Communication Systems

Running Head: COMMUNICATION SYSTEMS FOR INDIVIDUALS WITH AUTISM

Communication Systems for Individuals with Autism Andrea Barroso Wagner College

Communication Systems Abstract

Autism is a developmental disability which affects communication and social skills. It is a spectrum disorder, so each individual with autism varies in degree and severity. Children with autism generally have difficulty developing speech and language, which is a fundamental goal when teaching children. As much as 30-50% percent of individuals who have autism do not develop functional communication. As a result, different communication systems have been implemented in childrens programs to increase their communication skills. The most common form is the Picture Exchange Communication System (PECS), in which an individual gives their communicator a symbol in exchange for the concrete object of that symbol. Sign Speech teaches individuals signs for different words along with the speech, so they can also hear the word. Sign Speech is set up to teach syntax and grammar rules in the English language. The final communication system, Natural Aided Language, uses visual symbols that are placed on an environmentally specific language board or technology device for the purpose of facilitating interaction and communication. All of these systems help individuals with autism interact with others and increase social and communication skills.

Communication Systems Communication Systems for Individuals with Autism Autism is characterized by severe and pervasive impairment in several areas of

development in reciprocal social interaction skills, communication skills, and presence of stereotyped behavior, interests, and activities (Eden II Programs, 2003). It is a spectrum disorder; each individual is different and has different characteristics. In typically developing children, speech and language develop during the first three years of life; children with autism have difficulty developing those speech and language skills (Kobza, 2006). About 30-50% of individuals with autism do not develop functional communication, which includes gestures, signing, pointing (Eden II Programs, 2001). For many children, communication delays are the first signs of a potential problem reported by family members. Such delays in communication can affect childrens ability to interact effectively, as well as negatively influence other areas of development (Schwartz, Garfinkle, Bauer, 1998). A large portion of the teaching programs for individuals with autism involves efforts to improve their receptive and expressive language. Receptive language is the ability to understand what is being said to the individual, whereas expressive language is the ability to communicate thoughts and feelings by some means (Eden II Programs, 2001). An individual who has difficulty with receptive language is unable to respond to the command, touch ball but when hold up a picture of the ball and asked, what is it he can respond with a ball. An individual who has difficulty with expressive language has the opposite problem. When asked, what is it he cannot answer, but can respond to the command, touch ball by pointing to the picture of the ball. A fundamental goal of teaching children with autism is improved communication, the most socially acceptable for of which is speech (Bondy & Frost, 1994). The speech therapist

Communication Systems

develops and teaches communication systems and trains classroom staff and parents how to use these systems. When the therapist and classroom staff work together, they target language concepts, generalization of communication skills, and consistency in the implementation of these communication systems (Eden II Programs, 2001). A variety of systems have been used to help children with autism acquire functional communication skills. Some of these systems include the Picture Exchange Communication System, Sign Language, and Natural Aided Language. Communication Systems Sign Language Sign language was first developed as a way to communicate with individuals who are hearing impaired. Sign language is also used to teach individuals with autism who have little or no communication skills (Edelson, 2006). Research has shown that when teaching signs along with speech, called Signed Speech, it will most likely speed up a persons ability to speak (Kobza, 2006). Signed Speech differs from the American Sign Language in terms of syntax and rules. Signed speech uses the same syntax and grammar rules as spoken language, whereas American Sign Language uses their own syntax and grammar rules (Edelson, 2006). When beginning a sign language program, it is best to start with signs expressing basic needs, such as eat, drink, and bathroom. During my experiences, I have seen sign language used, but up to a certain extent. I had two individuals in a classroom that were completely non-verbal, the only sound that comes out of their mouths are moans when a teacher is prompting for a verbal response. These two individuals have their own technology devices when communicating, which will be discussed later in this paper. Their technology device is their main form of communicating with any of the other teachers. If for some reason they do not have their devices, they use sign language to communicate to others. The sign they use the most is for

Communication Systems

bathroom and eat. Other than that, they rely on their devices. Based on my experiences and observations, I feel as though sign language is useful if it is also used with another form of communication, and if the communicative partner also knows the signs. On my first day, these two individuals were signing to me, and I had no idea what they were telling me. Another student is taught sign to communicate, but she does not use it at all. In her book, she has a list of the signs she knows (i.e. music, bathroom, hug) and what they look like. If that was not in her book, I would have assumed that this individual has not learned how to communicate with others. Luckily for her teachers, she does not present any maladaptive behaviors as a result of not being able to communicate with others. Some research has shown that children who use sign language learn spoken language at a faster rate (Edelson, 2006). In a PET scan study of children with autism, it was shown that the same area of the brain is activated during speech and during sign (Edelson, 2006). This shows that the development of sign language can strengthen the connection in the brain to form verbal communication. Learning sign language benefits children socially and behaviorally. When children are able to express themselves, they are much more likely to seek out social interactions, and to be rewarded to doing so (Kobza, 2006). Also, behavioral outbursts are far less likely when children are not frustrated by being unable to express needs and wants. Picture Exchange Communication Systems The Picture Exchange Communication System (PECS) is an alternative augmentative communication system that was developed to help teach communication skills to children with limited speech abilities (Kobza, 2006). When using this system, children present pictures or symbols of an item to a communicative partner in exchange for that particular item (Bondy & Frost, 1994). PECS is different from other systems in two significant ways: first, PECS is based

Communication Systems

on child initiation (Schwartz, Garfinkle, Bauer, 1998). In each stage of training, children request preferred items and receive that item as a result of making that communicative act. Second, generalization strategies are embedded in the teaching program. Children are taught to request multiple items to multiple communicative partners in multiple settings (Schwartz, Garfinkle, Bauer, 1998). Before the actual training and teaching of the picture exchange can actually begin, an item that reinforces the child needs to be determined (Bondy & Frost, 1994). This is usually done through observation and in young children, it is typically food. The teacher will place various reinforcers in front of the child and watches the preferred item emerge. Once this is done, the actual picture exchange training can start. The first step in the program is teaching the child to physically exchange the picture of the preferred item (Bondy & Frost, 1994). Once that item is determined, the teacher removes all the other reinforcers and leaves the preferred one on the table. As the child is reaching for the item, the teacher places the picture of the item in his hand. As the child is holding the picture, the teacher then physically guides the child to release the picture into the teachers hand. At that point, the teacher smiles, immediately gives the item to the child and says, You want the pretzel? Here it is! The teacher does not respond to the actual exchange, but responds as if the child had spoken (Bondy & Frost, 1994). The teacher continues physically prompting the child to pick up the picture and eventually fades out of it. A child has mastered this step when the teacher does not need to physically prompt the child and the teachers hand is not held out as if she is expecting the picture. The second step in the program is to teach a spontaneous exchange. At this step, the teacher and the childs communication board is farther away from the child. This teaches the

Communication Systems

child that he has to go get the picture and place it in the teachers hand for the exchange (Bondy & Frost, 1994). It is important for the teacher not to anticipate the exchange, not to react until the picture is actually placed in the teachers hand. It is also in this step where the teacher can promote increased eye contact. The third step is to discriminate between two or more pictures. The goal is to gradually increase the pictures on the childs communication board (Bondy & Frost, 1994). Once this is completed, the child can then learn to make simple phrases, such as I want ______. At this point the child is learning typical verbal communication, and can then answer questions related to requests What do you want? (Kobza, 2006). PECS is an initial language training package that is helpful with very young children who display significant communication deficits (Bondy & Frost, 1994). The ability to communicate with others is extremely important for all aspects of life language allows children to communicate their wants and needs, it builds social and cognitive skills, and it allows for normal functioning in society (Schwartz, Garfinkle, Bauer, 1998). Many studies have shown that use of PECS can result in increased vocabulary, increased spontaneous communication, and in some cases, functional verbal speech (Schwartz, Garfinkle, & Bauer, 1998; Bondy & Frost, 1994). Research has also shown that children are typically able to understand PECS fairly quickly, and are then able to use their training to communicate with other people, not just their teachers. There are many benefits to PECS, including: an increase in spontaneous communication, an increase in verbal communication, a decrease in maladaptive behaviors, and an increase in social interactions (Kobza, 2006). Natural Aided Language Natural Aided Language uses visual symbols that are placed on an environmentally specific language board or technology device for the purpose of facilitating interaction and

Communication Systems communication (Cafiero, 2006). The use of a language board or technology device is

implemented once the individual has completely mastered the use of their PECS book and can move on to more complex forms of communicating. Language boards and technology devices are also used with higher functioning nonverbal individuals with autism, who understand the concept of language and communicating with others. Each language board a child must be specific to the environment or activity the child is participating in. Generic language boards that include a variety of vocabulary words for a variety of environments provide limited language stimulation (Cafiero, 1998). A language board that is specific to a certain environment, however, includes descriptors and expletives that create meaningful and rich language stimulation. Communication partners touch key words on the language board while saying those words so that receptive language training is occurring naturally during the activity (Cafiero, 2006). When starting a language board program, it is found easiest and best to start in an environment which is reinforcing to the child, usually meal times or activities that occur on a regular basis. At this point, a board can be created that includes words required to interact during a meal (Appendix A). These words also include visual symbols, created from a computer program, Boardmaker. A technology device is very similar to a language board in that it contains picture symbols and the individual using it can create meaningful conversation with another person during a specific activity or in a specific environment. The device, however, groups all the vocabulary words into categories and subcategories. In a language board, the teacher touches key words and says it to also train in receptive language. In a device, the individual touches the screen/button and a voice recorded in the device repeats the word that was touched to also train

Communication Systems

in receptive language. This is helpful in that the teacher does not need to be present when training in receptive language, the device does it for the individual. During my experiences working with individuals with autism, I have seen a language board and technology device being used and taught to individuals. One student has a small binder with lots of nouns and verbs for him to be able to communicate. Each page depicts a different activity, and is also cross referenced by categories. There are a few pages of just food items, a page on different cleaning supplies and chores, and a page he uses during his meal times. I have also seen technology devices being used in a classroom setting. One of the great advantages of using these devices, in my opinion, is that it can be modified and adapted according to the amount of vocabulary a student has. I have seen one technology device with just the following words: bathroom, music, chocolate, sandwich, and drink. Another device I have seen and used with the individual contains various categories and subcategories, which sometimes I get lost in and is unable to communicate what I want to say to the individual. This individual knows how to navigate through his device better than I do. There are various researches done about the advantages and benefits of using each of the communication systems discussed in this paper. Since autism is a spectrum disorder, each individual varies in their degree of severity. With that in mind, the benefits and success rates of each of the communication systems used depends on the characteristics of the individual. During my experiences with working with individuals who have autism, and I have seen every kind of communication system used in a school setting. Some use the technological devices, some have a PECS book, and one student does not even need a system, he can simply make requests and have meaningful conversation with you. Each of the systems are useful and helpful

Communication Systems

10

ways of teaching individuals to communicate with others, it is just a matter of which system fits best with that individual.

Communication Systems References

11

Bondy, A., & Frost, L. (1994). The picture exchange communication system. Focus on Autistic Behavior, 9(3), 1-19. Cafiero, J. (2006). Increasing communication skills in students with autism spectrum disorders: The AAC technology solutions. Retrieved December 1, 2006 from http://www.outersound.com/cafiero/articles/10-07-01.htm Cafiero, J. (1998). Communication power for individuals with autism. Focus on Autism and Other Developmental Disabilities, 13(2), 113-121. Edelson, S. (2006). Signed speech or simultaneous communication. Retrieved December 1, 2006 from www.autism.org/sign.html Eden II Programs. (2003). Autism Chapter. In New hire training book (pp. 1-9). Eden II Programs. (2001). Speech and Language Chapter. In New hire training book (pp. 1-11). Kobza, R. (2006). Alternative augmentative communication for children with autism: PECS and sign. Retrieved December 1, 2006 from http://sitemaker.umich.edu/356.kobza/home. Schwartz, I., Garfinkle, A., & Bauer, J. (1998). The picture exchange communication system: Communicative outcomes for young children with disabilities. Topics in Early Childhood Special Education, 18(3), 144-159.

Communication Systems Appendix A Words that may be used on a sample language board for snack time.

12

Pronouns I You

Nouns cup trash plate straw napkin juice cookie chips

Verbs want pour eat put drink taste finished open sit

Descriptors yummy yucky more

Misc. thanks please yes no