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 and 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 and are needs are being met?
Does the individual communicate effectively and safely when stressed, upset, or when in different environments?
Is the individual receiving the intended verbal and nonverbal messages from others?
Ways Caretakers Can Capitalize On Communication & Comprehension
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, hear or smell it, etc.
Intraverbals: Responding when someone else talks, verbal behavior with a response that does not directly match. Conversation such as 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.
Example: 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 such as tantrums, etc. When you notice the individual looking at the item, state the name of the item, then prompt the individual to say it, sign it or hand you a picture of it. Hold the item 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.
Don't wait until inappropriate behaviors occur to address communication.
Use principles of ABA
Example: Reinforcement, modeling, prompting, differential reinforcement, etc.
Functional communication training
Teach the child an alternative behavior to gain a similar reinforcer. Example: 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. Example: ABLLS-R, VB-Mapp, etc.
Model/demonstrate how to request item
When the individual desires something, model/demonstrate how to request item.
Provide ample opportunities for individual to use an effective communication system.
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 and protests are reinforced with the item (or removal of item).
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, 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 augmentative communication systems, formal and 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. 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. The individual must be able to differentiate between blue, yellow, red, etc. The 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 picture cues can be placed on a metal ring or can be in an individual's notebook depending on the needs of the individual. Example: 1. Clock in. 2. Check schedule.
Use incidental teaching strategies
This occurs in the natural environment in different locations (mall or living room) and with a variety of relevant persons (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.
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. Example: The teachers on the video asks, "Who wants a snack?". The child on the video raises their 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
Example:"I want ________". Velcro on blank line with three velcroed picture choices under the sentence strip. The 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. These are the same as communication boards and it needs to be functional. Therefore, the child/adult must have access to the system at all times such as different classes, going to the mall, visiting a neighbor, assemblies, etc.
Use sign language
There are some problems noted in research regarding the generalization of the use of sign language in other environments and 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
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.
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)