Communication What does the research say?

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1 Communication Communication is often perceived as referring merely to the act of verbalising. However, verbalisations (and actions) can and do occur devoid of communicative intent. Communication is comprised of interactions between people, and an exchange of information (Paul, 2003). Functional communication is defined by Frost and Bondy (2002) as: behavior (defined in form by the community) directed to another person who in turn provides related direct or social rewards. Prizant, Wetherby, Rubin, Laurent and Rydell, (2005) refer to these as social (e.g. getting attention) and non-social (e.g. acquiring something). For a child to develop effective communication skills, they must not only be able to use an effective form of communication that is understood by others (symbol use), but also be able to follow another s attention focus within the exchange (joint attention) or, in other words, have a reciprocal exchange or conversation (Prizant et al., 2005). Social-communicative skills form the basis for many phases of a child s development, such as relationship development, play skills, social and academic success, as well as emotional regulation, which assists in the prevention and reduction of problematic behaviours (Prizant et al., 2005). Communication difficulties are an inherent part of Autism Spectrum Disorder (ASD), as delays and differences in language development are part of the core characteristics. The Diagnostic and Statistical Manual of Mental Disorders (2013) lists Persistent deficits in social communication and social interaction across multiple contexts as part of the diagnostic criteria. Deficits encompass both receptive and expressive communication skills and disrupt the development of the Nine Critical Communication Skills identified by Frost and Bondy (2002). What does the research say? For a child to become competent, confident, and active in participating in social activities, they require the capacity to communicate and play with others in social situations (Prizant et al., 2005). This capacity not only supports social development, but has also been demonstrated to reduce behavioural difficulties. The developmental capacities that have been identified in research as critical for communicative competence are: 1. Successful engagement in reciprocal interaction and conversation, with a sense of effectiveness. 2. Emotional satisfaction from social-communicative interactions with numerous partners. 3. Communicating shared meaning for other social functions, such as sharing information and experiences. Furthermore, children who develop these capacities have stronger prospects of developing more advanced communicative skills (Prizant et al., 2005).

2 It is the social communication characteristics of ASD that presents the unique difficulties in the development of the three communicative intentions: behaviour regulation, social interaction and joint attention. Typically developing children develop these abilities before they begin to use words. Of noteworthy concern is that children with disabilities that do not display a social deficit are also capable of displaying these communicative intentions prior to using words. However, for children with ASD, the three communicative intentions represent a hierarchy of difficulty (Wetherby, 1986; Stone & Caro-Martinez, 1990; Wetherby & Prizant, 1993). Behaviour regulation, requiring the smallest social component, becomes the simplest and first emerging communicative intention and joint attention becomes the most difficult, as sharing observations and experiences is exclusively social in nature. This forms the rationale for setting communication outcomes aimed at behaviour regulation first, followed by social interaction and finally joint attention (Prizant et al., 2005). Practical strategy suggested for use in the school context - The following three strategies are suggested, to support children to develop communication skills: 1. Provide alternative means of communication. 2. Focus on the nine critical communication skills. 1. Provide alternative means of communication The SCERTS model (Social Communication domain) targets increasing competency, confidence and participation in social activities (Prizant et al., 2005) which requires competencies in joint attention and symbol use. Joint attention refers to the student s ability to engage in social interaction (to be able to share attention and emotion with a peer and express intentions to a communicative partner). Symbol use refers to the how of communication. Communicative means are either pre-symbolic (using gestures and objects) or symbolic (signs, picture symbols, and/or speech). Although the target goal is for a child to eventually use one main means of communication, providing several means enables the child to access an alternative in the event that one form is ineffective. The TEACCH approach (Mesibov & Schopler, 2004) is one of the earliest models of intervention for ASD. The model focuses on providing visual instruction and supports that help to create an organised and meaningful environment for individuals with ASD. Augmentative and Alternative Communication (AAC) systems, in particular the Picture Exchange Communication System (PECS) (Frost & Bondy, 2002) and social communication partners (Prizant et al., 2005) provide the support required to assist students to develop these skills (Ganz, Earles- Vollrath, Heath, Parker, Rispoli, & Duran, 2012, Siegel & Lien, 2015). A recent meta-analysis of twenty-four single-case studies by Ganz. et. al. (2012) supported the use of three types of Augmentative and Alternative Communication (AAC) systems to affect positive behavioural

3 outcomes for children with ASD. The greatest effect, perhaps not surprisingly, was demonstrated in the area of communication skills. The Picture Exchange Communication System (PECS) and speech-generating devices elicited larger effects than other picture based systems, though these were also effective. 2. Focus on the nine critical communication skills Supporting students with ASD in an educational setting requires ensuring they can effectively communicate with others via a socially acceptable method. If a child has not developed the skills to do this, it is likely they will utilise other, less desirable means to do so. The Picture Exchange Communication System Training Manual (Frost & Bondy, 2002) provides the rationales and strategies for teaching each of the nine critical communication skills, using visual supports. The following table (Table 1) lists the Nine Critical Skills of Communication, adapted from Frost and Bondy (2002), and some examples of visual supports that may be used are provided in table 2. For further information, refer to the Picture Exchange Communication System Training Manual (Frost & Bondy, 2002). Table 1: The Nine Critical Communication Skills. Productive Skills 1. Asking for reinforcers 2. Asking for help 3. Asking for a break 4. Indicating no to Do you want? 5. Indicating yes to Do you want? Receptive Skills 6. Responding to Wait. 7. Responding to transitional cues 8. Following functioning directions 9. Following a schedule

4 Table 2: Samples of visual supports Asking for reinforcer Asking for help Asking for a break Summary of Key Information 1. Communication requires an exchange of information (though either actions or verbalisations) between at least two parties. 2. Communication deficits and developmental differences are part of the core characteristics of ASD. 3. When planning educational goals for children with ASD, core characteristics such as differences in the development of communication skills, must be considered. 4. Augmentative and Alternative Communication systems, such as PECS, assist students with ASD to develop both expressive and receptive communication skills. 5. Supporting children with ASD to develop communication skills increases social competency, academic success and reduces difficult behaviours. As such, it forms the basis for all successful educational intervention approaches. References American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC. Aspy, R., & Grossman, B. G. (2011). The Ziggurat Model: Designing comprehensive interventions for high-functioning individuals with Autism Spectrum Disorders. Shawnee Mission, KS: Autism Asperger Publishing Company. Frost, L., & Bondy, A. (2002). The Picture Exchange Communication System Training Manual. Victoria, Australia: Pyramid.

5 Ganz, J., Earles-Vollrath, T., Heath, A., Parker, R., Rispoli, M., & Duran, J. (2012). A meta-analysis of single case research studies on aided augmentative and alternative communication systems with individuals with autism spectrum disorders. Journal of autism and developmental disorders, 42(1), Mesibov, G., Shea, V., & Schopler, E. (2004). The TEACCH Approach to Autism Spectrum Disorders. New York: Springer. Paul, R. (2003). Promoting social communication in high functioning individuals with autistic spectrum disorders. Child and Adolescent Psychiatric Clinics, 12(1), Prizant, B., Wetherby, A., Rubin, E., Laurent, A., & Rydell, P. (2005). The SCERTS [TM] Model: A Comprehensive Educational Approach for Children with Autism Spectrum Disorders. Brookes Publishing Company, Baltimore. Siegel, E., & Lien, S. (2015). Using Photographs of Contrasting Contextual Complexity to Support Classroom Transitions for Children With Autism Spectrum Disorders. Focus on Autism and Other Developmental Disabilities, 30(2) Stone, W. L., & Caro-Martinez, L. M. (1990). Naturalistic observations of spontaneous communication in autistic children. Journal of Autism and Developmental Disorders, 20(4), Wetherby, A. (1986). Ontogeny of communicative functions in autism. Journal of autism and developmental disorders, 16(3), Wetherby, A., & Prizant, B. (1993). Profiling communication and symbolic abilities in young children. Communication Disorders Quarterly, 15(1),