Communication and ASD: Key Concepts for Educational Teams

Transcription

1 Communication and ASD: Key Concepts for Educational Teams Marci Laurel, MA, CCC-SLP and Services (UCEDD) 1

2 Training Objectives Participants will: 1. Name at least three communication characteristics of ASD and state relevance for classroom practice. 2. Name two core communication challenges for students with ASD related to the development of academic skills. 3. Link at least two communication challenges to an evidence-based practice for intervention. and Services (UCEDD) 2

3 Thinking about the year just finished and the one to come What are your two top challenges in the classroom? What might be the relationship to communication skills? and Services (UCEDD) 3

4 Why are we talking about communication AGAIN! and Services (UCEDD) 4

5 Crux of ASHA Position on Providing Services to Students with ASD Problems in the use of language and communication are overarching because ASD is primarily a social communication disability. Diane Twachtman-Cullen, Ph.D. Editor-In-Chief, Autism Spectrum Quarterly and Services (UCEDD) 5

6 ASHA Position Continued These challenges result in far reaching problems, including difficulties with joint attention, shared enjoyment, social reciprocity in nonverbal as well as verbal interactions, mutually satisfying play and peer interactions, comprehension of others intentions, and emotional regulation. (Twachtman- Cullen, 2007) and Services (UCEDD) 6

7 What Type of Services Does ASHA Recommend? Services should be connected to FUNCTIONAL and MEANINGFUL outcomes. Preference is in favor of therapy in the natural environment. and Services (UCEDD) 7

8 Common Reasons for Denying Services to Students with ASD He speaks in full sentences Grammar and syntax are intact She did very well on all of the language tests Language skills are commensurate with chronological age Cognitive ability is commensurate with communication skills and Services (UCEDD) 8

9 DSM 5: Autism Spectrum Disorder Persistent deficits in social communication and social interaction across contexts Social-emotional reciprocity Nonverbal communication Developing and maintaining relationships Restricted, repetitive patterns of behavior, interests, or activities Stereotyped or repetitive speech, movements, use of objects Excessive adherence to routines Highly restricted, fixated interests Unusual reactions to sensory input or interest in sensory aspects of the environment and Services (UCEDD) 9

10 Autism Spectrum Disorder: Communication Characteristics and Services (UCEDD) 10

11 Deficits in Nonverbal Social Communication Eye contact Gestures Facial expressions Proxemics Prosody How does nonverbal communication impact school success? What strategies can support the development of nonverbal social communication? and Services (UCEDD) 11

12 Evidence Based Practices Supporting Communication Practices from Applied Behavior Analysis including Task Analysis Discrete Trial Training Prompting Reinforcement Functional Communication Training Visual Supports Picture Exchange Communication System Speech Generating Devices Naturalistic Interventions Peer-Mediated Instruction and Intervention Video Modeling Social Narratives Social Skills Training Visual Supports ence-based-practices and Services (UCEDD) 12

13 Evidence Based Practices Nonverbal Communication Discrete Trial Training Visual Supports Video Modeling Social Narratives Social Skills Training and Services (UCEDD) 13

14 Delays in Developing Language Difficulty with joint attention and symbol use Does not direct behavior to another person for the purpose of communication Difficulty expressing wants and needs Difficulty asking for help May use little or no speech Idiosyncratic ways of communicating, only some can understand Communicates needs through behaviors What are specific strategies for working with students with ASD in these areas? and Services (UCEDD) 14

15 Evidence Based Practices Language Practices from Applied Behavior Analysis including Task Analysis Discrete Trial Training Prompting Reinforcement Functional Communication Training Visual Supports Picture Exchange Communication System Speech Generating Devices Naturalistic Interventions Peer-Mediated Instruction and Intervention and Services (UCEDD) 15

16 Difficulty Initiating and Sustaining Conversation Difficulty following rules for conversation (turntaking, topic maintenance) Difficulty joining or ending conversation Fail to respond to comments only responds to direct questions Conversations limited to preferred topics, interests How do skills for social conversation impact school success? Is this a priority? and Services (UCEDD) 16

17 Lack of Social-Emotional Reciprocity Fail to initiate or respond to greetings, social routines Mind-blindness (Baron-Cohen) Difficulty understanding inferences Difficulty recognizing other s thoughts, feelings, beliefs Difficulty expressing empathy How does the team understand these challenges? What is your role in intervention? and Services (UCEDD) 17

18 Evidence Based Practices Conversation/Reciprocity Task Analysis Naturalistic Interventions Video Modeling Social Stories Social Skills Training Peer-Mediated Instruction and Intervention and Services (UCEDD) 18

19 Lack of Symbolic, Social Imitative Play Unusual use of objects Difficulty using objects to represent other objects (e.g. pretending a block is a phone or a cup) Less likely to combine actions in novel play themes Difficulty cooperating Does teaching play have a place at school? and Services (UCEDD) 19

20 Evidence Based Practices Play Practices from Applied Behavior Analysis including Task Analysis Discrete Trial Training Prompting Reinforcement Video Modeling Social Skills Training Peer Mediated Instruction and Intervention and Services (UCEDD) 20

21 Repetitive, Stereotyped Speech Immediate Echolalia Repeats other speakers previous utterance Delayed Echolalia Recites lines from movies, TV Repeats words or phrases from previous situations and Services (UCEDD) 21

22 Repetitive, Stereotyped Speech Idiosyncratic use of language Unconventional verbal behaviors Repeats sounds, words, phrases Makes up new words Uses highly specific meanings for words, phrases Asks repetitive questions How does the team respond to language that is not directed for a social purpose? and Services (UCEDD) 22

23 Nonverbal prompting Strong use of nonverbal communication Visual supports Limit adult language one up rule Avoid repeating One communication partner at a time Slow the pace Wait and signal Avoid jumping in and Services (UCEDD) 23

24 So Autism Spectrum Disorder is a disorder of social communication and skill deficits are appropriately addressed by members of the school team throughout the school day. and Services (UCEDD) 24

25 and Services (UCEDD) 25

26 Communication Children may learn to talk or use alternative methods of communication But these have little value if social interaction skills are not developed to provide opportunities to use those skills for meaningful communication with another person (Frea, 2015) and Services (UCEDD) 26

27 Communication In order to achieve communication you have to have 1. A sender 2. A receiver 3. A topic of joint focus 4. A method of communication (Schweigert, 2016) Without the first three, the fourth has no purpose and Services (UCEDD) 27

28 The ability to speak, sign or label and point to a picture does not ensure that communication will occur (Janzen, 2012) and Services (UCEDD) 28

29 Has Communication Occurred? Is there an exchange of information? Is a message either directed to or received from another person? and Services (UCEDD) 29

30 Nine Critical Communication Skills Frost and Bondy, Asking for desired item 2. Asking for help 3. Asking for a break 4. Rejecting 5. Affirming 6. Responding to wait 7. Responding to functional directions 8. Responding to transitional cues 9. Following a schedule and Services (UCEDD) 30

31 Social Communication Skills Early Skills Imitate Initiate Respond Take turns Persist Ask for help Shift attention and Services (UCEDD) 31

32 Social Communication Skills Conversation Respond to questions Respond to comments Suggest or negotiate a topic Maintain a topic preferred and not! End a conversation Perspective Taking Recognize thoughts and feelings of others Recognize effect of behavior on others Adjust communication based on reaction of others Adjust based on social situation and Services (UCEDD) 32

33 Social Communication Skills Meaning Non-literal language Fact vs. opinion Peer Group Get attention Share/cooperate Follow group directions Negotiate and Services (UCEDD) 33

34 Core Deficits in the Communication of Students with Autism Joint Attention: coordination of attention between people and objects Symbol Use: learning conventional or shared meaning symbols and Services (UCEDD) 34

35 Joint Attention Orienting and attending to a social partner Shifting gaze between people and objects Sharing affect (emotional states) with another person Drawing another person s attention to objects or events in order to share an experience What might be the impact of challenges with these skills at school? and Services (UCEDD) 35

36 Symbol Use Use of conventional gestures Learning conventional meanings for words Using objects functionally Symbolic play Dog What is the impact on academic skills? and Services (UCEDD) 36

37 Symbols and Meaning What are some of the objects and symbols that your students enjoy? What stands in the way of connecting these to function and meaning? the brain develops as a network of interconnected pathways, and teaching babies these isolated facts, these separate chunks of disparate information, devoid of context, only creates little no-exit cul-de-sacs. (Roots of Empathy, Gordon, 2009) and Services (UCEDD) 37

38 What about Reading? There s decoding The rest is LANGUAGE!! How do we make sure one is connected with the other?!!? and Services (UCEDD) 38

39 Challenges in Reading Comprehension Understanding that symbols have meaning Integration of language, social understanding and emotional understanding Vocabulary, story structure, character motivation and goals Everything you read you relate back to a social event in your life, a social event that happened to you! Felicia Nevarez and Services (UCEDD) 39

40 Or Math?? and Services (UCEDD) 40

41 I need a new coat!!! and Services (UCEDD) 41

42 Intervention and Services (UCEDD) 42

43 Priorities for Intervention and Services (UCEDD) 43

44 Engagement and Reciprocity At any age or stage Build around a preferred topic or activity Face to face interaction Less is more and Services (UCEDD) 44

45 Increase Comprehension Be sure to carefully assess Do not presume Visuals, visuals, visuals!! Wait Less is still more Pay attention to nonliteral language Teach compensatory strategies Plan ahead and Services (UCEDD) 45

46 Developing Expressive Skills Functional in the context Provide multiple opportunities One up rule Immediate and powerful reinforcement Adjust for social context Practice in a variety of settings and Services (UCEDD) 46

47 Understanding and Using Gestures for Communication Use exaggerated face and body expressions Hold expressions longer Model conventional and descriptive gestures Practice Practice some more! and Services (UCEDD) 47

48 Using Communication For A Variety of Purposes Move beyond protest and request Include: show share comment respond to questions respond to comments ask for information offer information and Services (UCEDD) 48

49 Communicating Across Contexts Functional means in all places Practice learned skills in a variety of settings Priming for context Class to class and Services (UCEDD) 49

50 Link Symbols to Meaning Understanding that symbols have meaning can be challenging at all levels Always link symbol to visual when learning Assess and teach in all subjects and throughout the school day PUPPY = and Services (UCEDD) 50

51 General Concepts for Intervention and Services (UCEDD) 51

52 Teach Communication Explicitly Multiple Opportunities for Practice and Services (UCEDD) 52

53 Teach for Generalization Teach for Initiation of Communication and Services (UCEDD) 53

54 Teach Within the Context of Reciprocity Use Visual Supports for Comprehension and Expression and Services (UCEDD) 54

55 Evidence Based Practices Supporting Communication Practices from Applied Behavior Analysis including Task Analysis Discrete Trial Training Prompting Reinforcement Functional Communication Training Visual Supports Picture Exchange Communication System Speech Generating Devices Naturalistic Interventions Peer-Mediated Instruction and Intervention Video Modeling Social Narratives Social Skills Training Visual Supports ence-based-practices and Services (UCEDD) 55

56 How Did We Do? Participants will: 1. Name at least three communication characteristics of ASD and state relevance for classroom practice. 2. Name two core communication challenges for students with ASD related to the development of academic skills. 3. Link at least two communication challenges to an evidence-based practice for intervention. and Services (UCEDD) 56