SPEECH, SIGN LANGUAGE, OR PICTURES: WHAT IS THE BEST CHOICE FOR YOUR CHILD AND WHEN DO YOU MAKE A CHANGE? Mark Stafford, MA, LPA, BCBA Executive Director, The Mariposa School

Introduction  Speech is always the goal.  How do we make the decision on a communication modality? (speech, sign, pictures)  What factors should be considered when making that decision?

Communication Options  Speech is always the goal.  Augmentative Communication Choices – Sign Language (ASL, Signed English) – Picture Systems Voice Output I-Pad/Tablet systems  Writing/typing-not appropriate for early learners

When we don’t use Speech  Must have some vocal production

When we would not use Speech  Must have some vocal production  Must gain instructional (stimulus) control quickly— echoic behavior

When we would not use Speech  Must have some vocal production  Must gain instructional (stimulus) control quickly— echoic behavior  Hard to physically prompt speech

When we would not use Speech  Must have some vocal production  Must gain instructional (stimulus) control quickly  Hard to physically prompt  Lack of success results in:  Frustration with communication/instructor  Avoidance of instruction/maladaptive behavior  Further withdrawal

Two kinds of Communication  Topography Based: There is a different response (topography) for each word.  Stimulus Selection: A single response (pointing, pick up) is used to select a stimulus from an array. (Michael, J. 1985)

Two kinds of Communication  Topography Based:  Speech  Sign Language  Writing (but developmentally out of sequence)  Stimulus Selction:  Pictures/PECS  Voice Output (by selecting pictures)  I-Pads/Tablets (still pictures)

What is Verbal Behavior  Definition: Behavior that is reinforced through the mediation of another person and that person (listener) must have had specific training in reinforcing such speakers.

What is Verbal Behavior  Definition: Behavior that is reinforced through the mediation of another person and that person (listener) must have had specific training in reinforcing such speakers.  Verbal is not vocal in this definition.

What is Verbal Behavior  Definition: Behavior that is reinforced through the mediation of another person and that person (listener) must have had specific training in reinforcing such speakers.  Verbal is not vocal in this definition.  First goal is to get verbal behavior (communication) going.

Factors to Consider in Choosing Sign or Pictures 1. Learner’s verbal community the learner is limited and is not independent in community 2. Both sign language and picture systems are shown to increase speech, but signs appear to have a slight advantage. 3. Portability: sign can be done anywhere without a device. 4. Must be able to “scan” an array of stimuli for pictures.

Factors to Consider in Choosing Sign or Pictures 5. Neither Sign or Pictures is giving up on speech, but is a way to get there. 6. Pictures lack all verbal operants, especially the tact. 7. Can add new signs easily. 8. When child becomes older either: A. Speech has been learned, or B. Go to pictures if unsuccessful with signs, or C. Writing can be used with signs as a communication method

Sign Language Advantages Portable Topograghy Based Easy to learn basics All verbal operants possible Special relation between response and response product Can physically prompt Cost Disadvantages Limited Community Fluent communication is difficult to learn Must be face-to-face Requires physical prompting in early learners.

When we would not use Sign  Poor motor control  Lack of imitation skills  Need quick instructional control  Lack of success results in:  Frustration with communication/instructor  Avoidance of instruction/maladaptive behavior  Further withdrawal

Picture Systems Advantages Easily understood Easy to use Can be inexpensive Response is easy Easy to prompt Disadvantages Limited Portability Limited vocabulary Some verbal operants impossible Lack special relation between response and response product Requires additional scanning response

Special Case for Ipad/tablets  Automatic Reinforcement  Easy to add and change pictures  Can have immediate visual change which may make up for lack of special relation between response and response product.  Appear to be successful but no known scientific research  Cost – limits portability more

Making A Change Discontinuing a vocal/speech emphasis Lack of echoic development Speech is unintelligible Maladaptive behavior increases But not giving up on speech!

Making A Change Discontinuing a sign language emphasis Lack of imitation Topography of signs is too poor Maladaptive behavior increases Speech has improved But not giving up on speech!

Important Points  Picture schedules are not picture communication systems  PECS is a branded communication system (Picture Exchange Communication System by Pyramid Educations Consultants Lori Frost and Andy Bondy)  Speech is a transitory stimulus. It leaves no permanent product.  Both sign and pictures should be paired with speech by the teacher

Conclusion  If you have a choice use sign language.  Topography based  All verbal operants  Immediate feedback (reinforcement) in special relations of separate movements.  Direct prompting possible.  Pictures can always be done later.  Both pictures and sign can result in improved speech.