Learning Language: Learning Language: Motivating The Mouth and Motivating The Mouth and

MindMindBy Susan P. Paul, M.A., CCC/SLPBy Susan P. Paul, M.A., CCC/SLP

April 20, 2007April 20, 2007Greentree SchoolGreentree School

Definitions• Speech Apraxia :”Difficulty executing and/or

coordinating/sequencing the oral-motor movements necessary to produce and combine consonants and vowels to form syllables, words, phrases and sentences in volitional control.” Kaufman

• Language Verbal/Non-Verbal Receptive/Expressive Form, Content, Use

Core Deficits in Autism• Joint Attention: the ability to establish and maintain

common focus of attention with another person• Emotional Regulation: the ability to regulate one’s level of

emotional arousal in order to maintain a calm and focused state

• Sharing of Affect: the ability to experience and express emotional states by directing affective displays to others

• Sharing of Intention: the ability to direct communicative acts to others to accomplish specific goals

• Sharing of Symbolic Systems: the ability to use abstract representational systems to communicate, share and engage socially with others

Approaches to Therapy• ABA• VB• DIR• RDI• TEACCH• PECS• SIGN LANGUAGE• AT and AAC• SOCIAL SKILLS INDIVIDUAL/GROUP

Best Practices• Individualized• Based upon child development• Address core characteristics of ASD• Derived from a range of sources (SCERTS)• Demonstrate consistency and logic

between long-term goals and treatment approach

Pre-linguistic Means and Functions

Functions• Behavior Regulation• Social Interaction• Joint Attention• Sharing Emotions Means• Gestures• Vocalizations

You and Me; Me and You• Relationship Building: Be willing to do

what you are trying to teach• Flexibility• Waiting• Positive Expression/Joy• Appropriate emotional expression• Attending/Listening Behaviors

JUST IMAGINE….Turn on the radio, but do not tune it. Leave it on

static and fuzz. Turn it up. Ask someone to turn the lights on and off. Strap yourself into a broken chair that is missing a leg and use a table that is off balance-you know the ones in the restaurants that make us all so mad. Now, put on some scratchy lace in place of a comfortable T-shirt, put your pants on backwards and wear shoes one size too small. Pour a bowl of grated Parmesan cheese, open a can of sardines and bring the cat box to the table. Now, snack on your least favorite food, the one you never eat because it comes with a gag reflex. With all of this in place,

pick up a book and learn something new.

Getting to Know You • Observations in variety of contexts Enthusiasms Behaviors Learning Style Sensory Needs Routines/Transitions• Team Input

“Greeting”• Therapy Approach: Activities need to be

motivating, meaningful and organized• Goals• Pairing • Cueing Modalities• Limits/Expectations• Verbal/Non-verbal

“Keeping the Conversation Going”

• Building Blocks• Cueing Hierarchy• Prompts and Fading• Object, Picture, Graphic

Representation• Balance Challenge with Ease• Predictability

“Uh-oh….Interruptions”• Setting New Goals• Flexibility• Feelings• Develop appropriate behavior

through language

“Let’s Continue”• Social Skills Groups• Social Stories• Peer Modeling• Video Modeling• Internet Programs (Do2Learn)• Buddy Programs• Incidental Teaching• Script Fading• Written/Textual Prompts

“What Now? It’s not working out.”

• Environmental changes to foster emotional regulation

--Routine and predictability --Transactional supports and visual

cues --Behavioral strategies --Sensory input

“OK. Thanks!”• Making Closure Internalizing Carryover Ready for more……

Essential Learning Tools• Attention/Integration/Memory use enticements, reduce rate, utilize

intonation features, wait, use consistent words for preparation, cues and praise, object placement

BALANCE Consistent and systematic fading of cues Manipulation and Sabotage

HOW TO• Attention: To objects, people, activities

and eventually to shift attention• Imitation—vocal, motor, verbal• Social interaction—reciprocity,intention,

relationships• Language Development• Emotional Regulation—self and interactive

Providing Opportunities• Manding -making requests for objects, for

help, for rejection• Making Choices• Attending• Greeting• Turn-taking• Expanding• Upping-the-ante• Enhance area of disability

Goals• NONVERBAL gestures personal space eye gaze facial expression head nods posture keyboarding PECS Signing

GOALS• VERBAL: Receptive before expressive

Form: Lexical organization through expansion, repetition

Content: Vocabulary Development through choices, categorization

Use: Explicit instruction, behavior contracts, social stories, acting

Problem-Solving• Poster of what to do when bored• Power Card• Thought Bubble• Parent Coaching Cards (Richfield)

Articulation• Making it Meaningful Pivot Syllable Cognitive Cues Melody Movement

“Reading” People• Tony Attwood• Michelle Garcia-Winner• Jed Baker• Barry Prizant

“Souls in a high state of advancement are often found in humble circumstances on Earth.”

--Dr. Michael Newton

Journey of Souls