Behavioral Health Treatment September 1997 Vol. 2 No.9
Special Issue: Reports from the 105th annual meeting of the American Psychological Association
ISSN 1089-2559

Retarded boy learns language at age eight

Although doctors had told parents their retarded son would never learn to speak, the French Canadian youngster began talking almost immediately after starting an intensive language development program.

The boy was 8 years and 4 months old when he was first examined by Philip Zelazo, Ph.D., professor of psychology and associate professor of pediatrics at McGill University-Montreal Children's Hospital Research Institute. The child suffered from several additional conditions, including attention-deficit/hyperactivity disorder and global dysphasia, when Zelazo first saw him. A wheelchair fabricator who had heard of Zelazo's work with similarly affected children had encouraged his parents to bring the boy to Zelazo. "Physicians told his parents that he would not speak," Zelazo says. "He was taught a handful of signs and pointed to pictures to communicate. Despite four years of extensive specialized services, he showed minimal effective communication, functioning at the expressive level of an 18-month-old on the language subscale of the Griffiths test of intelligence."

Zelazo instructed the parents in a treatment program that he developed called "Learning to speak: A manual for parents." The program requires 12 minutes of daily therapy, using verbal repetition and reward incentives to move the child from vocalization to simple one-syllable nouns, and, eventually, to simple phrases. Treatment sessions were conducted five to seven days a week.
"Because we were able to see some accomplishments almost immediately, the parents were motivated to comply with the treatment program," Zelazo says. In fact, they continued the sessions without a break for 16 months, noting improvements in the boy's language skills. For the first three months of treatment, therapists observed the training sessions to coach parents when necessary. To evaluate the program, some of the sessions were videotaped and the words produced were compared with conventional vocabulary measures. Zelazo says that even though 12 minutes a day might not seem like a lot of work, the extended effect eventually wore out the parents, who stopped the therapy for two months after working nearly a year-and-a-half continuously. Remarkably, Zelazo says when the parents picked up the treatment program again, the child had not lost any ground. He says that during the program the child's language improvement grew faster than one would naturally expect. During the first months of treatment, the child was able to coherently pronounce about five words in each of the 12-minute sessions; and by the end of 14 months, the number of words in each session was 73. By then, he was putting words together in pairs or three-word spontaneous utterances. At the end of the year, the child who had not spoken a word in more than eight years was able to spontaneously put together simple sentences. During the baseline testing period, the child spoke 29 words; after one year his vocabulary included 179 words; and 266 words after the second year.
"After one year of treatment, overall gains were sufficient to move this child from the severely to the moderately retarded range, a category change further enhanced at the two-year follow-up testing," Zelazo says. The child's IQ increased 13 points, from 32 at initial testing to 45 after two years. "His overall gains surpassed all expectations associated with severe mental retardation."

And, now in his 11th year, he continues to progress.
Although Zelazo says he was excited about the results that might be applicable to other children who have language problems, he cautioned that the high degree of success in this case is attributable to the remarkable work of very committed parents.

Based on interviews with Philip Zelazo and his APA meeting presentation, "Onset of Talking with Treatment in a Non-Verbal Nine-Year-Old." For more information, contact Dr. Zelazo at the Montreal Children's Hospital/McGill University, Department of Psychiatry, 2300 Tupper, Montreal, Quebec H3H I P3 Canada; (514) 934-4449.