Week 4 Review, ASD

Representational Gestures

(i.e., head shake, wave, clap, head nod, and depictive gesture or sign) Contact without objects without focused semantic contact reaching toward or touching an adult or self injury (e.g., slapping or hitting self).

Deictic Gestures

(i.e.,give, push/pullaway, reach, show, tap, point, indicative, throw/drop/hit, moving object toward adult, and using another's hand as a tool)

The development of communication in children influenced by the development of the following:

1) Joint Attention 2) Symbol Use

PECS Effectiveness

6 children used PECS(55 to 70 months, 5 with ASD) • All learned to use the system (through Phase VI) within 6 months & exhibited gains in spoken language with and without the use of the pictures • Children also increased eye contact and use of each other's names (Webb, 2000) 66 preschool children who used PECS Used for at least a year; 25 children used a combination of speech and pictures or a printed system 41 used speech alone; 76% of the children trained in their program developed speech & use it as their sole communication modality or augment their speech with a picture-based system Frequency of spontaneous language (both verbal and pictorial) The duration of social interaction with peers increased for one child with autism (6 years of age) using PECS (Kravitz, Kamps, Kemmerer & Potucek, 2002 20 children who use PECS • Children had autism and other learning difficulties• found that all but one learned to use PECS to request• 11 children learned to use sentence strips between 4-15 months;• 9 of the 20 children had increased their verbalizations following the introduction of PECS, • 7 of these children using words (Liddle, 2001)

The Communicative Act (Shumway & Wetherby, 2009)

A successful communicative act consists of three things: • A reason to communicate (Intention) • Away to communicate • Directed toward a person

Trends in ERP findings in children with ASD Preferred non-speech sounds to speech sounds Detected changes in non-speech but not speech sounds Preferred non-social stimuli to faces

ASD and Joint Attention

Assessment of Children with Autism for AAC

Assessment of Children with Autism for AAC No standardized instrument for AAC There are several models that give you useful information 1. The Participation Model (Beukelman & Mirenda, 2005) 2. SCERTS Assessment Process (Prizant, Wetherby, Rubin, Laurent, & Rydell, 2006) 3. Social Networks Tool (Blackstone & Hunt-Berb, 2003) 4. Augmentative and Alternative Communication Profile (2009)

Augmentative and Alternative Communication Strategies

Augmentative and Alternative Communication Strategies

Functions: A Reason to Communicate. (Why - Intention)

Behavior Regulation Social Interaction Joint Attention

Picture Exchange Communication System Phases

Behaviorally based program Phase I • Physically assisted to independent exchange started from child's initiation Phase II • Generalized Use- Seek out pictures and partners Phase III • Teaches discrimination of pictures in selecting the picture that represents the item they want. Phase IV simple sentences on sentence strip and attribution • Teaches child to use sentence structure "I want ___________." Phase V • Teaches child to respond to the question "What do you want?" Phase VI • Teaches students to comment about things in their environment both spontaneously and in response to a question like "What do you see?" and "What do you hear?"

A Way To Communicate (How) Gesture Forms

Deictic Gestures Representational Gestures

Zone of Proximal Development (ZPD)

Evaluating and planning objectives based on a child's joint attention skills After assessment, first objective is to teach an emerging ability Skill with support to spontaneous skills Diehl,2010

Expand Language Imitate

Expand Language • Talk about what the child is doing • Repeat • Expand • Give corrective feedback Imitate • Imitate the child's actions on toys • Mirror language

Graphic Communication Systems and ASD Con

Graphic Communication Systems and ASD Con Aided-Needs something external Language modeling Conversational partners

Graphic Communication Systems and ASD Pro

Graphic Communication Systems and ASD Pro • Static • Goes with visual learning style • Used for reception and expression

Picture Exchange Communication System (PECS)

Grounded in ABA Principles Using effective reinforcers through the application of request situations rather than labeling situations Begins with spontaneous communication Avoids prompt dependency Doesn't require extensive training prior to the initiation of the system (Bondy & Frost, 1998). • Videos available through PECS USA https://pecsusa.com/videos/

Joint Attention vs Joint Engagement for Intervention

Initiates Joint Attention (IJA) • Coordinated joint look • Showing • Give to share • Point Responds To Joint Attention (RJA) • Following point • Following gaze

"Visually coordinating attention to an event or object with another individual, sharing interest and social engagement, and showing an understanding that the partner is sharing the same focus".

Joint Attention Intervention

Joint Attention • Specific set of gestures used for sharing • Type of communication used (joint looks;showing, giving to share, point to share focus

Joint Attention vs Joint Engagement for Intervention

Joint Attention vs Joint Engagement for Intervention*

Joint Engagement Over arching quality and connective of the interaction Unengaged-not attending to object or person Object Engaged-playing with object toy appropriate toy Person engaged-interacting with person without toys Supported joint engagement-child and adult interacting with toy or object but adult doing heavy lifting Coordinated joint engagement-child and adult actively involved; clearly aware of adult and both initiate

• Joint attention occurs when the focus of the child and the communication partner are directed to the same object of phenomenon. • Both communication partners know this attention is shared.

Joint attention

Importance of Joint Attention

Joint behavior are behaviors used to follow or direct the attention of another person to an event or object to share an interest in that event or object (Siiler & Sigman, 2002). Ability to initiate and respond to bids for joint attention forms basis of social cognitive and verbal abilities (Mundy, et al, 2007) Joint attention strongest relation to concurrent language ability (Dawsonetal.,2004; Charman et al., 2003; Lord & Risi, 2007; Mundy, Sigman, & Kasari, 1990; Sigman & McGovern, 2005) Joint attention at age 3 predicted verbalability at age 9 (Lord&Risi,2007) Initial deficit in joint attention impacts child's development in the foundation of social cognition, behavior, and verbal skills.

Culturally and Linguistically Diverse Backgrounds*

Makes sure to consider: If you are asking something to do outside of cultural norms Turn taking • Facial expression and smiling may vary • Eye contact/Eye gaze

Manual Signs and ASD Con

Manual Signs and ASD Con Motor issues Transitory Language modeling Conversational partners

Manual Signs and ASD Pro

Manual Signs and ASD Pro Manual signs are an unaided AAC Strategy which mean nothing external is needed Manual signing thought to use less memory and abstract understanding

A Way To Communicate (How) More Formal Forms of Communication

More Formal Forms of Communication • Vocalizations • Speech • Signing • Giving objects • Exchanging pictures • Pointing to pictures • Speech Generating Devices

Speech Generating Devices

Portable computerized devices with speech output • Dynamic or static or both • Can use a variety of symbols • Use a variety of grids Three main AAC companies • Dynavox-Tobii • Prentke-Romich • Saltillo

Joint Action Routine

Routinized interactive game that mothers and young children frequently play (i.e., Peekaboo, Pat-a- cake) Turn-taking Small set of language Repetitive Opportunities for vocalizations Jointly engaged Linked to language development

Scaffold Identify Provide Use

Scaffold Scaffold Skills Identify Identify the joint attention skill to scaffold Provide Provide ample positive reinforcement of the child's skills Use Use The Prompt Hierarchy General verbal prompt Specific verbal suggestion Verbal command

Selecting AAC System

Selecting AAC System Initial vocabulary and planning for expansion a) Core b) Fringe Identifying instructional strategies a) Aided Language Stimulation b) Natural Aided Language c) Aided Input Train communication partners on the system Monitoring and adapting

AAC Displays

Semantic-syntactic Organization • Grammatical categories• Noun, verbs, adverbs, adjectives Taxonomic Organization • People, places, and animals Schematic Organization • Lunch• Bathtime • Shopping Pragmatic Organization Dynamic Display • https://praacticalaac.org/praactical/how-i-do-it-using-podd-books-and-aided- language-displays-with-young-learners-with-autism-spectrum-disorder/

Set up, Follow

Set up the environment • Sit close enough to make eye contact • Arrange toys within reach • Remove distractions Follow the child's lead • Wait before acting • Allow child to explore room • Show high interest in child's choice

Generalization and Termination

Show mastery across settings and people Teaching caregivers how to carry out strategies across daily activities at home does the following: • Increases Density • Promotes Generalization

Culturally and Linguistically Diverse Backgrounds

Social-pragmatics of culture Family's values of technology View of AAC as priority Most appropriate ways to teach families to use AAC Nature of symbols for AAC System

Data Collection

Spontaneous joint attention without prompting for at least three times across two sessions • Not sequential • Respond to any emerging skill • Reinforce • Model • Prompt

Kasari's Intervention for Joint Attention

Started with table (discreet trial intervention; DTI) and more naturalistic play format but discarded DTI because didn't need the pre-teaching. Language skills and social communication are core impairments Time-30 min sessions for 6 weeks or 24 half-hour sessions with 3sessions per week for improvement but ongoing intervention needed Personnel qualifications/training-Should have experience working with ASD trained in related discipline; parents that are trained and supervised by professional Settings and materials-lab, home, or school in a setting free from distractions; materials toys coordinated with play levels

Speech Generating Devices: APPs

Usually used on phones or iPad Can be used on PCs Inexpensive Most lack support

Week 4 Beginning Communicators

Week 4 Beginning Communicators

The neural circuits for processing of speech more affected than for sound processing in the areas of:

• Attending to speech sound changes • Discriminating (Longer latency for in category words) • Prioritizing (Sometimes no difference for in and out of category words)

Social Interaction

• Attractor maintains another's attention to oneself (i.e., get another person to look at or notice him or her)

Joint Attention Development: ASD

• Children with ASD's early problems with joint attention may actually stop or impede a natural social information cycle which provides the basis for social, cognition, behavior, and verbal skills • The social impoverishment starts early and changes the course of development in many areas •Joint attention should be viewed as a pivotal skill in that improvement should result in positive changes in other areas (Jones & Carr, 2004)

Joint Attention

• Direct another's attention to an object, event, or topic. (i.e. get another person to look at or to notice something; Commenting on something)

Data Collection for Decision Making

• Flexible and applicable across setting, events, and people • Valid and reliable • Shared by team members • Applicable to resources

Behavior Regulation

• Requests (i.e.,get something or get a person to do something) • Protests (i.e.,get a person to stop doing something)