Increasing Communication Skills in Students with Autism Spectrum Disorders: The AAC Technology Solutions

In 1943, Leo Kanner documented his findings on the challenging and often enigmatic disability of autism. The characteristics relative to the deficits in communication and socialization which Kanner detailed at that time are valid today and continue to challenge practitioners.

Augmentative and Alternative Communication (AAC)is the application of assistive technology through visual language systems to create and/or enhance existing communication modalities in individuals with disabilities.

It is only in the recent 10 years that AAC has been implemented and made available to individuals with autism. The course of research in the areas of autism, language stimulation and special education have brought focus on the viability of AAC use in natural environments for individuals with autism. In addition, research in education, behavioral psychology, neurology and physiology compel language intervention to begin as soon as possible to insure the best possible outcomes.

Article Contents
  • Early Indicators of Autism and AAC Interventions
  • Natural Aided Language
  • Naturalistic Learning
  • Creating Interactive Language Boards
  • Literacy Learning and Communication Skills Development
  • Accountability and Data Collection Systems
  • Where do we go from here?

  • Early Indicators of Autism and AAC Interventions
    The early indicators of autism, including difficulties in maintaining eye contact, gestural communication, protodeclarative pointing and joint attention are behaviors which provide the scaffolding for the development of language. Many specific AAC interventions can target these early indicators and may provide effective scaffolding for the development of symbolic communication. Autism and Family Functioning

    The behavioral, communicative and social deficits in individuals with autism are significant stressors on their families These stressors negatively impact family functioning more than in any other disability. In addition, parents' assessments of particular characteristics of their pre-school children with autism indicate language and communication to be the most serious and stressful component of the disability. Research studies implementing Natural Aided Language strategies through parent training have indicated increases in parent-child communication and decreases in parent perception of severity of their child's handicap as well as concurrent parent stress (Cafiero, 1998, 1995).


    Natural Aided Language
    Natural Aided Language is an augmentative communication strategy in which visual symbols (either icons or words) are placed on an environmentally specific language board or technology device for the purpose of facilitating interaction and participation in an activity. Communication partners touch key words on the language board while saying those words so that receptive language training is occurring naturally during the activity. Natural Aided Language is an enhancement and expansion of Goosens', Crain and Elder's (1992) Aided Language Stimulation, however in Natural Aided Language, the visual language is viewed as a legitimate and real language and every activity, environment and potential communicative need is interfaced with a visual language board with or without an AAC device. As a real and legitimate language, every person in the child's environment takes responsibility for using the language and implementing the language board. The child with autism is exposed to this language by his family, peers and professional helpers, thereby receiving intense receptive language stimulation with the expectation, without pressure, that expressive language(with or without AAC support) will eventually occur. The symbols most commonly utilized are the Mayer-Johnson Picture Communication Symbols. These symbols can be accessed through the Mayer-Johnson catalogs as well as a computer program, Boardmaker.


    Naturalistic Learning
    Natural Aided Language utilizes the best practices of naturalistic learning (documented to be most effective for youngsters with autism), natural language strategies and AAC. Naturalistic learning provides opportunities for children with autism to learn skills in real and meaningful environments whereby the reinforcer is contextually related to the activity itself.


    Creating Interactive Language Boards
    Initially it is important to introduce Natural Aided Language in a child preferred and reinforcing environment. Many families and teachers choose snack or meal times. These times are generally successful for youngsters with autism who enjoy meals and they will generally remain seated for the activity.

    A "placemat board" can be created by taking an inventory of the verbs and nouns required to interact during a meal activity. Vocabulary is chosen which drives the activity, that is, gets it started, moving and completed, as well as the objects required for the actual activity and descriptors for giving the child expressive options for commenting, acceptance or refusal.

    Pronouns Nouns Verbs Descriptors Misc.
    I cup want yummy Thanks
    You trash pour yucky Please
    plate eat more No
    straw put Yes
    napkin drink
    juice taste
    cookie finished
    chips open
    sit

    The vocabulary in above is strategically placed on the perimeter of a heavy piece of placemat sized poster board and laminated for durability. The placemat board provides a readily available language stimulation activity during the reinforcing time of snack. Caretakers interact and "chat" with the youngster naturally while touching key words. All communicative attempts on the part of the child are acknowledged as valid and shaped by parent, teacher or caretaker imitating and modeling child communication verbally and by touching the picture symbols.

    The Merging of Autism "Best Practices" and AAC Interventions Interventions for children with autism are many and may often represent what is often called "trend of the year." While AAC interventions are showing great promise in emerging research, AAC is not an end, but a means to address goals and objectives which improve quality of life for children with autism. As such, AAC can be used to address methodologies across the educational and behavioral spectrum: Applied Behavioral Analysis, Greenspan (Developmental Therapies), Sensory Integration, Psychogenic Therapies, as well as literacy learning and curricular adaptation. The use of VOCAs(voice output communication devices), such as the BIG MAC, Voice in a Box, and Talk Pad can enhance communication training by providing auditory feedback for the responsive student. Requesting, commenting, behavior management, as well as literacy and curricular adaptations can be addressed with Natural Aided Language Strategies on VOCAS. Strategies such as Modeling, Time Delay, environmental prompts and faded physical prompts can provide the structure for teaching AAC the student.


    Literacy Learning and Communication Skills Development
    There was a time when the sequence of literacy development detailed that a child first learns to listen, speak, read, and then write. Unfortunately, this often meant that children with autism were excluded from literacy learning experiences. In light of the fact that these children have a scatter of strengths and needs, and demonstrate strong visual processing skills, it is essential to provide reading and writing/keyboarding experiences for them. In addition, current, state of the art findings are detailing hyperlexic children who, with support have been using their literacy skills in interactive communication contexts. Picture symbol adaptations of journalling programs, general curriculum and literature (Dexter, 1998) can make communication and participation more accessible for students with autism.


    Accountability and Data Collection Systems
    AAC interventions, through the use of low tech symbol and alphabet boards, VOCAS, lap top computers and the internet, are beginning to show great promise for increasing communication, participation and socialization for individuals with autism. It is imperative, however, to interface every AAC intervention with a concurrent system of identifying outcomes, systematic instruction to address the outcomes, and practitioner-friendly methods of collecting outcome data. Data then must be utilized to address appropriate, individualized, program development. Data collection methods include simple communication board collection tools, videotape records, portfolios, as well as more complex or hierarchical data collection instruments.


    Where do we go from here?
    As families and practitioners struggle with the issue: "What is best for this child? Which interventions will provide the best outcome?" it is important to remember that autism is a spectrum disorder. Every child is a unique collage of strengths and needs. There is no "rubber stamp" best program for every child. (Freeman, 1996). AAC technology is showing great promise as a vehicle for implementing a variety of methodologies more effectively. More importantly, though, providing a means to communicate immediately, that is, at first diagnosis, is essential. Functional communication training minimizes the development of aberrant behaviors (Mirenda, 1998), and many researchers believe it provides the scaffolding for the development of more complex language and cognitive skills (Dexter, 1998; Cafiero, 1998, Kangas & Lloyd, 1988). Interaction, communication and discourse between people are essential parts our humanness. Individuals with autism are entitled to the tools necessary to exercise this most basic human right.


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