Using AAC to talk about emotions

Sally is usually a happy, bubbly girl. But today she’s different - quiet, and clinging to her mother. What’s going on? Is she scared? Tired? Sally doesn’t speak, but she can use her AAC system to ask for her favorite things. You show the feelings page of her communication system and ask her “How do you feel?” Sally points to “happy”, but she doesn’t look happy to you!

Bobby is a wizard at matching the faces on the “Feelings” poster in his classroom to the words and symbols in his communication book. He’s also starting to match the spoken word for a feeling to a symbol.

He learned by repetition and positive feedback. But this hasn’t helped him answer the question “How do you feel?” When asked, Bobby picks a symbol at random, saying he’s ‘happy’ when he’s sobbing, or ‘mad’ when he’s giggling. He can match these words to symbols, but he doesn’t know what they mean.

Sensations of feelings

Feelings are a special kind of vocabulary. We can’t point to them like objects (“Look, it’s a dog!”) or teach them like colors (“This one is blue”). Feelings are internal states that you experience inside your body.

Think about how your body feels when you’re sad. Is there a heaviness in your chest, a lump in your throat? Is your posture slumped? Are your eyes downcast? You’ve learned to associate these sensations with the word “sad”. When you see someone who looks like they're feeling these things, you guess that they're “sad” too.

Now think of how your body feels when you’re tired. Are you looking down? Are you moving slowly or not at all? Are your eyes downcast?

To another person, you might look sad. But you know you’re tired, because you don’t have that heaviness in your chest or lump in your throat. You can feel a lack of energy in your muscles. You feel your eyes closing because you’re about to fall asleep. You can feel the physical sensations inside that tell you that you’re tired, not sad.

Learning feeling words

How did you learn to differentiate your emotional state as “sad” or “tired”? You weren’t born with this knowledge! Like all the words you learned, you heard the adults around you saying sounds. You learned to associate these sounds with what you saw, heard, and felt around you. That red round thing you can squeeze and throw? People keep making “ball” sounds when that thing is there. They look at it or touch it and say “ball”. So you guess that’s what it is!

This is how humans are wired to learn words. It’s much easier to do with concepts that exist outside yourself. When you’re learning what a noun is called, you can see or touch or hear the noun at the same time people say it. You can feel textures when an adjective is mentioned. But only you know what is going on inside your own body. This makes teaching feeling words difficult.

Typically developing children learn the meaning of feeling words gradually. They may use them incorrectly as they're getting started, saying that someone is angry when they’re really surprised or sad. This shows how hard it is to tell what someone else’s feelings are, just based on what we can see. Children 2-5 years old begin to use feeling words in a developmental order (Widen, S.C. & Russell, J.A., 2008):

• Happy
• Angry
• Sad
• Scared
• Surprised
• Disgusted

But even when they learn these basic words, on average they label feelings correctly about 75% of the time.

Teaching feeling words

To learn a word, you need to understand the concept it represents. For concrete things, this is easy. For things, point to the thing and say the word. For actions, say the word while you’re doing the action. But feelings are sensations that happen inside of a person. People also show their feelings in different ways. How can we teach these words?

The best way to teach a feeling is to say that word when you think the person is feeling it. When a child is crying because he can’t have something he wants, you might say “I think you’re frustrated”. That way, the child gets to hear the word at the same time he feels the sensations from that emotion. It might take many repetitions to learn the word, but eventually the association will be made.

Of course, we can’t go around making young children sad or mad just to teach them words for these difficult emotions! The next best thing is to label emotions when situations come up around us. Parents can label their own emotions: “I can’t find my keys - I feel frustrated!”. Or they might label the emotion of another sibling: “Lisa is crying really hard! She might be hungry or tired.” “Ahmed is yelling and stamping his feet - he looks mad!”

Pictures don’t tell the whole story

We can use stories where characters have specific emotions. “Elmer can’t catch Bugs Bunny - I think he’s frustrated!” Using movies or books has advantages over photos of facial expressions. Research shows that it can be difficult to identify emotions from photos. There’s not enough information in a single picture: no body movement, tone of voice, breathing, or posture. A video of someone during an emotion is much clearer than a photo of his face.

Books and movies with stories are even better ways to teach emotions. They can show both the cause of an emotion and how to deal with negative emotions in a mature and effective way.

There is a lot of support material to teach typically developing children to name and deal with emotions by using books. It takes very little adaptation to use these same materials for children with developmental differences who may use AAC. A great place to start is Carole Zangari’s blog posts: Dealing with Feelings: 5 Ways to Encourage Emotion-related Expression by AAC Learners and 5 Visual Supports for Emotions and Feelings.

Other great sources of picture books about feelings that you can use in your teaching are Childhood 101: 16 Awesome Kids Books Exploring Feelings and Emotions and Imagination Soup: Picture Books That Teach Emotions.

The Center on Social and Emotional Foundations for Early Learning at Vanderbilt University has free, evidence-based resources on teaching emotions for teachers and parents. Their book list covers topics like dealing with different feelings, being a friend, self-confidence, and bullying. In the Book Nook on their strategies page, you’ll find guides for using specific books to teach dealing with difficult emotions. And be sure to check out Fostering Emotional Literacy in Young Children: Labeling Emotions and the accompanying one page summary for easy to implement, fun ways to teach feeling words.

Special impact on AAC learners

Everything we’ve talked about applies to children who can speak and children who use AAC for communication. But AAC learners are more likely to have additional challenges that may make it more difficult to learn feeling words.

Sensory processing differences

Children who need AAC are at greater risk for differences in the way they process sensory information. This is especially true for people on the autism spectrum. But anyone with neurological differences that affect speech may also be at risk for sensory processing differences as well. These differences can affect how our brain receives information from both the outside world and our own bodies.

Sight: Children with normal vision learn a lot from watching what goes on around them, including seeing people in emotional situations. This information is an important part of learning what words mean. A vision impairment can make incidental learning difficult. Children who need AAC are also at risk for Cortical Vision Impairment (CVI). With CVI, the eyes work fine, but the part of the brain that interprets what the eyes see doesn’t work properly. This can make incidental learning about feeling words difficult also.

Hearing: Hearing loss makes it difficult to take in spoken language. And even with perfect hearing, children who need AAC are at greater risk for auditory processing disorders. When the part of the brain that makes sense of speech doesn’t work as it should, learning what spoken words mean is especially difficult.

Interoception: Interoception is how the brain knows what’s going on inside your body. Nerves from the organs send information to the brain. This tells you how full the stomach and bladder are, how fast the heart is beating, how tense or relaxed muscles are, and more. Knowing how your body “feels” is an important part of knowing what emotion you’re experiencing. Any problem with interoception can make it very difficult to learn the labels for the emotions you’re feeling. See Interoception and Sensory Processing Issues: What You Need to Know for a description of interoception.

Anyone with these processing differences will need extra help to recognize emotions and learn words to describe them. Fortunately, there’s a great way to help: a teaching method you’re already using!

Don’t forget to model

Modeling on an AAC system is a great way to make the internal, fleeting aspects of feelings more obvious. This is especially true for AAC learners with sensory processing differences. For example, if you’re watching Beauty and the Beast and see Belle wandering lost in the woods, you can model “I think she’s SCARED”. If you’re at the grocery store with your child, and see another child crying, you can model “I wonder if he’s TIRED or MAD or HUNGRY?”

You don’t need to model the whole sentence, just the capitalized words. And you don’t need to have the AAC learner reply. You’re just giving him or her information on what these feeling words mean and where they can be found in his or her AAC system. If we don’t show AAC users how to find feeling words on their communication system, how can we expect them to tell us how they feel?

References

• How Emotions are Made: The Secret Life of the Brain, Lisa Feldman Barrett
• Widen, S. C. & Russell, J.A. (2008). Children acquire emotion categories gradually. Cognitive Development, 23, 291–312.
• Widen, S.C. & Russell, J.A. (2015). Do dynamic facial expressions convey emotions to children better than do static ones? Journal of Cognition and Development, 16 (5), 802-811.
• Interoception and Sensory Processing Issues: What You Need to Know, Amanda Morin
• How Do You Feel?: An Interoceptive Moment with Your Neurobiological Self, Bud Craig
• Alexithymia and Autism: When everyone is speaking a different language, Sonny Hallett