“the quality of the provision for educational assessment, training and research in the
Centre is outstanding”.
The joint Education and Training Inspectorate report April 2012
Middletown Centre for Autism
Communication
Presented By:
Centre for Autism
Middletown
Learning Outcomes
• The core issue of “communication difficulties” with children and
young people with autism.
• The importance of receptive understanding as basis for
expressive communication.
• The importance of informal assessment and reassessment in
various settings.
• To importance on the use of “visual aids” to assist both
receptive and expressive communication.
•
How to teach “functional” communication.
• Autism is a complex developmental disability that
essentially affects the way a person communicates
and relates to people.
• All people diagnosed with autism will experience
difficulties relating to the “Dyad of Impairments”
• The dyad is comprised of difficulties with
communication, Social Understanding and
impairment of imagination and flexibility of thought.
The Diad of Impairments
DSM-5
Shift from a triad of core symptoms to a dyad
of core symptoms
– DSM IV Previously: social, communication, restricted /
repetitive behaviours
– DSM-5: Social communication, restricted interests and
repetitive behaviours
Diagnostic Criteria
DSM-IV
DSM-5
Triad of core symptoms
Dyad of core symptoms ( May 2013
Social Communication
Social communication
Dyad
Triad
Restricted interests
and repetitive
behaviours
Restricted interests and
repetitive Behaviours
Social interaction
Core feature - unusual
sensory responses
Understanding the Dyad
“It is essential to understand the nature of autistic
conditions. People with these disorders, because of their
social impairments, cannot meet you half way. You have
to make an imaginative leap into their world and try to
see things from their point of view”.
Wing (1996,p87)
Differences in….
Social Communication
• May have spoken language that is
formal and pedantic/no language
• Voice may lack expression/scream
• Cannot understand implications of
different tones of voice
• May have difficulty using and
understanding non verbal
communication
• May not read or understand facial
expressions, gesture, body language
or vocal intonation.
• Takes things literally
• Has inability to understand implied
meaning
Continued..
•
•
•
•
•
•
•
•
•
Socially isolated
Social demands of others cause anxiety
Finds social cues difficult to read
Find it difficult to understand the thoughts and
feeling of others
May behave in a socially inappropriate way
May lack the strategies to establish and maintain
friendships
May cause offence without being aware
May appear egocentric or insensitive
May not know how to react to other’s feelings
Differences in….
Imagination
• Repetitive/restricted play.
• May engage in stereotypical behaviours (spinning,
rocking.)
• Difficulty distinguishing between fantasy and reality.
• Difficulty with planning, organisation, cause and
effect.
• Difficulty with change.
Thinking Differently
• If you know one person with Autism, then
you know one person with Autism! (Dr.
Stephen Shore)
“EFFECTIVE COMMUNICATION IS A FOUNDATION
FOR SUCCESSFUL SOCIAL INTERACTION AND
APPROPRIATE BEHAVIOUR” (L. Hodgdon) 2009
It is a myth that all children with autism are “in a
world of their own” (L.Hodgdon) 2009
Middletown Centre for Autism – Parent Training
• Speech is the mode
• Communication is the
point.
.
Body Language = 55%
Tone of Voice = 38%
Words = 7%
COMPONENTS OF COMMUNICATION SYSTEM
SPEECH
LANGUAGE
PRAGMATICS
“One of the features common to HFA and AS is that language
form and structure may be super-ficially intact while the ability
to communicate one’s intentions in context, particularly social
context, may be significantly impaired.”
COMPONENTS OF COMMUNICATION SYSTEM
SPEECH
LANGUAGE
PRAGMATICS
Communicative
Awareness of
Intent
Listener
Reciprocity
What is Communication?
Communication is a two way process.
We communicate:
- To express our needs and wants
- To question
- To comment
- To protest
- To clarify
- To express feelings
Process of Communication
Adult
Child
child/YP with
Autism
Object of
interest
Communication
• Communication involves a range of both verbal and non
verbal elements.
• To communicate effectively it requires us to:
-
Establish attention
-
Process information
-
Store information
-
Retrieve information
-
Send out a coherent message
Imagine the experience for the
person with Autism
• All on- Difficulty filtering out what is important
• All off- Difficulty shifting and re-engaging
attention.
Verbal overload - workshop slide
Intervention strategies
What can we do to help our children and young
people to develop their “social communication
skills” and to communicate with “intent”
Video clips
Make the desirable less accessible!
Communication
Object Exchange
Hanen More than Words
• Promoting the communication development of
children with autism.
Gaining Attention
“Attention Everyone!!”
Attention
“If the environment is right, the child's functional
communication skills will flow”
(Gina Davies, Specialist Speech and Language Therapist.)
Attention Levels in Typically Developing
Children-Cooper, Moodley, Reynell 1997
Stage 1
Fleeting attention. Extreme distractibility. The
child’s attention is held momentarily by
whatever is the dominant stimulus in the
environment and is easily distracted by any new
stimulus.
Stage 4.
Attention focus under voluntary control. The
child is beginning to control their own attention.
Attention is still single channelled but it can be
stopped /restarted under the child’s control
without adult support
Stage 2.
Rigid attention. Attention inflexible. The child
can concentrate for some time on a concrete
task of their own choosing .The child has
difficulty tolerating intervention or attempts to
modify the task by an adult .
Stage 5.
Two channelled attention. At this stage the child
can do 2 things at once The child’s attention
span may be short but they can be taught in a
group. The child is ready for whole class
teaching.
Stage 3.
Single channelled attention. Some flexibility is
developing in that they can tolerate a well timed
intervention or interruption more readily. The
child can only cope with doing one thing at a
time.
Stage 6.
Integrated attention. Well established and
sustained. The child can easily listen to
information whilst doing something else at the
same time even in a distracting environment.
The child can cope in a group learning situation
for long periods of time.
Gina Davies Attention Autism 2010
30
Developing Attention Skills
We need to consider how we are engaging our
children…….
• Are we offering an irresistible invitation to
learn?
• Does what you are doing inspire the child's
attention?
Inspiring Communication
• Something in common.
• Something worth communicating
about.
• Focusing on more than needs.
• Communicating for the fun if it!
Attention Autism Video
The How and Why Communication Checklist- Hanen (1999)
Consider the following with regards to your child’s communication
preferences:

Why do they communicate?

When they communicate?

How do they communicate?
The How and Why
Communication Checklist
Why Your Child
Communicates
To Calm or direct themselves.
To protest or refuse
To request:
Food/drinks
Objects/toys
Help
To continue a people game or song
Permission to do something
Information
To respond to others:
To follow directions
To makes choices
To answer questions
To greet:
Hello
Goodbye
Draw attention/comment on:
Object
Person
Event
Self
To talk about:
Past
Future
Feelings:
Happy
Sad
Angry
Afraid
To pretend
When your child
Communicates
How your child communicates
Know Your Child’s
Communication Stage
The child’s stage of communication depends on 4 things:
1. Their ability to interact with you
2. How they communicate
3. Why they communicate
4. Their level of understanding
It is important to identify your child’s stage of communication,
this will help you set goals and support their communication
needs.
The 4 stages of communication are:
(from the Hanen Centre 1999)
1. The Own Agenda stage
2. The Requester stage
3. The Early Communicator stage
4. The Partner stage
*This does not always follow a typical developmental pattern
The Own Agenda Stage
•
•
•
•
•
•
•
•
•
•
•
Expect the following:
Interact with you briefly and almost never with other children.
Want to do things by themselves.
Look for and reach for what they want.
Not communicate intentionally with you.
Play in unusual ways.
Make sounds to calm themselves.
Cry or scream to protest.
Smile.
Laugh.
Poor understanding of verbal communication.
The Requester Stage
•
Expect the following:
•
Interact with you briefly.
•
Uses sounds to calm or focus themselves.
•
Echo a few words to calm or focus themselves.
•
Reach for what they want.
•
Communicates needs mainly by leading or directing you by
hand.
•
Requests for a game to continue using eye contact, facial
expression, vocalisation and/or body movements.
•
Occasionally follows familiar directions, understand steps
and familiar routines.
The Early Communicator Stage
Expect the following:
• Interact with you and familiar people in familiar situations.
• Take more turns in people games and play with you for
longer.
• Sometimes request or respond by repeating what you say
(use of immediate echolalia.)
• Purposefully makes requests for motivating things and
using pictures, gestures or words.
• Beginning to protest using the same actions, sounds or
word.
• Understands the names of familiar objects and people
without visual cues.
• May say “Hi” and “Goodbye.”
The Partner Stage
Expect the following:
• Participate in longer interactions with you.
• Play with other children most successfully in familiar play routines.
• Use words or another method of communication to:
Request
Protest
Greet
Draw your attention to something
Ask and answer questions
• Start to use words or another method of communication.
• Formulate their own sentences.
• Have short conversations and often repair or fix conversations when
they break down.
The ideal state for
interaction and communication is…
CALM AND ALERT
Building Communication
• Start where the child/young person is
NOT where you wish they were.
• Start with communication they can
succeed with.
• Make sure you have something
worth the effort of communicating
about.
Communication
Remember to:
1. Comment not question.
2. Use your child's interests.
3. Set small steps towards communication.
4. Recognise the positives
and ……………
Have FUN!!!!!!!!!!!!!!!
Set goals by using your knowledge
of your own child.
• Informal assessment.
• Set simple communication goals.
• Make it functional!
Communication
Just because the person with Autism can speak does
not mean that they can communicate effectively.
But My Child Can Talk
It is important to remember that communication is more
complex than “just speech".
•
It involves multiple skills including establishing attention,
taking in information, interpreting that information,
remembering past information, and eventually
formulating a response.
•
The communication disability of children with ASD, is not
just a problem with expression. It is not determined solely
by a child's ability to speak.
Video
Unstructured Language
But My Child Can Talk cont…
• Visuals are to support children who may have
trouble, either expressively or receptively,
with spoken language.
• These visual supports may be modified or
reduced over time as the child becomes more
independent in his environment.
How Can Visual Structures Help With
Communication and Behaviour?
• Visual information such as objects, pictures, and written
language are non-transient. They remain present long
enough to provide an opportunity for the child to engage his
attention before the message disappears.
• The visual information can remain visible long enough to
enable the student to focus on it or return to it as needed to
establish memory for the message they are communicating.
•
Communication happens very quickly. Speech is transient; it
remains present for only a short period of time and then it
disappears.
•
A spoken message may be finished before our child is
focused enough to receive it.
•
Visual aids are not transient they are concrete forms that
stay with the child and aid understanding of what is
expected.
Visual communication aids
Hodge (1995) reports that “people with Autism
need additional time to process language.”
“Visual cues help because they are static and
stay in place longer.”
Keep in mind that the concept of visual support
and structure does not require elaborately
prepared tools. Once your ‘visual mind set’ is
established you will see lots of little things that
will help... Putting yourself under pressure to
produce elaborate systems my create more
stress that it solves. Start with only one.
Linda Hodgson Author of –
Visual Strategies for Improving Communication.
What Can We Do To Help?
• Say less!
• Stress!
• Go slow and show!
• Remember
• The majority of children with ASD are visual learners
and have a strong preference for visual versus
auditory.
“Remember that communication is more
than just speech.”
Speech is the mode, communication is the
point.
Remember, reduce, go slow and show.
Middletown Centre for Autism – Parent Training
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