Communication Therapy in childhood psychosis involves treatment      of speech, language, and interactional behaviour as well as attention      to the cognitive substrate that underlies communication performance.  As such, Communication Therapy with the psychotic child is  concerned with the child’s  difficulties with the structure, the meaning, and  the function of a speech act.

The particular approach to be described here is based on the      hypothesis that self-awareness and other  awareness deficits that  characterize childhood psychosis have consequences for speech, language,  and concept acquisition and maintenance. A child who is         psychotic is not  adequately aware of  his  own internal states and   action, and not adequately open to receiving information from the environment. The development of language and concepts seems to be   dependent on:     

1) The ability to  adequately monitor one’s own actions and thoughts.          

2) The ability to monitor actions and events outside the self (including   language).

  3) The ability to assess and make  comparisons between the two. It      is the continual ability to make  such comparisons and, consequently, to make any necessary adjustments in language and thought (concepts) that characterize a developing and active child in Piaget’s developmental psychology (equilibration theory) and in the auditory feedback model of language acquisition and maintenance. From the      viewpoint of  communication, then, psychotic children exhibit  deficits  in auditory monitoring, both as it relates to attending to salient and     relevant language and associated nonlanguage  experiences outside   themselves  (external monitoring), and as it relates to attending to  information  about language and the world that they have already   taken in and stored in their memories (internal monitoring). This auditory monitoring  disturbance, crucial to their communication  failure, exists as part of  their total disturbance in  self-awareness and  self-regulation.

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