical way of making desired objects appear without understanding that objects or actions have specific names. A sign such as ‘eat’ may be used in such a way.  If a child says or signs ‘eat’, food magically appears.
  3. Chaining of signs or words where a child says or signs every word or sign they know until the adult responds.  A parent or teacher asks the child what he wants to eat, and the child signs cookie, hamburger to get more bread. The child has learned these signs as motor actions that he must perform in order to get what he wants not as communication.
Why teach gestures?
It is important, then, to distinguish between a child’s intentional motor actions, like reaching for and grabbing a toy and his/her intentional communicative gestures. Traditionally, language is taught by teaching receptive and expressive language; vocabulary, syntax, phonology.  But, as we know teaching the spoken word and giving a child a large clearly articulated vocabulary does not automatically lead to purposeful spontaneous speech. This is why it is so important to directly teach our children communicative intent prior to the spoken word (or at the very least, concurrently with the spoken word). The most important part of teaching your child gestures is to teach communicative intent
  1.  Gestures are actually the easiest way to teach intent since gestures are not symbolic and develop from natural actions
  2. It is easy to structure naturally motivating situations to encourage a child’s use of gestures.
  3. Teaching gestures increase opportunities for pleasurable social interactions.
  4. Gestures are appropriate for students of all ages and abilities.
Teaching the “Give for Help” gesture is the easiest gesture for children to learn.  It is functional for sensory impaired students as well as students on the spectrum. In teaching this gesture, we begin with a favorite food item in a small clear plastic container that is too difficult for the child to open.  Although it is true that children with autism often have very few food interests, it is usually possible to find something motivating.  If all else fails, use fish crackers or pretzels (gluten free). Open the box with the child, name the item, “cracker”, eat one, and give one to the child. Get all excited, ‘yum, yum, yum’! Put the lid back onto the container.
The first four components of the “Give for Help” gesture are as follows.
  1.  The child deliberately extends the object to the adult.  You may be able to elicit this action by sitting in front of the child (who already has the object) by extending your hands to him/her.  If he/she does not extend or hand the object to you, you may need a second person behind your child who will physically assist the child in extending the object.  When the child hands the item to you, get excited.  Hold the child’s hand (with object) in your hand, pull hands up toward your face to encourage the child to look up, and say ‘You have crackers. You need help.” Be animated with a happy, positive voice.
  2. The child releases the object to the adult.  You may need to gently tug the box as you say, ‘you want a cracker”.  Keep the container near your face as much as possible to encourage the child to look towards you. This also encourages your child to extend the object to you.
  3. The child maintains interest in the object while the adult is holding the containerThis can be encouraged as a child sits in a chair or on the floor with adult behind.  Include excitement about opening the box.  “You want a cracker.  Yum!”
  4. The child expects the adult to perform the desired action with the object.  (In this case that would be giving him/her a cracker).  Trying to keep child’s attention by repeating, “cracker, you want cracker” or staying in front of his face hand the cracker to him.
You can repeat the above routine several times in one sitting, several times a day.  When possible vary the caregivers, containers and food item.
In order to have complete mastery of the “Give for Help” gesture, three more steps are added.
  1.  The child persists in the use of the ‘Give’ gesture until the communication partner pays attention and takes the container.  Waiting is always a very effective tool for allowing spontaneous language/communication to take place.  And waiting is an extremely effective tool here.  When the child repeats his/her give gesture and/or tries to get your attention, he/she is displaying clear intent.
  2. If the child is sighted, he/she makes eye contact (or facial referencing) with the adult as part of the give sequence.  At this point the child hands to you and looks up at you to make sure you are paying attention.  Again, you can initially encourage a child to look towards your face by holding the box near your eyes. If s/he is not sighted, s/he could hold his hands near you or the object or help you ‘open’ with hand- over-hand.
  3. Help the child to generalize by doing the above steps across people, across settings, using a variety of foods and objects in a variety of settings.  Make the ‘give for help’ gesture part of the child’s normal, daily routine.
When the above steps have been achieved in using food in containers, you can expand to favorite toys in a clear container then onto toys that naturally require help-winding up a toy car for instance.  Follow the steps above.
The first step in teaching students to use the “Give for Help” gesture is to understand your child’s current level of communication. If a child hands you an object but doesn’t maintain interest in it then the function of handing it off may be to ‘discard’ the item.  If he/she hands you an item or pushes it towards you and continues to maintain an interest in the item, then he/she is demonstrating a foundational step towards “Give for help”. You can test this by receiving the item he/she hands off and putting it aside.  If he moves towards or reaches again for the object or vocalizes towards the object or towards you, then he is showing an appropriate level of interest and beginning interaction.  Note:  this is not the same as a child following the command of “Give it to me”.  In such a compliance response, the child gives up the object.  In a give for help gesture, the child initiates and expects the object back.  In the first, the adult is in charge.  In the second, the child is’ in charge’.  This is how the power of communication is learned.
Overall, gestures establish a social connection and intention in communication.  Gestures establish a cultural reference for the development of language.  Gestures can even become a language.  In order for your child to develop functional communication interactions that give meaning to his world and to his social interactions, s/he needs to have intentional gestures directed towards a communication partner that communicates his/her desired actions around his preferred objects, foods or events.   The continuation of his/her symbolic language development is laid on this foundation.
Deborah Luetkenhoelter, M.A. /CCCS
  1.  Mundy PSigman MKasari C.
                Journal of  Autism Developmental  Disorders. 1990 Mar; 20(1):115-28.
A longitudinal study of joint attention and language development in autistic children.”
2. Diane Pien and Julia McKibbin Klein  “Gestures: The Missing Link to Language”, University of Washington, 1989

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