4-Year-Old Non-Verbal Child Who Screams to Get What He Wants

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I see a non verbal 4yr old child that has autism. He uses hand over hand manipulation to request desired object and screams. If you do not give it to him he will not stop screaming or looks away. I have been working with him to produce initial sounds, point, use PECs system but he seems unresponsive to it all.  In addition, it is hard to keep him seated during therapy. He likes to run in circles around the room and pull things off the shelf. Any suggestions?

My Suggestions:

  • Move to a non-cluttered room where he can run around but there’s nothing to pull off the shelves.  If not possible, try barricading or blocking shelves so he can’t get to the other materials
  • Bring in a back-prompter if possible
  • Get a single button that speaks a specific message.



  • When the child tries to get what he wants, the back prompter (or you) guides his hand to the button and pushes it.  Then, he gets what he wants (even if he screams)
  • The communication partner repeats what the button said (“you said cookie”) and praises for pushing the button
  • After a while, see if the back-prompter can fade off and he’ll do it on his own
  • In between trials, let him run around until he comes back for more.  If he doesn’t come back for more, find a more motivating reinforcer


  • Could also be done with PECS (but you already tried that) or some other picture communication but I like that the button talks
  • Could do hand-over-hand to help him do sign language also