Communication Profiles of Children with ASD.  

Children with Autism often present with difficulties communicating their needs effectively.  As Autism is a spectrum disorder, each child is unique and these difficulties may be characterised through an array of different learner profiles, for example:

• The child may present with a delay in skills such as babbling, pointing or gestures (pre-linguistic communication skills).
• The child may present with a delay in the development of speech norms when compared to children of a similar age, therefore negatively affecting their communication skills.
• Children may present as non-verbal, that is age appropriate speech norms have not yet developed, with the child having difficulty communicating using alternative means.
• Children may engage in high rates of immediate or delayed echolalia (repeating verbatim what they hear) or have a wide vocabulary repertoire, yet are unable to communicate their needs effectively.
• Children may present with language skills that are typical, or even advanced, for their age.
• It is important that the pre-school setting identify and recognise how each child communicates their needs and creates an environment to support and foster this mode of communication into a more effective and fluent communication repertoire.

Through careful classroom planning, staff training, and collaborative planning between home, school and health care professionals; the pre-school environment can help to reduce frustration and allow the child to communicate their wants and needs effectively, while increasing their social interactions with peers and adults.

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How we can increase Functional Communication Skills.

There are a number of ways in which we can teach children with autism to communicate effectively:

For the child who has intelligible speech, we can ensure the child is able to use his speech meaningfully while expanding the child’s vocabulary and use of speech

Or

For the pre-verbal child: Introduce an Augmentative and Alternative Communication System (AAC) such as Picture Exchange Communication System or Sign Language for non-verbal children with Autism and teach the child how to use this system to access what they want/need.

AAC incorporates the variety of ways that we communicate without speech; facial expressions, gestures, symbols, pictures, or writing. 

Children with Autism are often taught to use an AAC system as a bridge to the development of speech, with these systems central in reducing frustration and the occurrences of problem behavior.

Augmentative and Alternative Communication System (AAC).

AAC incorporates the variety of ways that we communicate without speech; facial expressions, gestures, symbols, pictures, or writing. 

Children with Autism are often taught to use an AAC system as a bridge to the development of speech, with these systems central in reducing frustration and the occurrences of problem behavior.

Different types of AAC systems:

The introduction of an AAC system with a young child with Autism has many advantages:

• Can replace inappropriate behaviours as a way of communicating with a more appropriate way get the child’s needs across.
• Fosters independence.
• Enhances social interactions between a speaker and a listener.
• Makes social interactions more valuable and meaningful for the child.
• Develops the pivotal skills of initiation of language and can serve as a foundation to the development of other language areas, e.g. comprehension of language (receptive language) and use of language (expressive language).

• There are many Apps available on smartphones and tablets that provide a way for individuals to communicate using pictures, symbols and written text. Some of these apps allow users to utilize voice output features that can be beneficial for the individual.  The use of technology within AAC is a growing field, with more and more accessible and easy to use options becoming affordable and available.

It is important that the educators, parents and a speech and language therapist work together to decide on the best intervention approach to increase the functional communication skills for each individual child with Autism.

Effective Communication.

What is functional communication?

Functional communication is a means of getting ones basic needs across, i.e. asking for something you want or need, asking to leave an aversive situation, or comment on a situation.

I have a non-verbal child with Autism in my class, which AAC system is the best to introduce for this child?  

It is important to liaise with the child’s family and speech therapist to ascertain what communication system is already in place at home. Once you know this, consistency across settings is very important to ensure that the child can:

• Use the AAC system in a variety of settings and
• That the AAC system is used across the entire day in order to alleviate frustration associated with the difficulty of not being able to get a message across.

If the child is not currently using an AAC system but has difficulty communicating effectively, it is important to introduce one that suits the child’s needs. Each child with Autism is unique and will respond differently to the introduction of sign language or PECS. 

 

Through consultation with the parents, choose a system that is accessible to the child and easily implemented across both school and home settings.  PECS can be introduced on a phased level, as described by Bondy and Frost (2002):

• Phase 1 – Teaching how to communicate – exchange of a single picture to access a desired item. The child does not yet need to choose between pictures.
• Phase 2 – Distance and persistence – The child must learn travel to his/her communication partner in order to exchange the picture and receive reinforcement/item.
• Phase 3 – Discrimination between pictures – The child must scan a set of pictures and choose the picture that corresponded to the item that she/he wants.
• Phase 4 – Sentence structure – The child will use the sentence starter “I want” plus the target picture, therefore creating sentences.

The following websites provide printable PECS pictures/resources:

Do2Learn.

Practical Autism Resources.

Visual Aids for Learning

SETBC.

Children with Special Needs.

Sign Language.

Sign language can be introduced using effective prompt fading techniques, consistency across all staff and the creation of multiple repetitions to practice the motor actions required. 

Lámh is an adapted version of Irish Sign Language, and is commonly used with individuals who have Autism and other disabilities.  Lámh describes the importance of creating a positive signing environment where the child is successful:

• Helps to improve eye contact.
• Reduce frustration.
• Develop vocabulary.
• Helps to develop speech.

More information on Lámh and the training courses can be found at:

Lámh.

Learn Irish Sign Language.

I have a child with Autism in my class who seems to have a lot of language, yet he cannot communicate his needs appropriately and is getting frustrated, what should I do?

Children with Autism often present with uneven language profiles that are difficult to assess. Although the child has a wide vocabulary of nouns, verbs and adjectives, we cannot assume that the child knows how to use this language to communicate his/her wants and needs. Similarly, a child may use a larger variety of words but not understand the meaning of those words.

Therefore, just as we utilise the strategies below to teach a child how to use sign language, the same strategies are important to understand how to teach a child with vocal language how to use that language to communicate effectively.

How do I teach a child to ask for what they want?  What strategies are best?

It is important that we create a positive learning environment where children are successful communicators. When we begin to teach a child to communicate using either words or an AAC system, it is important that we follow a number of key steps:

Take an inventory of the child’s main reinforcers i.e. all the things that the child likes to play with, eat, drink, engage with, watch, listen to etc.

Key Point:

Understanding the power of motivation is key to successful communication training.  This involves actively and consciously arranging the environment to create multiple learning opportunities to practice the act of communication. 

We typically ask for things when motivation is high, e.g. we ask for a drink when we are thirsty or ask to close the window when we are cold. 

It is the role of the educator to create situations where the motivation to request using the AAC system or the vocal response is high.

Using the reinforcers identified in the inventory, set up situations where the child learns that communicating using their mode of communication is valuable, teaching the child why communication is important.  This can be achieved by setting up communicative enticements. 

The following strategies can be effective:

• Reduce the amount of questions you ask the child, for example, avoid asking ‘What do you want?’.
• Rearrange the environment so that preferred toys or items needed for activities are out of reach.  Therefore, the child must use their communication system or a vocal request to access this item.
• Create multiple opportunities to practice this skill.
• Build up anticipation – engage in a fun play routines, then stop and wait for the child to show that they are interested and prompt the communicative response.
• Create problem-solving situations, for example, give the child their yogurt without a spoon, a puzzle without all the pieces, a car garage without the cars.
• Offer choices.
• Become aware of simple daily routines that can become effective learning opportunities; e.g. requesting ‘open’ to open the door to go outside at lunch, to open the crayon box.
• Use nursery rhymes and leave gaps in the songs with the anticipation that the children can fill in the missing word.

Key Point:

It is important to fade the prompting that you use in order to ensure that the child does not become prompt dependent.  If this occurs, it can be difficult to ensure spontaneous communication.

• If working with a child who has speech; fade the prompt level from a full vocal prompt (‘biscuit’) to a partial vocal prompt )’bis’) to a phonemic prompt (‘b’).
• If working with a child using an AAC system; fade the prompt level from a full physical prompt to a partial physical prompt to a gestural prompt.
• Use short, simple phrases and model the correct word.  Avoid saying ‘no’ or ‘say ____’.  Instead, model the word or prompt the picture exchange.  In some cases, a child with autism who engages in echolalia might imitate the full phrase ‘say ___’ as their request as opposed to using the target word.
• It is important to always utilise a Total Communication approach, particularly when introducing an AAC system.  This involves saying the name of the item while reinforcing a sign or picture exchange.

Key Point:

Repetition is key.  It is important that multiple opportunities are created in order to practice this new skill.

It is important to remember that the educator should understand the following:

• What is the goal for this child?
• How can I achieve this goal?
• Is the child learning why it is important to communicate and how they can communicate effectively.

Remember: 

Communication training should be a fun and motivating experience for both the child and the adult.  Play based instruction that capitalises on naturally occurring teaching opportunities are most beneficial and rewarding for the child.

So have fun!!

Pivotal Language Skills.

The pre-school classroom is an excellent environment for children with Autism to learn key, pivotal skills that will help foster and develop language. 

The daily routines of a pre-school, as well as the naturally occurring social interactions with typically developing peers, provide many opportunities for a child to acquire what Koegel and Koegel (2006) describe a number of pivotal skills:

• Symbolic play skills.
• Imitation skills.
• Non-verbal communication skills.

As well as this, it is important that children learn to understand words as a pre-requisite to using language.  Playing games in a group or in a 1:1 setting can help foster these important skills. 

There are endless activities that target a combination of language skills: language comprehension, expressive language skills, imitation skills, symbolic play skills and can increase attention to tasks.

• Clean Up Game – give the child directions as to which toy goes into the box, using a term such ‘bye bye _____’ can also help structure the activity e.g. after playing with Mr. Potato Head, the educator signals it’s time to clean up, and gives instructions to the child about which part goes into the box. “Bye bye eyes” and the child finds the eyes and puts them in the box. “Bye bye nose” and the child finds the nose and puts it in the bow etc. As the child becomes proficient in following your instruction (comprehension), change the game so that the child is labeling items that you are putting away (expressive).
• Nursery Rhymes and Action Songs – these activities are excellent tools to increase attention to activities, imitation skills, following instructions as well as improving body awareness and labeling of actions.  Change the words of common nursery rhymes, e.g. “Head Shoulders Knees and Toes” can be changed to “Head Shoulders Knees and Chin” etc.
• Find the … Game – Place common objects or pictures of common objects on the table and ask the child to “Find the cow”.  Sometimes it can make the game more meaningful if the child gets to ‘post’ the items into a postbox or container once they have chosen it.
• Boss Elsa/Bob the Builder – Using an array of toy objects, the adult and the child take turns telling the teddy or dolly what to do.  Therefore, the adult tells Elsa to “jump” and the child must manipulate the toy to jump.
• Simon Says – this simple game is excellent for developing turn-taking skills, listening skills, imitation, language comprehension and later, expressive language skills.
• Bubbles and Balloons – these activities are great ways to foster joint attention skills and vocal requesting.  Once the child is motivated by the bubbles, delay blowing the bubbles and model the vocal request/picture exchange and reinforce this by blowing lots of bubbles.
• Shaving Foam/Sand Play/Water Play – these sensory activities can be great ways to encourage language development, particularly requesting and imitation skills.  These activities are also excellent tools to model symbolic play with objects.

It is important to remember to adapt your language to suit the child’s level of language comprehension.  For example, if the child is learning to understand instructions that involve one key word “Find the ball”, your instructions should include simple words and short sentences. 

Do not use long, complicated sentences as the child may not understand what you are asking them to do, which could lead to frustration and what might appear to be refusal to follow instructions. 

Instead, clearly tell the child what you want them to do using simple, to-the-point language.  You can also use visual cues such as pointing and gesture to help facilitate language comprehension.

Remember: 

Repetition is key!! If you prompt the child to ask for ‘juice’, create many opportunities across the day to practice using that word, using modeling, recasting, and motivating situations to request.

Creating group activities that are motivating and meaningful for the child with Autism will help to develop increased attention skills and a positive learning experience for the child. 

Adapting your materials to match the child’s interests will allow the child to learn essential pivotal language skills in a fun and exciting manner. 

We can also incorporate Occupational Therapy games and activities to elicit language skills. 

There are a number of resources available online to help you make your group sessions motivating and dynamic:

• Do2Learn
• Pinterest
• Playing with Words