Presentation on theme: "Lisa R. Audet, Ph.D., CCC-SLP"— Presentation transcript:
1 Lisa R. Audet, Ph.D., CCC-SLP Let’s get them Communicating: Interactions and Children with Minimal Language __________________________________________ Lisa R. Audet, Ph.D., CCC-SLPAssistant Professor, Kent State University
2 Our Time TogetherIndividuals with autism spectrum disorders (ASD) have complex communication needs.Those with minimal language skills present us with our greatest challenge.Today’s presentation willincrease your understanding of the core features of ASD; andprovide you with specific strategies to increase comprehension, production, and social interaction in children who have minimal language skills.
3 Core DeficitsProblems with joint attention: eye gaze shifting for communication purposesDeficits in development of the Gestural Complex: giving, showing, distal pointingGestural Complex: The greatest predictor of emerging language development-particularly distal pointingDeficits in combining non-verbal and verbal communication behaviorsDeficits in adaptive solitary and social aspects of playDeficits in cognitive functional aspects of play
4 Core Deficits: Day to Day Children with ASD who have minimal languageReduced attempts to interactReduced readability of attempts to interactLimited conventional exploratory play with problem solving involvedShort attention spanEngage in same old play…over and over and over againRestricted social opportunities and success: the structure and evolution of conversationLimited meaningful, context embedded opportunities to learn language-the deep meaning of wordsIncreased rigidity, isolation, and frustration
5 Joint Attention Joint Attention: Must understand the nature of eye gaze for communication: to identify and share a topic of interest with anotherRequires rapid eye shifts and attention shiftSome children with ASD may be overwhelmed by the task, not comprehend or have the ability (at first) to demonstrate the skill
6 Joint Attention Strategies Identify target behavior: Gaze to orient to the speaker vs. gaze to initiate interaction (make a request, comment, protest)If to initiate:Be in the child’s visual fieldReduce amount of talkLimit amount of facial movement (pleasant neutral expression)Hold object of interest to the child next to your eyes andWait………Reinforce even the slightest gaze shift between your eyes and the object with the object of interestLabel the object (no need for empty “good job!” reinforcer)Allow the child to engage with the object of interestRepeat within a natural flow of interaction.In this context, do not say “look at me” as the focus needs to be on keeping the child as the initiator of the interaction.
7 Distal PointThe ability to use the pointer finger to direct another person’s attention to an object, person, event of interest with the purpose of sharing that object, person, event with the partner
8 Distal Point: Strategy One Gently rub the tip of the pointer fingerVerbally prompt, let’s get our hands readAvoid using hand over hand instruction/blocking the three remaining fingersKeep the emphasis on the finger that has “meaning” –the pointerEngage in shared book reading or other activities where together the adult and child point to different objects, pictures that are within reach of both individuals
9 Distal Point: Strategy Two Place desired objects out of reachWhen child reaches for the object gentle rub the child’s pointer finger andOnce the point is approximated, obtain the object for the childReinforce with words describing the event such as: “Jimmy said: Want X” so that the child begins to learn that his point has meaning
10 ReciprocityThe ability to engage in turn taking within a social interaction: non-verbal, vocal, verbalDyadic vs. Triadic InteractionsDyadic: person to person; person to objectTriadic: person to person to person; person to person to object
11 Reciprocity Strategies Begin with dyadic interactions using:Joint action routinesCreate a rhythm and routineImitate the child’s developmental, adaptive behaviorsScaffold the routine, child behaviors by:Adding vocalizationAdding an actionWithholding, wait to obtain social signal (gesture, eye gaze, vocalization, verbal approximation)Use vocal intonation to signal expectancy
12 Reciprocity Strategies Triadic InteractionsRemember if the child isn’t responding to the triadic interaction, shift back to the dyadic. The purpose is to build meaningful, social turn taking – that are pleasant to create a desire to have MOREWithin a dyadic interaction add an objectUse the object to build upon the dyadic (the object moves, engages in an action) that is part of a known routine.Withhold the object to elicit social signally: giving object to the adult, gaze shift, verbal/vocal approximation, sign etc.Use language to indicate that the object has stopped and/or the child’s desire: the bunny is not moving, I am sad, Jimmy wants the bunny to dance.Model the desired behavior: give the child the object, point to it, use 1-2 words such as “you do,” “make go” etc.Reinforce naturally with language: “yeah bunny dance,” “you made him go” and the action paired with positive facial expressions
13 Combined Means, Initiation & Readability Core feature:Children with ASD typically use one communication behavior vs. combining 3-5 (gesture + facial expression + vocal intonation + eye gaze + words)Reduced combined behaviors decreases readability of a communication behaviorDecreased readabilityIncreases likelihood we willMiss the actMisunderstand the intentAnd the child will become frustratedMore evident when the child is attempting to initiate vs. respond to an interaction
14 Combined Means and Initiations Interventionists need to begin to observe more:we take combined means for grantedit is so tacit to our functioning so;Observe, interpret, and respond to single communication behaviors (with a reasonable guess/hypotheses);Target the ability to combine 2 communication behaviorsStrategies:strategic wait, withholding, modeling, linguistic mapping to elicit the behaviors; naturally reinforce child initiated acts
15 Combined Means & Initiation: Importance The Gestural Complex and Joint Attention Lead to Language DevelopmentSo this is important to work on, especially with young children who have minimal skills before they develop less adaptive communication behaviorsHumans communicate to initiate and respond to interactions; so intervention must include development of meaningful and readable initiated acts
16 Initiated Acts: The Context Initiated communication actscommunication behaviors (verbal/non-verbal) where a child begins the interactionStrategies:Build upon child’s interestDevelopmentally the child initiates at first to request actions, objects, recurrence, and protestCreate scenarios within natural routine for the child to use adaptive communicative behaviors for the above social purposes.
17 Enhancing Communication within Play Imitate child’s behavior: Label the action (parallel talk)Scaffold the behavior: Add a new object or event; One at a timeModel a new behavior or actionUse strategic and expectant wait: facial expression, vocalizations, verbalizationsLabel problems the child encounters and waitRespond to any/all social signals as meaningful to encourage reciprocitySabotage the interaction to create real problems
18 Teaching Children with ASD how to Listen Never repeat a directive more than twiceLeast-to-most promptsStrategic waitSlow the paceLook at the person versus an object
19 Strategies to Increase Comprehension Consistent Follow-ThroughIntegration of Multiple Modes of RepresentationMultiple Repeated Examples