Pre-Verbal Experiences

Pre-Verbal and Visual Expressions

The description of basic aspects of narrative and literary medicine identifies us as health providers with preferences, values, and strategies founded on this model. Our basic practices rarely stray very far.  This module on the pre-story process in as part of narrative medicine and narrative practice will be more coherent (making sense) if our story includes ways to bring together the emotional and social features, preferences, hopes and wishes and attunement or the rhythm of being with people. With young and nonverbally expressive children we have learned to adapt a variety of diverse tools to aid us in our assessment and intervention efforts using dramatic, performing and visual expressive art forms. 

These practices include the use of story foundations that help that work through and master the conflicts associated with disruptions in the lives of people and act to discharge and redirect pent up feelings and un-metabolized stress (undigested) through such expressions as music, dance, mime, play and art and other creative processes.

Such is using pictures as one example of visual support where photographs act as visual organizers supporting routines, predictability, and order. These graphic organizers give structure to the routines of the everyday.  When words are not enough, pictures offer a way to support memory using more of a self-portrait, a mirror using memory that reflects special moments with people and events.  We are interested in using photographs more as a communication tool giving order to experience, not just as an art form.  The use of disposable cameras (we often give these out in our program) has been found useful.  The child may take pictures of both things they like as well as what they dislike.  This provides hints into how integrated the child is (dealing with discrepancies) as well as offering insights into the child’s boundaries as to their ambivalences within their world. With young or developmentally delayed children more hand on hand instruction for situations for picture taking is needed, or the results may be a film role shots of a floor or wall, the child being more interested in pushing the buttons than what images are being taken.

Non-Verbal Talk and Play Practices:

These are all examples of different art forms that express people’s lives as they see themselves reflected in other’s stories and later will describe ways that allow for oral story telling, journaling and writing and reading process. (especially picture books and story books for younger children), and the use of self expression through other art forms as a means of enhancing one’s story.

The use of photography and photographic images:

A child centered website for taking pictures at

Movies are a multi-sensory story source:

The use of play practices:

Play development is constructed in great part by promoting a healthy attachment state of mind involving a responsive partner who can engage in sensitively contingent and reciprocal ways matching and attuned to the child’s feelings, ideas and behaviors. This begins as a mostly non-verbal dance where many kinds of symbols are shared together in play. Click here for attachment Links.

Play Observation Skills

Music, fine arts, media and performing arts offer ways to communicate beyond words or before spoken language using preverbal symbols. These include but are not just limited to familiar actions, sounds, cues, conventional objects in play with gestures, feeling states, affects, posture and bodily movements.

See "Reach Out and Read" Article below: