she understands a perceptibly greater range of commands and suggestions of the ‘put your foot in’, ‘climb up in your chair’ variety. These are all quite long; she seems to respond to them as complete tone patterns rather than separate words. She will, for example, respond to ‘Come on, let’s go upstairs and have your bath,’ but shows no comprehension of much easier sentences made with words within her current vocabulary like, say, ‘Butter, Elly?’ These words she understands only when she says them.
What she understood was in fact a limited range of routine expected commands. I tried once — not then, but six months later — to make a game where the commands required a flexible response: ‘Put the bean in my pocket,’ ‘Put the marble in my hand.’ It was too soon. I got no comprehension at all.
Yet there was progress. We allowed ourselves a little encouragement. Comprehension — even routine comprehension — seemed to us, at this point, infinitely more significant- than actual speech, since comprehension was the strongest sign that Elly could give that she was in contact with other human beings. It is possible to speak without contact; the very word ‘autistic’ points to this, and speech can be autistic. But comprehension is contact itself. For the time being we could be comfortable with the slow increase in what Elly seemed to hear — if the word ‘comfortable’ could ever fit our underwater existence. For speech itself, we would have to wait.
And all this time, what were we doing? Not very much, in fact. Such techniques as we evolved were hardly worthy of the name. But few and obvious as they were, they were all that Elly was ready for, which was lucky for us. We too needed time to learn how to help Elly give meaning to sound.
Again and always, it helped that we had other children. More often, parents of autistic children are less lucky; the disorder seems, like many others, to pick out the first-born. But we had watched three different children learn to talk in their three differing ways, and we had learned how to talk to little children. Little normal children, that is — obviously it could not be the same for Elly, who heard almost nothing that we said. But it could not be so very different either — after all, the range of what one can reasonably say to very small children is not great. With Elly the range was all downward towards zero. Yet it was plain that it must never reach there. We must not chatter to Elly, for a constant background of noise is more easily ignored than single, occasional sounds — and to Elly, all speech was noise. But whether or not she seemed to hear us, we must talk.
We tried to talk simply and directly, waiting, if possible, until Elly was already looking in our direction. We spoke as clearly as we could. We avoided long sentences. We used her own vocabulary as far as possible, little as she appeared to comprehend it. We tried not to use more than one term for the same thing. We were faithful in naming objects that Elly used or played with or merely focused on, at the moment of focus, although months turned into years and she acquired only a pathetic fraction of the hundreds we named. Deliberately, we introduced our games and activities by words; in fact, at four, the bulk of her thirty-one-word ‘vocabulary’ consisted not of simple object-words, but stock responses to familiar activities, like the noise she made for ‘there she is’ in peekaboo, or the ‘whee’ as she went down the slide. We experimented with varying loudness and softness - a loud sound, close by, was something more likely to attract her attention, and besides, there lingered in our minds some apprehension of deafness, partial if not complete. Later on, when she began to lower her defences, we were to find she could respond to a whisper, but in the early years we were careful to keep our speech direct and clearly audible,
But what is ‘really’? ‘You have to admit,’ I said, ‘that if she can do things like that, it's striking that she doesn’t understand anything you say.’ And of course she had shown no signs she knew Joann was in the room. She heard me rarely enough; she almost never seemed to hear a stranger.
But Joann was no ordinary stranger. She knew things I did not - the techniques she had had to find to break through to her sluggish, defective little son, who was apparently so different from our deft Elly. Joann was highly coloured, gay, vivid, aggressive, larger than life. She shouted at Elly — not words, but nonsense syllables: Ba-ba! La-la! And Elly heard her. Instead of shrinking, as perhaps should have been expected, she looked at her and laughed. Months after, she was still saying ‘La-la!’
But speech is not the only kind of meaningful sound. There is also music. One of the best arguments against genuine deafness in Elly was that early on she had shown signs that she could hear music. The ninth entry on her vocabulary list (age two) was a word only by courtesy. It was a sound, and it had a consistent referent, but it was in fact ah imitation of music. When I sat down at the piano, Elly would say ‘daddle-addle-addle’ and move my hand to C #. It was by that that I understood her; I would not otherwise have caught on to the idea that ‘daddle-addle-addle’ represented the two repeated notes in the left-hand part of Mozart’s C-major Sonata, the almost-trill that provides the background when the second theme comes in. But as so often with Elly, nothing came of this early response. She abandoned the word and lost interest in the music, to which she had in any case been attracted not by the pretty theme but by the repetitive notes. Nor did she take an interest in anything else I played. It was not until the summer she was three, a full year later, that I noticed any response to music again.
As with Joann’s syllables, this was something she did not learn from me. Though I sang to her regularly, and though some of her own sounds were not unmusical, she had never herself sung any tune I could recognize. But on a visit to friends-it lasted a week and was a distinct break in Elly’s usual routine — their teenage daughter sang to Elly ‘Row, row, row your boat.’ She made of it a rocking, pushing game that pleased Elly, who continued to sing it for a few weeks after her return home. She sang it all the way through — we could even recognize the word ‘row’. Then it joined Mozart in limbo. We still sang it, of course, and rocked and played the game, but as far as Elly was concerned it was gone.
We got a folk-song record that fall, simple, direct songs a child would enjoy, and Elly seemed to like it well enough. We played it often; it had about twelve songs on it. That January, when she was three and a half, I thought — I was almost sure — I heard her singing one of them, a Scottish folk song, ‘Three Craws Sat Upon a Wall.’ To reinforce and encourage, I began softly to sing along with her. I should have known better; I knew well enough from other experience how important it was not to seem to notice when Elly made a step forward. Elly stopped at once as I began to sing.
But my helpful meddling had delayed her singing, not destroyed it. After six weeks she sang it again all through, I not being so foolish a second time. A new readiness was on its way. By March of that year she was singing five distinct songs, including one tune she had invented, and she had reactivated ‘Row, row.’ She sang them well. Even her first ‘Row, row’ six months before had been as good as the best of her siblings at her age; now, as she sang more freely, her intervals grew exact, her rhythm perfect. And as a year earlier she had begun to acknowledge the simple desire for food, now she found a way to acknowledge a more subtle one. Not by speaking, of course, or by singing herself — instead she would put a gentle hand on my lips to indicate she wanted me to sing. Which was progress as thrilling as the song itself.