Just two and a half years ago, Bethany was what I would describe as completely non-verbal. She had very few words and could not say mummy or daddy. She couldn’t ask for a drink. She couldn’t ask for something to eat. She couldn’t tell me if she wanted to do something or go somewhere. She couldn’t tell me she felt sick. She couldn’t tell me if something hurt on her body, or whether someone had hurt her. She couldn’t say yes or no.

Bethany was unable to communicate verbally except through screaming or crying. Her behaviour was baby-like when she was four and five years old. There were many tantrums due to the communication problems.

Bethany has progressed significantly since those days. She can now request a drink or specific items of food. She will ask for a bowl if she wants cereal. She will let me know if she wants the toilet or to go swimming. She can say “ouch” but not necessarily tell me what hurts. She can ask for a hug or for her tablet.

Beth can also copy phrases that she hears us say or things she has heard on TV shows. The problem with this is that she is just echoing things she likes the sound of. She doesn’t always understand what she is saying. This behaviour is echolalia and is common among Gestalt language learners. She can now say “yes” although she normally chooses to say “no.” In fact, she often says “no” when she means yes. This is frustrating for us at times.

The early days were difficult. There was lots of challenging behaviour. The behaviour was the symptom of the communication problems she was experiencing. It was hard to be patient and to constantly play the detective. We were always trying to figure out whether she was hungry, thirsty, hurt, sick, tired, dirty, overwhelmed…. You get the picture. In Autism circles, they call it iceberg theory. The behaviour you see is the iceberg. The causes are under the surface.

As Bethany developed, she became adept at pulling us places to try and show us what she wanted. She eventually learned to gesture and to point (often with her middle finger unfortunately). But it was still difficult to figure out what she was wanting at times.

We bought “now and next” boards and picture cards, so we could have visual schedules to let her know the plan. Sometimes she ran to us with a picture of what she wanted. We used words with the pictures to help her learn. We used physical object references to help her understand the names of the objects. We played Yakka Dee on repeat on BBC iPlayer. We tried to keep our language as simple as possible. At school they used pictures, symbols, Makaton, and speech. I became aware that some gestures Bethany was using at home were Makaton signs. I signed up for a basic Makaton course.

Just over a year ago, Bethany started to say mummy. She was six years old. It was special to me to finally hear it. Last summer she started to say daddy. My husband was beginning to think it would never happen. She can say “Lucy” but seems to have given Lucy the nickname “Shula” instead.

With the increase in Bethany’s verbal abilities, the behavioural meltdowns have reduced significantly. They still happen sometimes, but far less frequently, and sometimes just because we have said “no” to her about something. She can be extremely stroppy when she does not get her way.

We are pleased that Bethany is now able to communicate to a basic standard, but I wonder if she will ever be able to tell me that her throat is sore or that her joints are aching. I wonder if she will ever be able to answer questions or tell us about her day at school.

I wonder if she will ever manage to have a normal conversation or discussion. Will she be able to discuss history or science? Will she ever have political or religious opinions and be able to voice them? Will she ever be able to explain if anyone does anything inappropriate to her? Will she communicate above a basic standard of needs and wants?

I don’t know the answers to these questions. I could choose to live in fear of the answers to these questions.

But I do not choose fear. I choose to hope.

This girl, Bethany, has come so far! And she is a determined girl. I refuse to limit her. May she fulfil all her potential!