ATI 2014 Motor Implications in ASD & AAC, Meier

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Motor differences in autism cannot be ignored; specifically for individuals who lack functional oral speech. This session, presented live, explores the important role motor planning plays in best practice AAC assessment, arrangement of high tech and low tech communication displays, teaching and prompting, and core vocabulary learning.
First presented at the Assistive Technology Institute 10th Annual Conference on 2/1/14 by Gwendolyn Meier, SLP, MT

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ATI 2014 Motor Implications in ASD & AAC, Meier

  1. 1. Motor Implications in ASD & AAC Gwendolyn Meier, SLP, MT Villa Esperanza Services gmeier@villaesperanzaservices.org Monday, February 3, 14
  2. 2. Motor Skills Play a Role • AAC Assessment • Teaching • Prompting • Communication displays - high & low tech • Core vocabulary learning & use Monday, February 3, 14
  3. 3. Moving to Budapest! Monday, February 3, 14
  4. 4. Moving to Budapest! Monday, February 3, 14
  5. 5. AAC Assessment • The snapshot • The full assessment • • Trial/teaching period • Monday, February 3, 14 Icon recognition (e.g., TASP) Present a few systems • Final recommendation
  6. 6. Teaching AAC • HOW are we teaching this new language? Hungarian: • More likely to learn in meaningful chunks at first • Before segmentation occurs Is there someone here who speaks English? Beszél itt valaki angolul? (BE-seyl it VÅ-lå-ki ÅN-go-loul) Monday, February 3, 14 Where is the toilet?  Hol van a mosdó? (hol vån å MOSH-doa?)
  7. 7. Teaching AAC • HOW are we teaching this new language? In AAC: • More likely to learn sequences made meaningful by the reaction they elicit Monday, February 3, 14
  8. 8. Teaching AAC • HOW are we teaching this new language? Hungarian: • Flashcards? • Scripted interaction? • Conversation? Monday, February 3, 14
  9. 9. Teaching AAC • HOW are we teaching this new language? In AAC: • Labeling? • Requesting? • Answering questions? • Scripted interaction? • Conversation? Monday, February 3, 14 • Icon recognition? • Verbal cues? • Motor patterns? • Gesture cues? • Visual cues?
  10. 10. Teaching Language • Use strengths to shore up weaknesses In autism: (-) Auditory weakness (-) Symbolic weakness (+) Visual strength (?) Motor skills Monday, February 3, 14
  11. 11. Teaching Language • Modeling and Augmented input highlight the auditory boundaries between words • Human speech alone does not Monday, February 3, 14
  12. 12. Teaching Language • Neurons that fire together, wire together (Hebb’s rule) • Seeing and hearing language • Add motor pattern • With the motor pattern for producing words comes increased ability to perceive that word in spoken language* Monday, February 3, 14
  13. 13. In infancy... • With the motor pattern for producing words comes increased ability to perceive that word in spoken language* *Halloran & Halloran, 2006. Language Acquisition Through Motor Planning. Center for AAC and Autism. Monday, February 3, 14
  14. 14. AAC is a Multi-Sensory Language Modeling & Augmented Input • See the visual, See the movement, Hear the auditory feedback, Experience the natural consequence Monday, February 3, 14
  15. 15. Language Acquisition... ...requires organization and interpretation of the world through a system of symbols and referents. ball cat bed Monday, February 3, 14
  16. 16. Language Acquisition... ...requires organization and interpretation of the world through a system of symbols and referents. • AAC visuals (objects, photos, icon, text) add an element of “referent” to spoken words that have no physical referent want Monday, February 3, 14 go outside
  17. 17. Symbol Comprehension The key to making the iconic or arbitrary symbol-to-referent connection may be in the comprehension skill that the learner brings to the task. Namy, L., Campbell, A. & Tomasello, M. (2004). The changing role of iconicity in non-verbal symbol learning. Journal of Cognition & Development, 5, 37-57. Monday, February 3, 14
  18. 18. Symbol Comprehension • Without understanding of the referent, the iconicity of the visual symbol may not affect his learning of its meaning ✴ The iconic symbol may appear just as meaningless as the arbitrary symbol until it is given meaning through its use Barton, A., Sevik, R. & Romski, M.. (2006). Exploring Visual-Graphic Symbol Acquisition by Preschool Age Children with Developmental and Language Delays. Augmentative and Alternative Communication,Vol 22(1), 10-20. Monday, February 3, 14
  19. 19. TM PECS & Symbol Comprehension • TM PECS Phase 3: Discrimination Training - Aims to teach icon discrimination skills given a limited field of choices Monday, February 3, 14
  20. 20. Picture Communication Books Rely on icon association/ understanding Monday, February 3, 14
  21. 21. A Dual Role for Symbols • Visual-graphic AAC icons themselves play a role in their acquisition • The message to represent an idea AND • The medium to achieve communication Sevcik, R. A., Romski, M. A., & Wilkinson, K. (1991). Roles of graphic symbols in the language acquisition process for persons with severe cognitive disabilities. Augmentative and Alternative Communication, 7, 161–170. Monday, February 3, 14
  22. 22. VIDEO • Core vocab teaching in ASD w/AAC Monday, February 3, 14
  23. 23. • How is her icon recognition? • How is she going to learn to use “Put” + “on” to request? Monday, February 3, 14
  24. 24. Teaching AAC • HOW are we teaching this new language? In AAC: • Labeling? • Requesting? • Answering questions? • Scripted interaction? • Conversation? Monday, February 3, 14 • Icon recognition? • Verbal cues? • Motor patterns? • Gesture cues? • Visual cues?
  25. 25. So, how do we teach new movement patterns? Monday, February 3, 14
  26. 26. Model + Consequence $$$ What’s the pay off $$$$ Monday, February 3, 14
  27. 27. Visual Cues? Monday, February 3, 14
  28. 28. Physical Support for the Correct Movement Pattern PROMPT Monday, February 3, 14 TM
  29. 29. Practice! Practice! Practice! Daily Over time With support With meaningful consequences Monday, February 3, 14
  30. 30. Motor Skills in ASD • Various altered motor behaviors in autism: • • Slower repetitive hand movements • Reduced ability for rapidly alternating movements (diadochokinesis) Slower and less accurate manual dexterity Staples & Reid. (2010). Fundamental movement skills and autism spectrum disorders. Journal of Autism and Developmental Disorders,Vol 40(2), pp. 209-217. Monday, February 3, 14
  31. 31. Motor Skills in ASD 1. Implicit motor learning processes are relatively intact in autism * Gowen, E. & Hamilton, A. (2013). Motor Abilities in Autism: A Review Using a Computational Context. Journal of Autism and Developmental Disorders, Vol 43(2), pp 323-344. Monday, February 3, 14
  32. 32. Motor Skills in ASD 1. Implicit motor learning processes are relatively intact in autism 2. Reaction times improve to the level of NT subjects given repetition • Serial reaction time task (SRT) * Gowen, E. & Hamilton, A. (2013). Motor Abilities in Autism: A Review Using a Computational Context. Journal of Autism and Developmental Disorders, Vol 43(2), pp 323-344. Monday, February 3, 14
  33. 33. Serial Reaction Time Task Monday, February 3, 14
  34. 34. Monday, February 3, 14
  35. 35. Motor Skills in ASD 1. Implicit motor learning processes are relatively intact in autism 2. Reaction times improve to the level of NT subjects given repetition • Serial reaction time task (SRT) 3. Proprioceptive input may be more reliable than visual input when learning new motor patterns Gowen, E. & Hamilton, A. (2013). Motor Abilities in Autism: A Review Using a Computational Context. Journal of Autism and Developmental Disorders, Vol 43(2), pp 323-344. Monday, February 3, 14
  36. 36. Imagine...PECS Phase 1 • Learning the “give” efficiency with practice Monday, February 3, 14
  37. 37. Pick from the Right Monday, February 3, 14
  38. 38. • Use motor learning strength to teach the motor pattern • Paired with a motivating consequence Monday, February 3, 14
  39. 39. • Then reduce the amount of visual cue Monday, February 3, 14
  40. 40. Motor Plan VS. Icon Comprehension • Consistent placement of icons and meaningful use of them in communication may be more important than iconicity of the picture • Learners don't need to be able to recognize/"point to"/"give" an icon that is named before they can use that icon to get something done in the world Monday, February 3, 14
  41. 41. Motor Plan VS. Icon Recognition • Consistent placement of icons and meaningful use of them in communication may be more important than symbol iconicity • Learners don't need to be able to recognize/"point to"/"give" a icon that is named before they can use that icon to get something done in the world Monday, February 3, 14
  42. 42. Why Teach Core Vocab? YouTube Monday, February 3, 14
  43. 43. Why the fuss about Motor Learning? EVERY learned physical activity depends on motor learning • Walking, driving, climbing/descending stairs, eating, dressing, typing, reading, Smartphone or computer access Monday, February 3, 14
  44. 44. Automatic Motor Patterns Monday, February 3, 14
  45. 45. When motor patterns change... Volitional Automatic Monday, February 3, 14
  46. 46. Imagine... Monday, February 3, 14
  47. 47. Monday, February 3, 14
  48. 48. Monday, February 3, 14
  49. 49. When Motor Patterns Change • It brings our awareness to our movements • Requires re-learning • Ideation - Plan - Execution - Feedback ✴ Not conducive to communicating! Monday, February 3, 14
  50. 50. Speaking • Automatic motor patterns for words and phrases are established as meaning is attached (in infancy) • We don’t think about how to physically speak • Focus on: the words to use, how it will be interpreted, our listener’s background...etc. Monday, February 3, 14
  51. 51. AAC Automaticity is aided when: 1. Consistent motor patterns to access vocabulary we need 2. There is a unique pattern to reach your word, regardless of the activity 3. Reliable, motivating consequences for use of symbols Halloran & Halloran, 2006. Language Acquisition Through Motor Planning. Center for AAC and Autism. Monday, February 3, 14
  52. 52. Consistent motor patterns are extremely important when... • When using multiple pages of vocabulary • • • When icon recognition is weak Teaching the use of core vocabulary and use of more abstract vocab/symbols • Monday, February 3, 14 Visual tracking and scanning are not efficient A visual search is meaningless
  53. 53. When Motor Patterns Change • By shifting locations of pictures: • Awareness moves from the message to the execution • We are actually testing • • • Visual scanning skills Icon association/understanding Adding cognitive load ✴ Not conducive to communicating! Monday, February 3, 14
  54. 54. We can take advantage of motor learning when: • Patterns build upon themselves as language grow • Plan the end at the beginning • Preserve relative location Monday, February 3, 14
  55. 55. Between activity-based pages...preserve location Classroom Monday, February 3, 14 Snack
  56. 56. Consistent Placement Monday, February 3, 14
  57. 57. Another benefit... Monday, February 3, 14
  58. 58. Today Tomorrow “Here is your schedule” Monday, February 3, 14
  59. 59. As language system grows...preserve location Monday, February 3, 14
  60. 60. Motor patterns don’t change Monday, February 3, 14
  61. 61. NEW! in 2013 Monday, February 3, 14
  62. 62. Monday, February 3, 14
  63. 63. Monday, February 3, 14
  64. 64. When we use motor learning to our advantage... • Our lower-functioning students can generate multi-word phrases... ...across multiple pages ...using core vocabulary ...for greater communicative competence! Monday, February 3, 14
  65. 65. AAC News & Info Monday, February 3, 14

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