"C" 
Communication & Comprehension Capitalized

• Identify communication strengths & challenges
• Remember communication is behavior 
• Be proactive!

How is an individual with autism communicating his/her needs, wants, desires and protests?  Is the individual whining, crying, pulling you toward an object, reaching for an object, giving you an object, using gestures or sign language, presenting a picture of the object to you, vocalizes, making one word utterances, using phrases or sentences?  All of the above are examples of communication.  

Communication challenges are one of the three defining characteristics of individuals with autism. These challenges in communication include both receptive and expressive language skills.  

Begin capitalizing on communication - be proactive. Assess the environment - what is encouraging the individual to communicate or use inappropriate behaviors?  What can be changed or added in the environment to make communication easier for the individual?  Is the intended "message" from the individual understood by others (even strangers understand what is being communicated)?  Is the communicated message effective (it works for the individual - needs are being met)?  Does the individual communicate effectively and safely when stressed, upset, or when in different environments? And, is the individual receiving the intended verbal and nonverbal messages from others?  

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         Ways To Capitalize On 
Communication & Comprehension

To Capitalize On Communication & Increase Comprehension, Caretakers May Need To...

• Learn Verbal Behavior Strategies -  Verbal Behavior focuses on the functional analysis of language - it looks at the conditions - environment under which a person will use their language.  It can include speaking, using gestures, using sign language, using picture communication systems, and augmentative communication devices. 

• Use of Verbal Operants -  VB focuses on the following verbal operants: "Mands" (requests - it is said because you want it), "Tacts" (labels objects or actions - you say it because you see it, or hear it, or smell it, etc.), and "Intraverbals" (responding when someone else talks, verbal behavior behavior with a response that does not directly match - conversation, answering a question - it is said because someone else asked you a question, or made a comment),  "Echoics" - (repeating what the other person said - it is said because someone else said it) & "Receptives" - (following directions - you "do" what someone instructs you to do).

• Create "reasons" for the child to use verbal behavior -whether through signing, pictures, or words (manding or asking for something needed or desired is a wonderful way to encourage communication)  

• Place desired items out of reach to encourage individuals with ASD to have a "need" to communicate (do not give the item for inappropriate behavior - tantrums, etc.) - then when you notice the individual looking at the item... state the name of the item.. then prompt the individual to say it (or sign it.. or hand you a picture of it) - hold it and then as soon as the child uses verbal behavior (says it, signs it, or hands you the picture) give it to the child immediately! 

• Reinforce the individual's use of verbal behavior (not tantrums or the lack of attempts to communicate to you)

• Be proactive (don't wait till inappropriate behaviors occur to address communication)

• Use principles of ABA -  (e.g., reinforcement, modeling, prompting, differential reinforcement, etc.)         

                                           

• Functional Communication Training - teach child an alternative behavior to gain a similar reinforcer - (e.g., instead of a child screaming to escape an undesired task, the child will be taught to ask for a break or sign a break, hand teacher a "break" card, etc. - then the child receives the break) - screaming is no longer needed because using a break card works & is quicker, etc. 

• Ensure Appropriate Assessment is Current - Know the child's strengths and challenges in this area - (i.e.,  ABLLS-R; VB-Mapp, etc.) 

• Model/demonstrate how to request item - When individual desires something, then model/demonstrate how to request item

• Provide ample opportunities for individual to use an effective communication system

• Schedule Speech Therapy (click on "resources" on toolbar - locate information on: ASHA  &  Speech and Language Impairments (NICHCY Disability Fact Sheet #11, January 2011) 

• Incorporate the individual's interests and preferences- Incorporate a child's interests and preferences when teaching and encouraging communication! (Ensure that there a relevant reason (or need) for the child to communicate? In other words, the individual is not just saying words... but the words (or attempts) at communicating one's wants, needs, & protests are reinforced with the item (or removal of item). For example, if an individual "loves" trains, then place a particular train up high - out of reach, but within sight.  Then when the individual spots the train - or tries to get it, then prompt by saying (or showing a visual or pointing to the train).. "Say.. 'train'"...  (or model the appropriate sign for "train"  or model using the appropriate sentence strip or picture using PECS). It helps if the word "say" is spoken softly - with emphasis on the word, "train".  If not, then some individuals might possibly repeat the word "say" too.  

• Use an "Alternative" to speech and/or signing: use of augmentative communication systems  (formal & informal strategies that assist communication efforts instead of or in addition to spoken speech - Durand, V.M., Ed. Zager, D., 2005)

• Use Visual Supports (remember, this can be an object, focal point, written word, a finished product, etc.)

• Model the Appropriate Response (demonstrate how to perform the task, for example, saying, "hands down" while placing your hands down)

• Exaggerate the appropriate or desired communicative response if needed

• Use Verbal Prompting (Ensure the individual understands - when we use too many words or talk to others when we are giving a verbal message to an individual with language/communication challenges, then be very clear in the verbal prompt. Use simple, verbal prompts until the individual has the skills to comprehend multiple cues - "Get your blue cup" - is a multiple cue - individual must be able to differentiate between blue, yellow, red, etc.  Individual must also differentiate between a glass and a cup.)

• Use Cue Cards - sometimes the presentation of these can be faded to where the individual has the cues next to them in a discreet manner (written or pictures - these can be placed on a metal ring or can be in an individual's notebook depending on the needs of the individual - e.g., 1. clock in... 2. check schedule... )

• Use Incidental Teaching Strategies (This occurs in the natural environment - different locations (e.g., mall or living room) and with a variety of relevant persons (e.g., teacher, parents, and peers).  Teaching episodes are initiated by the child/adult with an ASD and is encouraged using natural reinforcers - reinforcers related to the topic of discussion.  children/adults to initiate 

• Use Video Modeling (An example of video modeling would be a video clip of a same aged peer demonstrating raising his/her hand to respond to a teacher question - e.g., the teachers on the video asks, "who wants a snack?"... the child on the video raises his hand - this involves teaching gestures to get needs met)

• Use Pivotal Response Training (Developed to bring out necessary/pivotal learning skills:  motivation, responsiveness to multiple cues, social initiations, and self-regulation) 

• Use Sentence strips (e.g.,"I want ________"  - velcro on blank line - with 3 Velcroed picture choices under the sentence strip - child places choice on the blank line to assist child in making request while also ensuring message and need is comprehended and fulfilled by others when needed)

• Use a "Picture Exchange Communication System" PECS  (same as communication boards - it needs to be functional - therefore, the child/adult must have access to the system at all times - different classes, going to the mall, visiting a neighbor, assemblies, etc.)

• Use Sign Language  (There are some problems noted in research regarding the generalization - the use of sign language in other environments & with other people in society.  The problem noticed was that many community members do not understand sign language and did not interact successfully with the individual attempting to communicate using sign language. Durand (1990) found that many signs used by individuals with an ASD were idiosyncratic (unusual) and were difficult for even the best teachers to understand. However, every child and situation is different, so if it is working for your child - celebrate!  Keep going... just be aware of some potential obstacles to address.)

• Use Positive Reinforcement when individual initiates communication with speech, signs, vocal output, pictures, etc. 

• Use a Vocal Output Device- this can be a possible option for the child/adolescent/adult (use synthesized speech - however, note that sometimes greater dexterity and fine motor skills are needed) ​
• Use Communication boards - individual points to pictures (if this is used, it is important that the individual learns to initiate  communication using the communication board vs. only using the communication board when prompted by a parent or teacher, i.e., "what do you want" - if used, it needs to be functional - where the individual does not rely on the prompts... so fade prompts)

To clarify expressive language problems, Webber and Scheuermann (2008) explained that with a receptive language problem, an individual with autism may be mute (nonverbal) or have few verbal skills, may be verbal but echolalic, or may be able to speak - but experiences  problems with articulation, grammar, intonation, and functional language (i.e., only requesting, and protesting, not commenting, conversing, or explaining).  

Ogletree and Oren (2001) stated that the principles of ABA  are tightly woven into the fabric of intervention methodologies for communication disorders.  Ogletree and Oren added that prompting, cuing, modeling, chaining, differential reinforcement and fading are some of the other behavioral techniques used by practitioners to enhance communication instruction.  

Sometimes, inappropriate or challenging behaviors become the way an individual disagrees or receives what he/she wants (communicates). This is reinforced/encouraged if one receives the desired item/activity/person or escapes an undesired item/activity/task/person right after the challenging behavior.    

Tissot, C. & Evans, R. (2003) stressed that sometimes we  falsely state that an individual without spoken words is unable to communicate when in actuality, the individual has an ineffective communication system. 

Cohen and Volkmar (1997) also noted that a "lack of an effective communication system is associated with increased tantrums, aggression, and even self-injury". So, how is the child, adolescent, or adult with an autism spectrum disorder, communicating their needs, desires, emotions, or protests to others?  

Additionally, if a more effective and socially acceptable communication system is needed, then address it immediately.  Because, if a child, adolescent, or adult can receive what he/she wants from yelling, screaming or hitting,  then, from the child's perspective, why use their words, sign language, picture exchange communication system (PECS) or visual supports? 
 

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References: Hodgdon, L. (2000); Bondy, A. & Frost, L., (1994); Carr & Felce, (2007); Ganz & Simpson, (2004); Kluth, P., (2004); Mirenda, P. & Beukelman, D., (1998); Callahan, K., Shukla-Mehta, S., Magee, S. & Wie, M., (2009); Parsons, S. & Mitchell, P., (2004); Webber, J. & Scheuermann, B., (2008); Tissot, C. & Evans, R., (2003)