Virginia Autism Council

Virginia Autism Council
4/25/2017 Strategies for Supporting Adolescents and Adults Proactive Strategies Social Sensory Communication Handouts: Please print this presentation in the form of “handouts” with 3 or 4 slides per page. Slide 18 is to be “hidden.” Slide 18 – one copy for each packet Outline: 1.25 hours should be designated for this section. There are a number of activities throughout the training. Some activities are done as a whole group, while others are conducted as small groups or individuals. Time designated for each activity will vary. Activities and supplies needed for this presentation are located on slides 4 – internet video embedded in slide 7 – question cards on index cards & 4 pieces of flip chart paper and markers 16 – Individual Profile 18 – worksheet – print one copy of slide #18 for each packet 34- Three YouTube videos of ACC options 42 – Worksheet for Taboo/Depends/Safe – print one for each table Examples of communication systems: wallet, communication book, device, etc. Visual Supports and other AAC devices Key Points for this section (slide 44 ) Print and post it on a wall. Welcome to this session on Supporting Communication. We will use the term “functional communication” to refer to communication by any means that allows a person to get basic needs and wants met within a natural context. We will not be focusing on articulation, fluency, or syntax, but rather on the means (ways) and functions (reasons) of communication. Strategies for Supporting Adolescents and Adults with ASD

4/25/2017 Topics The Foundation for Communication Communication and Behavior Communication Systems Communication Strategies and Activities Communication Supports As we have already discussed, communication differences make up part of the criteria for autism spectrum disorders. Today we are discussing the following communication topics: The Foundation for Communication Communication and Behavior Communication Systems Communication Strategies and Activities Communication Supports Strategies for Supporting Adolescents and Adults with ASD

Person Centered Approach
Virginia Autism Council 4/25/2017 Person Centered Approach . Make the least dangerous assumption: presume competence In a person centered approach to communication, we should make the least dangerous assumption. The expressive language of a person with ASD is not necessarily a reflection of their intellect. Temple Grandin tells us that “through the increased use of augmentative and alternative communication, we are discovering that many…with autism have taught themselves to read, some in more than one language; that these individuals are highly aware of their surroundings and have self- learned far more than teachers and parents can imagine. It’s their bodies that don’t work, not their minds.” Strategies for Supporting Adolescents and Adults with ASD

4/25/2017 “In my language” Show Wretches and Jabberers trailer. If you have internet access, show the Wretches and Jabberers video from You Tube. It is an 8 min. video clip; you do not need to show the entire clip. You will need to preface this with the following comments to prepare the audience: We’re going to show you a clip of two men who on first glance you would not think are not competent as communicators. The first few minutes of the video may be confusing for you. At the end of the video, ask, Is she a competent communicator? How does she communicate? Why does she communicate? With whom is she communicating? Wretches and Jabberers trailer. Strategies for Supporting Adolescents and Adults with ASD

4/25/2017 The Foundation for Communication Let’s begin with The Foundation for Communication: what is communication, what is needed for effective communication, and what are some of the communication challenges persons with ASD face. Strategies for Supporting Adolescents and Adults with ASD

4/25/2017 Why? Use / Purpose How? Form / Means Communication Components In order for communication to occur, there needs to be a communicator, a message, and a listener. Communication is a social act depending on a message from a speaker to be heard by a listener. Communication cannot occur unless all three components are present: When we talk about communication, in general, we are referring to the intentions of the person, the means or way in which the person communicates, and the actual message of communication. It is the act of sharing information from one person to another. This is really what we will focus on in this presentation. A way to look at communication is to think of all the components that make up communication, in general. We can look at it in terms of answering the following questions. Why? Intentions for communication such as requests, comments, refusals Communicative intent is the term we use to mean the reason why we communicate—in other words, what’s my purpose for communicating? Am I trying to ask for something, tell someone something, reject something, greet someone, etc.? How? The way a person communicates: Verbal, gesture, sign, picture, text How we communicate includes sounds words, gestures, intonation, volume, tone, pacing, facial expression, and body language. We use all of the means to code our language. Think of a time when you used a behavior to communicate instead of using words. We use our whole bodies to communicate, although we generally rely on speech as the most efficient communication method. Another consideration is the means or the mode. How do you communicate? What modes do you use? – Think about those with autism whom you support. What modes do they use? Is the mode always understood? Is the mode always appropriate? What? Language used to convey meaning; vocabulary; message Language is the organization of thoughts and ideas. When we learn to use a symbol or word to represent something (vocabulary) and when we organize our words to mean different things (syntax) we are developing a language system that we can use to communicate our ideas. When we talk about what the individual is trying to convey, this is the message of communication. Who, Where, When? Following social rules; being appropriate to context Pragmatics refers to the use of language for functional or social reasons. This involves the people skills we use when communicating. Think of the last time you went to a party and tried to enter a conversation that was already going on. What did you do to enter that conversation? Did you walk up, step into the middle of the conversation, and boldly introduce your self by saying “Hi, I’m (Name), Can I talk with you?” What did you do instead? Who, When, Where? Context What? Message Strategies for Supporting Adolescents and Adults with ASD

4/25/2017 Communication Challenges Activity Why? How? What? Who, Where, & When? Activity Preparation: Make one index card per person at each table with the following words on different index cards How What Why Who, Where, & When Prepare and post 4 chart papers around the room with words on the top of the chart Place markers at each flip chart station Instructions: You should have received a word card. Using the information from the previous slide (go to previous slide) generate a list of examples of challenges that individuals with ASD have with each building block of communication. For instance, under “how” you may write “volume - too loud for the setting”. Then go to the chart paper that corresponds to your word. Select one person to write the information on the chart and share out at the end of the activity. Allow 7 minutes for completing the activity. Allow 8 minutes for reporting out at the end of the activity. As participants share their responses make sure all the content in the subsequent 5 slides is covered. Strategies for Supporting Adolescents and Adults with ASD

Nonverbal Communication
Virginia Autism Council 4/25/2017 Nonverbal Communication Expressing self without words Difficulty recognizing or using body actions Difficulty with pointing and smiling Difficulty with eye contact Difficulty with facial expressions Nonverbal communication is the ability to use eye contact, gestures, facial expressions, physical proximity, and other forms of body language to convey a message. It also involves understanding the nonverbal signals used by other people. While persons with ASD are able to use body movements to accomplish tasks or for self-stimulation, they may not use body movements for social or communicative purposes. Strategies for Supporting Adolescents and Adults with ASD

4/25/2017 Verbal Communication Expressing self with words and other ways to communicate Often limited to using words for requesting Limited in using words for commenting, describing, telling Verbal communication is the ability to understand and use words to convey messages. This may involve using speech, sign language, pictures, a voice output system, or written language. Verbal communication may be used to make requests, share ideas, or express feelings. Some persons with ASD have limited verbal language. That is, they are able to communicate with words, but it may be limited to using words for requesting highly preferred items or actions. They may not use words for more social purposes, such as commenting, sharing an experience, relating information unless it is highly interesting to the person. Unusual verbal behavior is often seen in persons with ASD: Echolalia is a common characteristic with persons with ASD. It is repeating words or phrases that the person has heard. This may occur immediately, or be delayed by hours or even days. Echolalia may have communicative intent--interactive and intentional Echolalia may be sign of emerging language make connections for child--relationship of what child says to what it means/reference child may be using too high language forms such as pronouns (use proper names) help child recognize power of language: use simpler form of language Perseverative speech is another common feature of persons with ASD. Generally speaking, preservative speech is speech without communicative intent--non-interactive and non-intentional may be related to emotional or processing difficulties Vocal quality (pitch and volume) and prosodic features (rhythm and inflection) may also develop unusually in the person with ASD. Vocal quality and prosodic features add meaning to verbal language. Sometimes the speech of the person with ASD sounds unusual because he lacks central coherence or meaning and sometimes the person may have difficulty organizing all of the speech muscles to produce rhythmic speech. Strategies for Supporting Adolescents and Adults with ASD

Receptive Communication
Virginia Autism Council 4/25/2017 Receptive Communication Understanding and responding to communication Difficulty following directions / multiple steps Difficulty with figurative / vague language Difficulty understanding the perspectives of others Difficulty interpreting the behaviors of others Strategies for Supporting Adolescents and Adults with ASD

Prosocial Communication
Virginia Autism Council 4/25/2017 Prosocial Communication Saying the socially “nice” thing Difficulty using words with social meaning May use words to request but not to be polite or indicate appreciation May be direct Prosocial communication is the ability to understand and use verbal or nonverbal actions to meet the emotional needs of others. This may include offering to share toys/food, giving compliments, apologizing, etc. AutismPro Persons with ASD who have verbal language may not use prosocial communication. That is, they may be able to interact with another, but may not use appropriate social language. They may be overly direct, say things that could be offensive to another, and not use phrases just for the purpose of fitting in or being polite. They are not intending to be rude. They fail to grasp the point of being polite or have the skills necessary to participate in easy social communicative exchanges. Strategies for Supporting Adolescents and Adults with ASD

4/25/2017 Conversation Need to Learn To summarize info or get to main idea To listen and understand another’s perspective; to take turns To modulate; to place less emphasis on facts and more on ideas Difficulties Too many details Reciprocity/flexibility/ conversing appropriately Prosody Being able to have a conversation requires being flexible in using language across many different functions, not just to request what I want, but to listen and respond to what the listener is saying. Perspective-taking requires being able to step out of oneself and relate to how another might think or feel. It is being able to see through THEIR eyes. Conversational exchange is a cooperative event in which participants work together to regulate the ebb and flow of information Topicality--initiating, maintaining, and changing topics: topic relevance and topic maintenance. Being able to stay on topic and change the topic smoothly are characteristics of someone who is skilled in the art of conversation. Conversation requires ability to read, interpret, and respond based on social, cognitive knowledge Comments and questions rely on how we think about others and how others think about us -Supporting each other -Adding to the conversation—”adding on” -Bridging back to own interests (allow individuals to stay personally connected to information) Questions -Seeking information about personal interest -Seeking information about another’s interest Types of questions -Greeting (How are you?) -Initiate interaction (What have you been doing?) -Maintain topic ( “What did you do there?) -Bridge/take back control (change topic slightly back to your interest: conversation partner talking about movie he saw; you ask if saw movie you have seen -Questions that form comments (Wow, you really did that?) For more information and ways to teach these skills: Thinking About You Thinking About Me, Michelle Garcia Winner Strategies for Supporting Adolescents and Adults with ASD

Functional Communication Goals
Virginia Autism Council 4/25/2017 Functional Communication Goals Requesting /manding Choice-making Refusing Affirming/Negating Self-advocacy There are clear benefits of teaching persons with ASD to communicate across a number of intents or functions. Working on goals of requesting (food, desired items, help, finished) will give persons with ASD more control over their environment. It will allow them to advocate for themselves. This is the most important benefit. Requesting food/objects  eliminates grabbing  establishes opportunities for interaction Requesting help  eliminates frustration  builds relationship Requesting finished  gives person a means of regulating Choice-making  turns over control of individual choices to person Refusing  gives person a sense of control over his life Affirming/negating  allows person to exercise his opinion or clarify Strategies for Supporting Adolescents and Adults with ASD

Virginia Autism Council 4/25/2017 Functional Communication Goals Turn-taking Greeting Closing Commenting Interaction/ Intraverbals These goals will lead to improved interaction. This may be important for many. Depending on the work or community living situation, the benefit of interaction skills will vary based on the individual. Describe: Turn-taking  teaches waiting  requirement for any interaction Greeting  announces self  opens an opportunity for interaction Closing  brings closure to an interaction Commenting  conveys individual personality  promotes sharing of feelings and thoughts Strategies for Supporting Adolescents and Adults with ASD

Virginia Autism Council 4/25/2017 Functional Communication Goals Assistance Answering Asking Describing Sharing feelings Clarification/ Independence These skills will give the person with ASD a means of clarifying communication. Describe : Relating information  allows person to share experiences  leads to common connections Asking for information  leads to learning  provides clarification  improves understanding of perspectives Answering  shows understanding  provides clarification  enhances dialogue Sharing feelings  extends self to others  opportunity for giving and receiving compassion Strategies for Supporting Adolescents and Adults with ASD

4/25/2017 Activity Select one function/intent. Describe behavior if Steven is unable to communicate the intent and benefit if he learns to communicate it. Requesting Turn-taking Refusing Making choices Greeting/closing Affirming/negating Commenting Asking Answering Sharing feelings Get your profile of Steven. Use your Communicative Intent and Behavior worksheet and complete it with others at your table. Take out worksheet from packet. Identify one of the functions/intents that Steven is missing. Share with participants at your table what you have written down. Identify the problem behavior or challenges that may arise because Steven is missing this communication. Identify the benefit if the Steven learns to communicate this intent. Allow 5 minutes for this activity. Let’s take a look of an example of this activity on the next slide. Strategies for Supporting Adolescents and Adults with ASD

4/25/2017 Intent (Select one) Resulting behavior Benefit to person if person learns communication skill ___Requesting X Turn-taking ___Refusing ___Making choices ___Greeting and closing ___Affirming or negating ___Commenting ___Relating information ___Asking/answering ___Sharing feelings Pushes ahead in line Interrupts others Monopolizes conversation Eliminate behavior incidents when in lines or waiting Demonstrate more appropriate skills in group situations Have conversation This is an example that is not related to Steven but will help you as you look at Steven’s communication. It will help you know what you will be doing with others at your table. Select one of the intents or purposes for communication. In the next column, describe the problem behaviors you may observe when a person is not able to communicate their need for this function. In the third column identify what opportunities may arise when a person is able to communicate this function. An example of this is Turn-taking  grabbing at the game pieces, talking out of turn, dominates conversation  teaches waiting and is a requirement for any interaction Strategies for Supporting Adolescents and Adults with ASD

4/25/2017 Intent (Select one) Resulting behavior Benefit if person learns communication skill ___Requesting ___Turn-taking ___Refusing ___Making choices ___Greeting and closing ___Affirming or negating ___Commenting ___Relating information ___Asking/answering ___Sharing feelings Select one of the functions/intents from the list below. Describe behavior you may observe if person is unable to communicate that need. Identify potential benefit if person learns to communicate this need. Hide slide. Print slide in black and white for small group activity. Strategies for Supporting Adolescents and Adults with ASD

4/25/2017 Communication and Behavior We have already said that we communicate for a purpose. We will examine some of those reasons or intents and see why many persons with ASD resort to using challenging behavior in an effort to communicate when they don’t have effective communication skills. Strategies for Supporting Adolescents and Adults with ASD

4/25/2017 Functions of Behavior Underlying basis for most behaviors Attention Object / action seeking behaviors Avoidance or escape seeking behaviors Gratification seeking behaviors/self-stimulatory Reactive/release seeking behaviors The underlying basis for most behaviors can be related to the following functions or intentions: attention / object / action seeking behaviors: desire/need to get something, action, or attention avoidance or escape seeking behaviors: desire or need to avoid or rid self of something considered unpleasant or undesirable gratification seeking behaviors/self-stimulatory: desire or need to provide soothing, pleasure, gratification to self reactive/release seeking behaviors: basic automatic or autonomic response (respondent) Not all behaviors are communicative: need speaker/message/listener for behavior to be communicative. Behaviors can be INFERRED or interpreted to have meaning in which case they communicate. Ask for example. Reactive emotional responses can become communicative, if reinforced. Ask for examples. Strategies for Supporting Adolescents and Adults with ASD

What Is the Person Communicating through Behavior?
Virginia Autism Council 4/25/2017 What Is the Person Communicating through Behavior? When analyzing behavior, ask yourself: What is the person saying? What is the purpose/function? What does the person get from this behavior? Receive? Avoid? We will use the following steps to analyze behavior: We will look at the context or what is happening/activity. We will observe what the person actually said or did. This is not what we think was meant, but what was actually observed. We will hypothesize, after examining the surrounding events, what we think was the purpose of the behavior, e.g., get something, avoid something We will then see how the behavior is reinforced. A behavior is reinforced if the response to the behavior serves to maintain or increase it. Finally, we will think about what the person might need to learn to improve communication/social skills (using more age-appropriate behavior). Strategies for Supporting Adolescents and Adults with ASD

Virginia Autism Council 4/25/2017 What Is the Person Communicating through Behavior? Leads to the question: What skills does the person need to learn to replace the inappropriate behavior? We will hypothesize, after examining the surrounding events, what we think was the purpose of the behavior, e.g., get something, avoid something We will then see how the behavior is reinforced. A behavior is reinforced if the response to the behavior serves to maintain or increase it. Finally, we will think about what the person might need to learn to improve communication/social skills (using more age-appropriate behavior). This is considered teaching replacement skills. Strategies for Supporting Adolescents and Adults with ASD

4/25/2017 Decrease Challenging Behavior Increase Communication Skills The effect of increasing communication skills is that usually there is a corresponding decrease in challenging behavior. Developing a consistent mode or form of communication allows the person to rely on a system that is reliable. No person should be left without a clear and reliable way to communicate. Persons with communication difficulties will look for patterns that produce a predictable outcome. Without an acceptable way to communicate, they will develop their own system which will often involve inappropriate behaviors. Improve non-verbal communication Pay attention to and foster the use of non-verbal communication. This is a weakness in some persons with developmental disabilities, particularly persons with ASD. We gain and give much information through the use of non-verbal communication such as facial expressions, and body movements. Increase the repertoire of interests so that there are more interactive opportunities and less solitary activities. Improve form and/or content of speech or AAC content Use the devices throughout the day across multiple activities. Increase the need for communication. Create interactive language for AAC devices. Be creative in developing messages. Expand functional communication skills. Create opportunities to communicate across functions, not just requesting and refusing, but relating information, asking, commenting. Improve conversational interaction: listening, turn-taking Create opportunities for more than one turn—keep the conversation going. Strategies for Supporting Adolescents and Adults with ASD

Virginia Autism Council 4/25/2017 What Is the Person Communicating through Behavior? Context Behavior Function (Purpose) Received / Avoided (Response) Replacement Behavior (Skill needed) Lunch Grabbed fries off another person’s plate Acquired fries Person ate fries (Positive reinforcement) Teach how to request "Can I have some fries?" Examples on this and the following slide demonstrate how undesirable behaviors can be reinforced. Persons will resort to whatever they know works to get needs met. We need to teach appropriate skills to satisfy needs or desires. This is what we refer to as replacement skills. In this chart, we can see that the context for the first example is lunch. The behavior observed is that the person grabbed fries off another person’s plate. We can interpret the function or purpose of this behavior was to acquire or get the fries so he could eat them. The person’s behavior was reinforced as he was able to eat the fries he grabbed. The replacement communicative behavior is asking for some fries from the person who had them or asking his parent to send money in for fries for his lunch. Strategies for Supporting Adolescents and Adults with ASD

Virginia Autism Council 4/25/2017 What Is the Person Communicating through Behavior? Context Behavior Function (Purpose) Received / Avoided (Response) Replacement Behavior (Skill needed) Work Touched coworkers hair Gain Social attention Social interaction with coworker Teach person script to interact In the third example, this person is seeking social interaction or social attention. However, the person does not have the skills to seek interaction appropriately. We need to teach him how to do this. Have the participants brainstorm things the person can be taught to say or do to replace the inappropriate behavior. Strategies for Supporting Adolescents and Adults with ASD

4/25/2017 Replacement Skills Communication Skills “I need help.” “I don’t like this.” “I don’t want that.” “I need a break.” “I want that.” “I want more.” “Look at what I did.” “Look at me.” “Talk to me.” Behavior Screaming (to escape) (to get something) Persons who use challenging behavior to communicate for escape or attention often use the same behavior for both purposes. It seems to “work” for them. Look at the example, screaming can be used both to get out of an unpleasant situation/task or it can be used to get the attention of someone. It is important to know which function the behavior is serving so that you can teach the appropriate replacement skill. If the person is screaming to escape from an unpleasant task, then you would want to teach the person to say or express in a functional way: “I need help.” “I don’t like this.” “I don’t want that.” “I need a break.” If the function of the behavior is to get attention, you would want to teach the person to say or express in a functional way: “Look at what I did.” “Look at me.” “I want that.” Strategies for Supporting Adolescents and Adults with ASD

Pivotal Communication Skills Affecting Behavior
Virginia Autism Council 4/25/2017 Pivotal Communication Skills Affecting Behavior How to refuse appropriately How to make general requests How to request help How to indicate a problem Many of the challenging behaviors we see in persons with ASD are directly related to the lack of communication skills in these areas: difficulty refusing appropriately; not knowing how to request for desired needs and wants; not knowing how to ask for help; and not knowing how to let someone know there’s a problem. These critical communication skills will allow a person to better manage his or herself across many situations he or she faces throughout a day. It will allow a person to feel in control and be successful in managing his or her life. Without these skills, a person will feel out of control and frustrated and not being able to get basic needs and wants met. Strategies for Supporting Adolescents and Adults with ASD

4/25/2017 Communication Systems This is the section that you will share your devices and other communication systems that were not shared during the proactive strategies section. We’ve talked about the functions of communication and the strategies to teach communication skills. Now let’s look at the various systems or forms persons with ASD may use to augment communication when verbal language is not reliable and not the primary means for communication Examples of Systems Verbal Vocal Gesture Sign Picture Text Electronic device Strategies for Supporting Adolescents and Adults with ASD

Communication Systems
Virginia Autism Council 4/25/2017 Communication Systems Verbal Augmentative/Alternative Communication (AAC) Sign Visual symbol Communication device We use the term “augmentative system” when the person has some verbal language, but needs to augment that with an additional system. When a person cannot rely on verbal language at all, we usually refer to this system as an “alternative system.” We refer to both systems as AAC, Augmentative and Alternative Communication. All of the AAC systems have benefits and drawbacks. Speech is obviously the most efficient system. When a person’s speech is not reliable for communicating at the level and need of that person, then we consider some augmentative or alternative system. Strategies for Supporting Adolescents and Adults with ASD

4/25/2017 Sign and Gesture No equipment needed Transient Requires motor skills Requires recall/retrieval memory skills Requires a trained communication partner We all use gestures to augment our communication. What are some commonly used gestures we use? (waving, come here, etc.). A sign is a formal and discrete communication act. Sign is one type of augmentative or alternative system. The benefits include: It doesn’t require any equipment. That makes it portable. No time is spent preparing the system other than teaching it. The drawbacks of using sign include: It is transient (ie. short in duration: lasting for only a short time and quickly coming to an end, disappearing, or changing) It requires immediate processing. It requires the ability to execute the sign. Some persons with ASD have poor fine motor skills and their signs are not well recognized by others than their immediate family and service providers. Many individuals improve with time and practice. In addition whether signs are executed as intended, or with a modification, many people in the individual’s environment may not be familiar with signed communication. Signs and gestures can be very effective for communicating messages that regulate interaction such as more, finished, enough, help, stop, etc. These types of messages are difficult to depict in picture while the signs or gestures are fairly easy to imitate and learn. Strategies for Supporting Adolescents and Adults with ASD

4/25/2017 Visual Symbols Non-transient Requires recognition memory Requires minimal motor skills Equipment needed The use of visual symbols is another type of AAC. This includes any visual representation for a word, action, feeling, etc. Visual symbols can be object representations, photos, line-drawings, or text. As we move through this section on AAC, keep in mind the proactive visual supports strategies. All of these AAC supports are proactive strategies. The benefits of visual symbol system include (object, photo, line-drawing, text): -It is non-transient. It doesn’t require immediate processing time as does the use of signing and verbal language. -It requires recognition memory which is easier than generating a sign or word from memory. -It requires minimal motor skills. The person does need to use some type of motor skill whether that is pointing or picking up a symbol and giving it to someone, but this is far less difficult than signing. The drawbacks include: -Equipment is needed. A wallet, picture board, or book requires someone to carry it which can be cumbersome. -It requires sequencing to select the symbols in the right order when constructing a sentence. Strategies for Supporting Adolescents and Adults with ASD

Speech Generating Device
Virginia Autism Council 4/25/2017 Speech Generating Device Provides verbal model Promotes verbal imitation Clarifies pragmatic intent Ensures listener attention Requires equipment and programming Needs to be carried or mounted The benefits of a speech generating device are many: It provides a verbal model. Hearing the word can encourage repeating or imitating the word which may help the person verbalize over time. A device with speech output clarifies the pragmatic intent. A picture of an apple doesn’t tell the listener what the person means by “apple” unless he uses more words. Usually, when a device is programmed, it is programmed with the intent clarified. For example, the message behind the picture of “apple” may be, “I want an apple.” The use of a device ensures the listener’s attention because the listener can hear the message. As applications for the iPad and other tablets and smartphones are becoming more sophisticated, students are able to scroll through dynamic screens, select a string of images or typed words and build sentences as their skills become stronger – they can quickly form a full sentence in order to clarify, “I want an apple” from “the apple fell on the floor”, for example Strategies for Supporting Adolescents and Adults with ASD

Considerations for Selecting Communication Systems
Virginia Autism Council 4/25/2017 Considerations for Selecting Communication Systems Chronological age of person Developmental age of person Communication level of person Communication needs of person Physical ability of person Must be available AT ALL TIMES! When deciding on a communication system for a person with limited verbal language, we need to consider: Chronological age of person Developmental age of person (cognitive level) Communication level of person Communication needs of person Once a communication system is established, it must be available to the individual AT ALL TIMES. This is their voice, and it must never be set aside due to inconvenience to family, or support staff. Can you give an example of how these considerations would be used to decide whether or not to use a picture system, manual sign, a device, objects, or a letter board? Strategies for Supporting Adolescents and Adults with ASD

4/25/2017 Video Augmentative Communication Examples These videos are on YouTube. You will need Internet access. When using AAC – there is not necessarily a right or wrong system. You want to choose a system that will work for the person. The important thing is decide quickly and begin teaching right away! Everyone needs to be able to communicate! Video 1) adolescent at a restaurant – discuss how he is able to be independent and make choices Video 2) adolescent at home at meal time learning to use his system (this is a long video and you do not need to show the whole thing) Video 3) adolescent in the community with mother (may want to shorten this one too) Strategies for Supporting Adolescents and Adults with ASD

Communication Strategies and Activities
Virginia Autism Council 4/25/2017 Now that we have reviewed some of the skills that we need to teach we will discuss some general strategies for encouraging and fostering communication for the individual with ASD. Can we influence or have an impact on how a person with an ASD learns to communicate or improve his or her communication skills? The answer to that question, of course, is yes. Consider the following ways in which we can promote and respond to a person’s communication: First, pay close attention to how the person with an ASD attempts to communicate, no matter how subtle. You may see a person with an ASD approach someone and then just stand next to that person. Often, the person with an ASD wants something, but either does not know how to request or ask, or may just assume the adult will figure it out. Give examples. At this point, it is helpful to ask the person with an ASD to “show” you what he wants rather than give him what you think he wants. Second, respond to the effort and attempt to communicate. Say, “You showed me that you want a cookie. Here’s a cookie.” Third, model what the person did (sign, point) or said with more clarity. Expect more precision and clarity in communicating from the person as the person gains skills. Fourth, always speak to the person appropriately and with respect. Do not talk down to the person, even though you may need to use simplified language. Remember that communication requires that we learn to speak or communicate in a manner that the listener can understand. If the listener does not understand what we said, then we need to reflect how we communicated that information. Perhaps we need to break down what we say into smaller units or provide concrete visual supports. Once the person with ASD understands, many of the challenging behaviors subside. Communication Strategies and Activities Strategies for Supporting Adolescents and Adults with ASD

Determine the Communication Goals!
Virginia Autism Council 4/25/2017 Determine the Communication Goals! Remember the slides we just discussed regarding functions of communication? Think about those. Let’s spend a few minutes generating ideas for communication goals for those whom you support that will enhance self-advocacy, clarify information, or increase interaction. Have participants call out specific communication goals. Here are some suggestions and comments you can make. -For many, nonverbal communication will be important to teach. We may want to promote a pointing response or teach a social smile. -While most persons with ASD have some verbal language, it may be limited to one word utterances for specific items or activities. We need to increase vocabulary of things in the environment that are part of their daily living activities. We need to go beyond labels and include more social language. This will be individualized for every person with ASD. We will need to identify the needs of the person and prioritize how to expand on expression. -Increase ability to understand and follow directions and increase vocabulary. -Teaching polite and socially appropriate language requires teaching specific social-communication skills such as teach the use of polite phrases for specific situations. This will definitely need to be individualized based on the needs of the person. Here are some examples. Examples Thank you and please are simple courtesies that may be helpful I understand, I don’t understand, I don’t know - can help the person convey whether they know what to do or how to proceed. In some cases, if a person with ASD may appear to ignore another person or a question if they don’t know what to do or don’t know the answer. Providing an appropriate response will help with this. Sorry – when teaching this it will also be necessary to teach when to use it. I need a break – teaching the person an appropriate way to say I am overwhelmed, or I need a break can be a prosocial component. Excuse me – similarly, teaching the person to say excuse me can be helpful. This can be used in a variety of contexts. For example, when needing to physically get around a person, when interrupting another, or even, when they are needing to excuse themselves from a situation. Can you think of some examples of socially appropriate communication that will need explicit instruction? Conversational skills are critical. Persons with ASD may not listen or may not appear to be listening which can be problematic. As we communicate with another, we do many behaviors which indicate we are engaged. This helps our partner to know how to respond. We may need to teach those with ASD these skills. For example, we may need to teach conversational markers, nodding, facing a person or other skills. Individuals may prefer to talk about the same topic, they may not know how to enter a conversation so they open it with their favorite topic, or they may have a limited range of topics in which they are able to converse. We can ask the persons to listen and share back what the other person has said and respond accordingly. Sometimes, this is referred to as “active listening.” A person with ASD may learn to take “turns” talking, but may not be really listening and talking about the topic, preferring to talk about his own topic of interest. We may also need to teach how to end a conversation. A person with ASD may just walk away when he or she feels finished with the conversation. We need to teach a way to close that conversation by using phrases such as: “Well, I’ve got to go now…”; “I’ve got to get back to what I was doing…” ; Got to go, see you later…” Verbal Nonverbal Receptive Conversation Strategies for Supporting Adolescents and Adults with ASD

Communication Supports
Virginia Autism Council 4/25/2017 Communication Supports Strategies for Supporting Adolescents and Adults with ASD

Virginia Autism Council 4/25/2017 Communication Supports Communication boards / book For individuals who can point and who have a large picture or written vocabulary, the use of a communication board or book may prove to be a simple way to accelerate communication. This system is flexible and portable and gives the person a way to generate his own personal language if using a written or encoding system. The vocabulary selected for the book or board depends of the interests and needs of the individual. In this slide, the person is using a letter board and spells what he or she needs to say. Note that some common and frequent phrases are listed on the board. It would be time consuming and require unnecessary effort to spell frequently used phrases every time it is needed. Communication boards are sometimes used as backup systems for persons who have electronic communication devices or for those who may need a back up system for verbal language when experiencing stress. Strategies for Supporting Adolescents and Adults with ASD

Virginia Autism Council 4/25/2017 Communication Supports Cue cards No, thank you. I don’t understand I need help. A cue card is a visual support used to help a person communicate in a stressful or confusing situation. It is also used to remind a person to use a particular skill that still needs practice. Some examples of this are listed on this slide. Cue cards can be very helpful when a person needs a reminder. “A cue card depicts a single message in either written or picture form, for use in a specific situation.” AutismPro Can you think of some ways any of these cards would help reinforce a communication skill with your individual with ASD? Strategies for Supporting Adolescents and Adults with ASD

Virginia Autism Council 4/25/2017 Communication Supports Scripts Conversation starters / terminators I want a cheeseburger, small fries, and a diet Coke Here are other examples of communication supports. Provide a visual of what to say/how to respond in different social situations A script is exactly as it sounds. It is an actual “script” of what to say in a given situation. For example, if a colleague says, “what’s up?” the person can say, “nothing much!” Conversation starters may give the person with ASD some ideas for other topics and could, over time, actually increase their interest in other topics. Again, use visual supports. This can be in many forms. For example, having a picture of the beach trip he took over the weekend may provide a visual support for knowing how to converse. Teaching appropriate responses may help. For example, if a coworker talks about her kids, teaching the person with ASD a correct response will help. There are a variety of supports for different social situations. We may need to limit the amount of time a person is given to talk before letting someone else have a turn. Another example is to have a picture of the words “excuse me” to act as a reminder on how to interrupt. Sometimes using a concrete way to show turn-taking helps a person with ASD recognize that people in a group takes turns talking just as they do when playing a game. Using an object to pass back and forth can help make turn-taking more concrete and clearer to the person with ASD. We may need to teach how to change topics appropriately by using “bridge” statements such as: “To change the topic…”; “Getting back to I’m going to Kings Dominion on Saturday Strategies for Supporting Adolescents and Adults with ASD

Virginia Autism Council 4/25/2017 Communication Supports Peers Provide nonverbal cues Provide verbal assistance It would be remiss not to discuss peers as a natural ongoing communication support. Peers can help provide nonverbal cues as well as verbal assistance to support and enhance communication. Strategies for Supporting Adolescents and Adults with ASD

Choosing Topics of Conversation
Virginia Autism Council 4/25/2017 Choosing Topics of Conversation Depends Safe Topics Taboo 1_____________ 2_____________3_____________ 4_____________ 5_____________ Here is an example of a conversation support that may be used to help with conversations. Way of teaching which topics are taboo or safe. Start with taboo and safe and after these are clear to individual, teach those that depend on the situation. Do guided practice with whole group. Have the group identify items that may fit under each heading. Taboo Depends Safe 1. 1. Not as easy as it looks, now is it?  Strategies for Supporting Adolescents and Adults with ASD

4/25/2017 Activity: Steven Take advantage of naturally occurring opportunities Create additional opportunities Ensure motivation / reinforcement Teach through routines Alter the environment Use communication supports Activity: We will complete this as a whole group. Think about Steven. Let’s identify some of his communication goals. now, let’s go through the teaching strategies and outline how we can target communication using these strategies in the context of his home and work. Guide participants through this exercise providing numerous examples for each step. Strategies for Supporting Adolescents and Adults with ASD

4/25/2017 Closing Points Seek to understand the desires and needs of the person Seek to understand the communication challenges the person faces and its impact on behavior Provide communication supports the person desires to maximize inclusion in the community Strategies for Supporting Adolescents and Adults with ASD

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