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Communication and Autism Spectrum DIsorders

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Kristin J. Szewczyk, M.S./CCC-SLP February 1, 2009 Now that we have reviewed the functions of communication used by individuals with ASD, we will now discuss the ... – PowerPoint PPT presentation

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Title: Communication and Autism Spectrum DIsorders


1
Communication and Autism Spectrum DIsorders
  • Kristin J. Szewczyk, M.S./CCC-SLP
  • February 1, 2009

2
  • Communication is simply defined as
  • an exchange of information however, the
    process of communication is much more complex.
  • (Hedge, 2001, p. 2)

3
  • Problems with Communication

4
  • Communication deficits are one of the primary
    characteristics
  • of autism spectrum disorders (ASDs)
  • (American Pyschiatric Association, 2000)

5
Common Problems with Communication
  • Speech
  • May Never Develop Speech
  • 30 of individuals with ASD are Non-Verbal (Klin,
    2006)
  • Articulation Errors
  • Difficulty understanding Prosody
  • Inflection of Speech
  • Oral Motor Difficulties
  • Cannot imitate oral movements
  • Drooling
  • (American Speech-Language-Hearing Association
    ASHA, 2009b Prelock, 2006)

6
Common Problems with Communication
  • Expressive Language
  • Echolalia-Repeating what is said
  • Immediate
  • Delayed
  • Difficulty expressing wants/needs
  • Poor Vocabulary
  • Difficulty with Pronouns
  • Difficulty with non-literal aspects of language
  • Reduced sentence length
  • (ASHA, 2009b Prelock, 2006)

7
Common Problems with Communication
  • Receptive Language
  • Difficulty following directions
  • Difficulty answering questions
  • Pragmatic Language
  • Social Language
  • Difficulty with Initiating and Maintaining a
    Conversation
  • Difficulty understanding Facial Expressions/Body
    Language
  • Poor Eye Contact
  • (ASHA, 2009b Prelock, 2006)

8
  • Functions of Communication

9
Functions of Communication
  • Three Primary Functions of Communication in
    Individuals with ASD
  • Regulate Behavior
  • Social Interaction
  • Joint Attention
  • (Wetherby Prizant, 2005)

10
Functions of Communication
  • Regulate Behavior
  • First function to develop
  • Making requests
  • Objects
  • Activities
  • Expressing Wants/Needs
  • Hunger/Thirst
  • Asking for help
  • (Prelock, 2006 Wetherby Prizant, 2005)

11
Functions of Communication
  • Social Interaction
  • Play Activities
  • Requesting involvement with Family/Friends
  • Social Greetings
  • Hello/ Bye-Bye
  • Bring Attention to Self
  • Showing Off
  • (Prelock, 2006 Wetherby Prizant, 2005)

12
Functions of Communication
  • Joint Attention
  • Shifting attention between individuals and
    objects
  • Gaining an individuals attention
  • Directing an individuals attention
  • Make Comments
  • Ask Questions
  • Provide information
  • (Prelock, 2006 Wetherby Prizant, 2005)

13
  • Methods of Communication

14
  • Verbal Communication
  • Augmentative and Alternative Communication (AAC)

15
Verbal Communication
  • Using spoken words to express wants/needs,
    request items/activities, make comments,
    ask/answer questions, and engage in social
    interactions

16
AAC
  • AAC is a combination of symbols and methods that
    are used to improve communication (Downey
    Hurtig, 2003)
  • Object Exchange
  • Sign Language
  • Total Communication
  • Picture Exchange Communication System (PECS)
  • Voice-Output Communication Aids (VOCAs)

17
Object Exchange
  • Real Objects
  • Child gives communicative partner an object to
    indicate what he/she wants
  • Example Child gives parent a book to indicate
    that he/she wants to read a story
  • Child must have easy access to the objects in
    order to make wants/needs known
  • (Strokes, 2006)

18
Sign Language
  • Movements made with the hands to represent
    letters and words
  • (National Institute on Deafness and Other
    Communication Disorders, 2008)

19
  • (Lifeprint.com, 2008)

20
Total Communication
  • An AAC method that involves using verbalizations
    and sign language simultaneously
  • (Goldstein, 2002 Prelock, 2006)

21
PECS
  • Developed to improve the communication skills of
    preschool students diagnosed with ASD
  • Child exchanges pictures with an individual to
    communicate
  • Consists of six phases
  • (Frost Bondy, 1994, 2002)

22
PECS Phases
  • Phase I How to Communicate (Frost Bondy,
    2002, p. 67)
  • Instructor presents the individual with a
    preferred item
  • Individual chooses a picture that represents the
    preferred item
  • Individual gives the picture to the instructor to
    request the item
  • Instructor gives the individual the desired item

23
PECS Phases
  • Phase II- Develops independent requesting
  • Individual chooses a picture from his/her PECS
    book
  • Individual finds the communicative partner and
    gives the picture to him/her
  • Only one picture is used during this phase
  • (Frost Bondy, 1994 2002)

24
PECS Phases
  • Phase III-Continues to develop independent
    requesting
  • Individual selects a picture from a larger field
  • Individual independently selects a picture from
    his/her PECS book and finds a communicative
    partner in order to make the request
  • Number of pictures increases as the individual
    gains accuracy and experience
  • (Frost Bondy, 1994 2002)

25
PECS Phases
  • Phase IV- Combining pictures to make requests
  • Individual uses a sentence strip located at the
    front of his/her PECS book to build more
    complicated requests
  • Individual must locate the I want picture as
    well as the picture of the item or activity
    he/she is requesting
  • Individual then finds a communicative partner in
    order to make the request
  • (Frost Bondy, 1994 2002)

26
PECS Phases
  • Phase V- What do you want?
  • Individual uses a sentence strip located at the
    front of his/her PECS book to build more
    complicated requests
  • Individual must locate the I want picture as
    well as the picture of the item or activity
    he/she is requesting
  • Individual then finds a communicative partner in
    order to make the request
  • (Frost Bondy, 1994 2002)

27
PECS Phases
  • Phase VI- Independent Communication
  • Individual independently responds to a variety of
    questions and makes comments using his/her PECS
    book
  • (Frost Bondy, 1994 2002)

28
PECS
  • (Strokes, 2006)

29
VOCAs
  • Electronic device
  • Child pushes a button on device
  • Pictures/printed words on the buttons represent
    messages
  • Pre-recorded message plays
  • Vary in complexity and cost
  • (Nunes, 2008)

30
VOCAs
  • (The Sensory Company, 2003)

31
VOCAs
  • (AdaptAble Minds, n.d.)

32
VOCAs
  • (SuperDuper Publications, 2009)

33
VOCAs
  • (DynaVox Technologies, 2008)

34
Benefits of AAC
  • Beneficial for verbal/non-verbal children with
    ASD
  • Increases number of vocalizations/verbalizations
  • Improves functional communication skills
  • Expressing wants/needs
  • Requesting
  • (Blischak, Lombardino, Dyson, 2003
    Charlop-Christy, Carpenter, Le, LeBlanc Kellet,
    2002 Dyches, Davis, Lucido, and Young, 2002
    Goldstein, 2002 Mirenda, Wilk, and Carson
    2000 Nunes, 2008

35
Benefits of AAC
  • Improves communicative initiations
  • Responses
  • Comments
  • Improves social interactions
  • Decreases problem behaviors
  • (Blischak, Lombardino, Dyson, 2003
    Charlop-Christy, Carpenter, Le, LeBlanc Kellet,
    2002 Dyches, Davis, Lucido, and Young, 2002
    Goldstein, 2002 Mirenda, Wilk, and Carson
    2000 Nunes, 2008

36
  • Selecting a Method of Communication

37
  • When selecting a method of communication, should
    consider the following
  • Communication needs of your child
  • Physical capabilities of your child
  • Childs level of motivation
  • Flexibility/Accessibility of the method of
    communication
  • Consult with a speech-language pathologist (SLP)
  • (ASHA, 2009a)

38
  • Communication Strategies

39
Strategies
  • Naturalistic Language Teaching
  • Joint Action Routines
  • Visual Strategies
  • (Goldstein, 2002 Prelock, 2006 Tissot Evans,
    2003)

40
Naturalistic Language Teaching
  • Instruction and learning is provided during
    naturally occurring situations
  • Uses child-preferred materials
  • Learn and generalize skills at a faster rate
  • Child is reinforced for appropriate initiations
    and responses to communication
  • (Harris Delmolino, 2002 Prelock, 2006)

41
Naturalistic Language Teaching
  • Milieu language teaching
  • Child-directed modeling
  • Mand-modeling
  • Time-delay
  • Incidental teaching
  • (Goldstein, 2002 Harris Delmolino, 2002
    Prelock, 2006)

42
Milieu Language Teaching
  • Child-Directed Modeling
  • Uses childs interests
  • Establishes joint attention
  • Adult/Instructor provides verbal models
  • Reinforce correct responses
  • Repair incorrect responses
  • (Harris Delmolino, 2002 Prelock, 2006)

43
Example of Child-Directed Modeling
  • Interest Child enjoys going for rides in the
    car
  • Adult/Instructor Say, Open the door.
  • Child responds Door.
  • Adult/Instructor Say, Open the door.
  • Child responds Open the door.
  • Adult/Instructor Nice talking!
  • Adult/Instructor then opens the door to the car.

44
Milieu Language Teaching
  • Mand-Modeling
  • A mand is a verbal instruction or request
    (Prelock, 2006, p. 413)
  • Teaches functional communication skills
  • Utilizes childs interests
  • Establish joint attention
  • (Harris Delmolino, 2002 Prelock, 2006)

45
Mand-Modeling
  • Adult/Instructor instructs the child to follow a
    command or complete a request
  • Provides a verbal model
  • Reinforce correct responses
  • Repair incorrect responses
  • (Harris Delmolino, 2002 Prelock, 2006)

46
Example of Mand-Modeling
  • Child approaches playdough, which is the childs
    favorite activity
  • Adult/Instructor Say, I want playdough.
  • Child says Dough.
  • Adult/Instructor Say, I want playdough.
  • Child says Want playdough.
  • Adult/Instructor Say, I want playdough.
  • Child says I want playdough.
  • Adult says Nice talking!
  • Gives child the playdough

47
Milieu Language Teaching
  • Time-Delay
  • Using pauses between the mand and the provided
    model/cues
  • Develops independent communication
  • (Harris Delmolino, 2002 Prelock, 2006)

48
Example of Time-Delay
  • Child wants to watch a movie and stands in front
    of the TV
  • Adult/Instructor waits until child makes the
    request
  • Child says, I want to watch a movie.
  • Adult/Instructor completes the request

49
Milieu Language Teaching
  • Incidental Teaching
  • Increase language/conversational skills
  • Environment arranged to facilitate communication
  • Utilizes childs interests
  • Child must interact with adult to make a request

50
Milieu Language Teaching
  • Adult instructs child to make a request or answer
    a question using a more complex response
  • Provides a model
  • Provides correction
  • Provides reinforcement
  • (Harris Delmolino, 2002 Prelock, 2006)

51
Example of Incidental Teaching
  • Child wants a cookie and says, Cookie.
  • Adult/Instructor What kind of cookie do you
    want?
  • Child I want a chocolate cookie.
  • Adult/Instructor Here is your cookie. You
    like chocolate cookies. I like chocolate
    cookies, too. Do you think Daddy likes chocolate
    cookies?
  • Child Yes. He eats chocolate cookies, too!

52
Joint Action Routine
  • Utilizes familiar routines
  • Involves two or more individuals
  • Provide some items for routine, but withhold
    others
  • Child requests items needed to complete the
    routine
  • Adult/Instructor asks child questions during the
    routine
  • (Prelock, 2006)

53
Joint Action Routine
  • Three types of joint attention routines
  • Routines with a specific product or outcome
    (Prelock, 2006, p. 408)
  • Routines planned around a theme or story
  • Turn-taking routines
  • (Prelock, 2006)

54
Example of Joint Action Routine
  • Breakfast
  • Adult/Instructor What do you want for
    breakfast?
  • Child Cereal.
  • Adult/Instructor What kind of cereal?
  • Child Lucky Charms.
  • Adult/Instructor gives child the box of cereal
  • Child I need the milk.
  • Adult/Instructor gives the child the milk.
  • Child I need a bowl and a spoon.
  • Adult/Instructor gives the child the bowl and
    spoon.

55
  • Why use visual strategies?

56
Visual Strategies
  • Children with ASD are visual learners
  • Makes concepts concrete
  • Improves focus and attention
  • Reduces anxiety
  • Improves communication
  • (Rao Gagie, 2009 Tiss0t Evans, 2003)

57
Visual Strategies
  • Modeling
  • Live
  • Video
  • Social Stories
  • Scripts

58
Live Modeling
  • Also known as in vivo modeling
  • Child observes an individual demonstrating a
    desired behavior
  • Parents, peers, other adults/children
  • Goal is for child imitate and use the desired
    behavior in other situations
  • (Charlop-Christy, Le,
    Freeman, 2000
    Prelock, 2006, p. 420)

59
Live Modeling
  • Benefits
  • Effective in improving social and communication
    skills
  • Implemented by a variety of individuals
  • Parents, siblings, teachers, etc.
  • Used in a variety of settings and situations
  • (Charlop-Christy, Le, Freeman, 2000
    Prelock,
    2006

60
Video Modeling
  • Child watches videos of an individual
    demonstrating a desired behavior
  • Others
  • Parents, peers, other adults/children
  • Self
  • Again, goal is for child imitate and use the
    desired behavior in other situations
  • (Buggey, 2005 Delano, 2007 Hitchcock,
    Dowrick, Prater, 2003 Sherer et al.,
    2001)

61
Video Modeling
  • Benefits
  • Effective in improving social and communication
    skills
  • Ususally obtain quicker results than live
    modeling
  • Can be used repeatedly in a variety settings and
    by different individuals
  • (Baharav Darling, 2008 Charlop-Christy, Le,
    Freeman, 2000 Delano, 2007 McCoy
    Hermensen, 2007)

62
Modeling Considerations
  • First, choose a behavior to teach
  • Examples
  • Saying hello/ bye
  • Answering questions
  • Conversational skills
  • Turn-taking
  • (Charlop-Christy, 2004)

63
Modeling Considerations
  • Next, determine steps achieve desired behavior
  • Examples
  • Saying hello / bye first
  • Asking question
  • Beginning a conversation
  • Helps to watch childs peers
  • Success
  • Demonstrates behavior 75 to 80 of the time
  • (Charlop-Christy, 2004)

64
Visual Strategies
  • Social Stories
  • Short stories that are written from the childs
    point-of-view
  • Provides information about a social situation and
    how to respond appropriately
  • Individuals involved
  • Order of events in the situation
  • Feelings of other/self
  • (Ivey, Heflin Alberto, 2004
  • Sansosti Powel-Smith, 2008)

65
Social Stories
  • Benefits
  • Reduces problem behaviors
  • Improves social communication
  • Increases appropriate social interactions
  • (Crozier Tincani, 2005 Thiemann Goldstein,
    2001
  • Ivey, Heflin Alberto, 2004 Sansosti
    Powel-Smith, 2008)

66
Example of Social Story
  • http//www.frsd.k12.nj.us/autistic/Social20Stori
    es/Pages/asking_other_kids_to_play.htm.

67
Visual Strategies
  • Scripts
  • Used to teach social and conversational skills
  • Taught using modeling, cues, and reinforcement
  • Script is written on a cue card
  • May include pictures or other symbols depending
    on individuals reading level
  • May be tape-recorded
  • (Charlop-Christy Kelso, 2003
  • Ganz, Kaylor, Bourgeous, Hadden, 2008)

68
Scripts
  • Scripting process
  • Adult asks a question
  • Presents cue card to individual containing the
    response
  • Individual is told to read the response out loud
  • Adult then instructs the individual to read the
    response while maintaining eye contact
  • Process is repeated until conversation is
    finished
  • Provide reinforcement
  • Verbal praise Great job!
  • Preferred food, toy, or activity
  • (Charlop-Christy Kelso, 2003
  • Ganz, Kaylor, Bourgeous, Hadden, 2008)

69
Script Example
  • Adult Do you like to watch T.V.?
  • Child Yes. Do you like to watch T.V.?
  • Adult Yes. Whats your favorite show?
  • Child Power Rangers. What show do you like?
  • Adult Cheers. Do you watch videos?
  • Child Yes. Can we watch a video?
  • Adult Sure!
  • (Charlop-Christy Kelso, 2003, p. 125)

70
Scripts
  • Benefits
  • Improves conversational skills
  • Improves social interactions
  • Peers
  • Adults
  • Decreases echolalia and speech perseverations
  • (Charlop-Christy Kelso, 2003 Ganz, Kaylor,
    Bourgeouis, Hadden, 2008)

71
Visual Strategies
  • Resources
  • Boardmaker
  • http//www.mayer-johnson.com/MainBoardmaker.aspx
  • Microsoft Clip Art
  • Writing with Symbols
  • http//www.mayer-johnson.com/ProdDesc.aspx?SKUM16
    5

72
Visual Strategies
  • Resources
  • PixWriter
  • http//www.slatersoftware.com/pixwriter.html
  • Digital Camera
  • Google Images
  • http//www.google.com

73
Conclusion
  • Communication is a complex process
  • Especially difficult for individuals with autism
  • Three Functions of Communication
  • Regulate Behavior
  • Social Interactions
  • Joint Attention
  • (American Pyschiatric Association, 2000 Hedge,
    2001 Prelock, 2006)

74
Conclusion
  • Many available methods of communication
  • Choose the one that best fits the communication
    needs of your child
  • Communications Strategies for in the Home
  • Naturalistic Language Teaching
  • Joint Action Routines
  • Visual Strategies
  • (ASHA, 2009a Charlop-Christy Kelso, 2003
    Goldstein, 2002 Harris Delmolino, 2002
    Ivey,Heflin Alberto, 2004
  • Prelock, 2006 Sansosti Powel-Smith, 2008
    Tissot Evans, 2003)

75
  • OPPORTUNITIES TO COMMUNICATE ARE EVERYWHERE!!!

76
References
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