Teaching Communication and Other Important Skills to Young Children with Autism
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Transcript of Teaching Communication and Other Important Skills to Young Children with Autism
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By Tracy Vail,MS,CCC/SLP
Letstalksls.com
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What Are Important Skills to Teach Young Children with Autism?
Communication skills: allow the child to get their needs met and replace maladaptive behaviors and engage in social interactions.
Non-verbal communication: Teaches the child that people’s faces/bodies carry important information.
Interactive Play Skills: teaches flexibility, improves relationships, replaces self-stimulatory behaviors
Imitation Skills: Allows the child to learn from the environment.
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Ask and ObserveAsk the parents! What are their priorities?Observe the child- What areas are causing the
child the most difficulty in life right now?Look at where the child is currently
functioning and determine the necessary component behaviors/skills to meet the goals of the parents and child.
What are the goals of the family in 1 yr? 5 yrs? 10 yrs?
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Most Common Approaches UsedBehavioral Approaches- ABA- Applied
Behavior Analysis and Applied Verbal Behavior, TEACCH
Developmental Approaches- SCERTS, Floortime/DIR, RDI
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Developmental, Individual Differences, Relationship Based Intervention,
DIR/Floortime
A warm and intimate way of relating to a child. A floor time philosophy means engaging, respecting and getting in tune with the child in order to help the child elaborate through gestures, words and pretend play what is on the child’s mind. As a technique it is a process that is used to support the emotional and social development of the child. (Greenspan, 2002)
This model serves as the context or “container” of the therapy we do. But what does it mean?
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Relationship Development Intervention (RDI)
A cognitive- developmental approach designed to remediate Autism.
Deals with autism as a neurologically based, information processing disorder.
Proposes to remediate the “Core Deficits” in Autism including motivation, communication, emotional regulation, episodic memory, rapid attention shifting, self-awareness, appraisal, executive functioning, flexible thinking, and creative problem solving.
Great stuff based on research by many in the field of psychology but what do these “core deficits” mean? How do we know when these skills have improved? What is the child doing? How can we measure it? AND, is it really necessary to spend thousands of dollars being trained to address these issues?
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Hanen MethodTeaching communication and play skills
through adult- child interactions. Parents/therapists are to:
Observe, Wait and Listen (OWL)This approach is very similar to DIR in that the
child leads and teaching is conducted based on the interests of the child.
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Behavioral ApproachesScientifically validated based on many
years of research.Based on measurable behaviors either
internal or observable.Based on the “laws of learning”Places the responsibility of learning on the
“teacher” rather than the studentMany “faces” to behavioral interventions.
Not all programs look alikeData driven program decisions
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Applied Verbal BehaviorBased on the research of BF Skinner on
“why” people communicateLanguage is categorized into verbal
operants or functions: Mand, Tact, Echoic, Intraverbal (as well as “listener” behaviors)
There’s a strong focus on developing “intraverbal links” or relationships between words.
Language is taught as a behavior with specific teaching procedures used
Both natural environment teaching and intensive teaching are used based on the age and skills of the child
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TEACCHThe long-term goals of the TEACCH approach are both skill
development and fulfillment of fundamental human needs such as dignity, engagement in productive and personally meaningful activities, and feelings of security, self-efficacy, and self-confidence. To accomplish these goals, TEACCH developed the intervention approach called “Structured Teaching.”
The principles of Structured Teaching include:Understanding the culture of autism. Developing an individualized person- and family-centered
plan for each client or student, rather than using a standard curriculum.
Structuring the physical environment. Using visual supports to make the sequence of daily
activities predictable and understandable . Using visual supports to make individual tasks
understandable(TEACCH Website)
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Can We Combine Behavioral and Developmental Approaches?
YES!!!
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Factors to ConsiderNo single “program” works for all children to
address all their needs.Every human being’s learning is a combination
of internal and external factors.Motivation of the child is the most important
factor to consider when making treatment decisions.
Parents often have preferences and skill sets that should be respected.
Different children respond better to different approaches.
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Relevant Information About Learners with AutismThey tend to have very analytical mindsThey tend to have unusual motivations and
consequently unusual reinforcersThey tend to be “rule based” learnersTheir bodies experience the world in an unusual
waySome are quite rigid and anxiousThey often have difficulty understanding the
“rules” of social interaction and communicationSo what…..Now what?
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Use Whatever Works to Teach the Most Important Skills to each Individual child at the Given Time
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The Language We UseOften it isn’t what we do but how we talk
about what we do that makes approaches seem so different.
The language we use to talk about what we do should be precise, agreed upon and based on “observable” or “measurable” change.
As professionals we are charged to provide “evidenced based practices”. Show me the data!!
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What do you see happening?
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A Few Possible Observations
He interacted with the instructor for 3.5 minutes.
He requested using gestures 4 times with no prompting.
He imitated body movements twice with no prompting.
He looked at the instructor twice and smiled.
He laughed in response to the instructors actions twice.
He initiated a social game twice with no prompting.
He shared affectHe shared attentionHe both opened and closed
5 circles of communicationThe instructor followed the
child’s lead
He demonstrated a preference to engage in a regulatory pattern with ongoing variations
He regulated his actions to maintain social coordination
He responded to guides role actions to maintain the regulatory status of the pair.
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Children are Complete Human Beings
They have a right to communicate to get their needs met
They want and need successful relationships in their lives
While they have some similarities, they all have unique needs that should be addressed
Each family structure is different and has unique priorities and needs
Child and family needs will change over time and programs need to reflect that
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General Language CategoriesLanguage used to meet the needs of the
individualLanguage used for social interactions and
building relationshipsLanguage used for “learning” or academic
settings
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Verbal Operants
Mand Motivation Says “car” gets car
Echoic “Say car” Says “car” social/secondary
Tact Car present Says “car” social/secondary
Intraverbal “We ride in the ..”Says “car” social/sec.
Antecedent/Stimulus BehaviorConsequence
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Motivation and Reinforcement
Motivation-
1. Temporarily increases the value of a reinforcer
2. Temporarily increases the behaviors that have been followed by that reinforcer in the past
Reinforcer- increases the likelihood that a behavior will happen again in the future
If a behavior is increasing in frequency, it is being reinforced!
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Communication To Meet NeedsMands/requestsUse an augmentative system if the child is not
yet vocal: signs, PECS, voice output devicesTeach “errorlessly”- full prompts then fade
your promptsMake sure you have motivation before
teaching the requestTarget 3-4 words at any given time.
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Conditions to TeachFill-ins: choo choo little …R= trainEchoic- shape articulation Choices- Block? Car? – Do you want
block or car?What do you want? What should I do?Noting said- object presentNothing said- object absent (pure
mand)
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Choose a Response FormIf child is non-vocal, must use an
alternative/augmentative systemAugmentative communication encourages rather
than discourages vocal productionsExperiment to determine how the child responds
to various formsPicture/object exchangeSignsCommunication BoardsVocalVoice output devices
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Teaching SignsMake sure the signs you teach can be
immediately reinforced.Choose iconic signs to begin teaching (look
like the object)Make sure all those in the child’s environment
know the child’s signs so they can be reinforced.
Early signs to avoid: more, yes/no, potty, open
Think: Objects, then actions, then adjectives
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Introducing Signs
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Signing Block
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Picture Exchange Communication System
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Communication Boards
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Shaping SpeechBegin with vowels since they carry the most
meaningShape the syllable structure to increase
intelligibilityAvoid teaching simplification patterns typical in
young children as they tend to be VERY hard to correct in children with Autism.
Continue reinforcing requests with augmentative systems until vocals are intelligible to most people
Always say the word correctly before delivering the reinforcer
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Avoid Dropping Sounds too Early
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Watch for Sign/Vocal Confusion
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Reinforce All Vocal Attempts
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Use Imitation
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Shape Speech in the Context of Requesting
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Use Music
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Use Books
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Avoid reinforcing extra sounds
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Interactive PlayBuild trust/relationship by being
predictableTeach flexibility by slowly
introducing changeFocus on engagement, shared affect,
joint attentionSocial imitation, social smilesnon-verbal communication
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Move In and Out of the Comfort Zone
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Beginning PatternsStart a pattern based on what the child is doing or
introduce your own patternMake sure the child has a role in the interaction.
You can be doing the same things or different things.As soon as the child is taking a role consistently,
vary the pattern. If the child withdrawals from the interaction, make the change more gradual next time.
Use silly sounds, breath intake, pauses right before the change will occur.
Reinforce behaviors you want to see more of!
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Follow the Child’s Lead
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Facial gazing, social imitation, pattern
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Use the child’s interests
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Expand Language and Play Skills
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Advanced Pretend Play
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Negotiating/Problem Solving
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Non-Verbal CommunicationPairing Experience – pairing people with
reinforcement/establish social reciprocity/engagement- non-verbal behaviors exhibited by 2 people for the function of sharing reinforcing interactions. (many may be considered requests for the interaction to continue- imitate as a mand for the “listener” to repeat the behavior.)
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Affect Sharing/Social Smiles
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Imitation/Shared AffectMirroring Behaviors:Shared affect- Reinforced by adult
imitating the child’s affect in an exaggerated manner.
Social imitation- reinforced by continued presence of adult/child who’s attention has been established as a conditioned reinforcer.
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Use Sounds and Pauses to Increase Facial Gazing and Shared Affect
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Non-vocal RequestsMands/Requests= non-vocal behaviors exhibited by the
child that serve the function of obtain an item or action Look- reinforced by obtaining access to the item being
looked at.Reach (+ look)- reinforced by obtaining access to the
item being reached for.Point (+look)- reinforced by obtaining access to the
item at which the child pointedGive to activate (+look)- reinforced by activation of the
object/toy.Action to sustain (+look)- reinforced by repetition of
the action.
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Following Non-Verbal DirectionsGestural Listener= responding to gestural
mands/requests of others to exhibit a behavior.
Follow point – reinforced by adult attention or other conditioned reinforcer
Follow gaze- reinforced by adult attention or other conditioned reinforcer
Follow yes/no- reinforced by adult attention or other conditioned reinforce.
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Following Point
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Chains of BehaviorsCombined- chains of behaviors that involve
looking to request information then following a non-verbal receptive instruction.
Look + follow point- look is reinforced by having information provided and follow point is reinforced by conditioned reinforcement
Look + follow gaze- look is reinforced by having information provided and follow gaze is reinforced by conditioned reinforcement
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Moving from Point to Gaze
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Combined ContinuedLook + respond to head nod/shake (yes/no)-
look is reinforced by obtaining information and response to yes/no reinforced by conditioned reinforcement
Point and look + respond to head nod/shake (yes/no)- point and look reinforced by obtaining information and response to yes/no reinforced by conditioned reinforcement
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Joint AttentionGestural Bid for Joint Attention = child
exhibits non-verbal behaviors for the function of drawing another’s attention to an object, event, or other environmental stimulus. The attention of the adult must be established as a conditioned reinforcer. (True Joint Attention as defined in behavioral literature)
Show object (+look)- reinforced by affective response/attention of adult/child
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Joint Attention Cont.Look at object (+ look at person) reinforced
by affective response/attention of adult/childGive object (+look)- reinforced by affective
response/attention of adult/childPoint at object (+ look)- reinforced by
affective response/attention of adult/child
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Thanks for All You Give to Children!