AAC & Facilitated Communication in

Individuals with AutismSarah Choss & Sara Cook

CSD 823X

Autism Spectrum Disorders (ASD)

• Autism and Autism spectrum disorder are terms to describe a group of disorders that affect brain development.

• Range from incredible severe to a very high functioning form where it is very difficult to tell if someone has ASD. Typically, it is those with more severe forms of ASD who use alternative communication.

• At this time, there are no known cases of autism

• 1 in 88 children are diagnosed with autism

Characteristics of ASD

1. Impairments in social interaction2. Impairments in Communication3.Restricted and repetitive patterns of

behaviors, communication, activities, and interests

4.Attention and motor difficulties5.Physical and health problems

Each type of ASD contains some combination of these characteristics.

Types of ASD

ASD includes the following disorders:

• Autistic disorder

• Asperger syndrome

• Pervasive developmental disorder-not otherwise specified (PDD-NOS)

• Childhood disintegrative disorder

• Rett syndrome

Augmentative & Alternative

Communication (AAC)

Definition

Augmentative and Alternative communication is defined as the use of other communication modalities to support or replace verbal communication.

Examples of AAC DevicesLow Tech: (Non-SGDs)

• Picture Exchange Communication System (PECS)

• Word/Letter Boards

High Tech: (SGD or VOCA)

• The Tango

• The Xpress

• iPad or iPod with Proloquo2go

Benefits

• Provides independence for the individualo Does not require a facilitator or assistant at

all times.

• Functionalityo For individuals who are nonverbal, AAC

devices can provide a way to communicate his or her wants and needs. In some cases, these alternative devices will help foster oral speech and language development.

• Social Skillso Allows the individual to engage in meaningful

communicative exchanges with others in his or her environment.

Facilitated Communication (FC)

What is Facilitated Communication?

Facilitated Communication involves another person, called a facilitator. The facilitator holds a person with autism's hand while he looks for letters and moves his hand around a keyboard or letter board. The facilitator does not type or guide the person's hand, but provides physical support for the person's forearm, wrist, or fingers and providing positive feedback for correct responses. Eventually, the person will learn to move his hand on his own and will no longer need feedback of support.

FC Controversy

• Many believe the facilitator is controlling the person with autism's hand and speaking for him. o Studies have proven this to be the caseo Wendrow case

• Oftentimes, FC is done in lab and persons with autism do not adjust well to this setting.

Benefits of FC for Individuals with Autism

• Many people have learned to speak independently

• With autism specifically, it helps individuals to gain motor control

• Provides supports to produce meaningful and complex messages

• The facilitator provides physical and emotional support

AAC and FC in Therapy

Assessment for Alternative

Communication1) Identify communication needs through interviews, surveys, and observation

2) Assess skills (ex: receptive or expressive language, verbal speech, cognitive skills, literacy, sensory skills, motivation, family support etc.)

3) Identify if have other people to facilitate communication and environmental barriers

4) Determine appropriate type of alternative communication & how to teach the necessary skills

5) Teach the user and facilitators how to use the system

Considerations Specifically for Autism

• Individuals with Autism tend to have problems with fine motor control and may have problems with AAC device

• Respond better to pictures than words.

• AAC helps teach social interaction & planning

• Computer-based devices do not send confusing social messages and provide a consistent way to communicate

AAC Uses for ASD in TherapyExamples:1.Picture Exchange Communication

System a.k.a. PECSo Using visual representation to teach children

to communicate their wants and needs.

2. DynaVox o Reading development for children with ASD

Video: AAC in Therapy

http://www.youtube.com/watch?v=hoF1UJ9YBUY

Examples & Case Studiesfor AAC & FC

AAC: Josh

• 6 years old at the time of assessment for AAC, diagnosed with Autism at 3;6

• Main form of communication before using an AAC device was natural speech and pointing.o Josh's natural speech usually consisted of one

to two word utterances to express wants or needs that were difficult to understand

• He uses the Powerbook made by Apple Inc.o When assessed, Josh needed a device that

would allow him to expand his expressive vocabulary, create more complex sentences, and initiate communication at home and at school to name a few.

FC: Jamie

• 19 year-old, Jamie, has autism.

• He types on a keyboard while his mom holds the keyboard, providing physical and emotional support

• He has since learned to speak, but needs to type out his thoughts first

• FC has worked for Jamie as he can now communicate with others without anxiety

Video: FC & AAC in Real Life

http://www.youtube.com/watch?v=CzYIidZvfjA

When living with a neurological condition (or with a loved one who has

one), it can be very easy to focus on the challenges and limitations. But in my life, I have found that focusing on abilities, finding new ways to adapt, have been crucial to my successes in life. Seeking those solutions can even

be seen as a form of creativity. -Individual with Autism

ReferencesBeukelman, David & Mirenda, Pat (2005). Augmentative &

Alternative Communication. Pittsburgh: Paul H. Brooks Publishing

Wallis, C. (2006, May 10)."Helping" Autistic People to Speak." Time.Retrieved from http://www.time.com

Wisely, J. & Brasier, L.L (2011, June 15). Sex abuse claims in Wendrow case fall apart in court. Detroit Free Press, Retrieved from http://www.freep.com

Center for Disease Control and Prevention (n.d.). Facts About ASD. Center for Disease Control and Prevention. Retrieved from http://www.cdc.gov

Light, J., Roberts, B., Dimarco, R., & Greiner, N. (1998). Augmentative and alternative communication to support receptive and expressive communication for people with autism. Journal of Communication Disorders, 31(2), 153-180.

References Cont.Carr, Deborah, and Janet Felce. "The Effects of PECS Teaching to

Phase III on the Communicative Interactions between Children with Autism and their Teachers." Journal of Autism and Developmental Disorders 37.4 (2007): 724-37. ProQuest Psychology Journals; ProQuest Research Library. Web.

Light, Janice C., et al. "Augmentative and Alternative Communication to Support Receptive and Expressive Communication for People with Autism." Journal of communication disorders 31.2 (1998): 153-80. ERIC.

Light, Janice C., et al. "Augmentative and Alternative Communication to Support Receptive and Expressive Communication for People with Autism." Journal of communication disorders 31.2 (1998): 153-80. ERIC

Zangari, C.; Lloyd, L.; Vicker, B. (1994). "Augmentative and alternative communication: An historic perspective". Augmentative and Alternative Communication 10 (1): 27–59.