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Autism,AAC
and Motor Learning
Gwendolyn Meier, SLP, MT
Villa Esperanza Services
gmeier@villaesperanzaservices.org
Thursday...
Disclaimer
• The speaker has no financial or non-
financial interests in the information or
products in this presentation
Th...
Thursday, April 3, 14
The Speech & Language Center
Thursday, April 3, 14
Thursday, April 3, 14
Today’s screen shots can be found in the full
presentation - link on the CSHA 2014 tab at
scaacn.blogspot.com/p/csha-2014....
Agenda
Maximizing Motor Skills in:
• Autism
• AAC Assessment
• Teaching
• Prompting
• Communication displays - high & low ...
Slideshow
Thursday, April 3, 14
Terminology
• Symbol = Icon
• Comprehension = Recognition
• Device = Any visually-based AAC
system
• Student = Learner of ...
Moving to Budapest!
Thursday, April 3, 14
Moving to Budapest!
Thursday, April 3, 14
AAC Assessment
The snapshot
• Test of icon
recognition (e.g.,
TASP)
• Present a few
systems
• Final
recommendation
The ful...
Teaching Hungarian
• HOW are we teaching this new language?
Hungarian:
• More likely to learn in meaningful
chunks at first...
Teaching AAC
• HOW are we teaching this new language?
In AAC:
• More likely to learn sequences made
meaningful by the reac...
Teaching Hungarian
• HOW are we teaching this new language?
Hungarian:
• Flashcards?
• Scripted interaction?
• Conversatio...
How are we teaching this new language?
In AAC:
• Labeling?
• Requesting?
• Answering
questions?
• Scripted
interaction?
• ...
Teaching Language in
Autism
• Use strengths to shore up weaknesses
In autism:
(-) Auditory weakness
(-) Symbolic weakness
...
Teaching AAC Language
• Modeling and Augmented input highlight the
auditory boundaries between words
‣ Human speech alone ...
Teaching AAC Language
• Neurons that fire together, wire together
(Hebb’s rule)
In AAC:
• Seeing language
• Hearing languag...
In infancy...
• With the motor pattern for speaking
words comes increased ability to
perceive that word in spoken
language...
In AAC infancy...?
• With the motor pattern for navigating to
words comes increased ability to perceive
that word in spoke...
Multi-Sensory Language
Modeling & Augmented Input
• See the visual, See the movement, Hear the
auditory feedback, Experien...
Modeling for Milo
Thursday, April 3, 14
Language Acquisition...
...requires organization and interpretation of the
world through a system of symbols and
referents...
AAC Language Acquisition...
...requires organization and interpretation of the
world through a system of symbols and
refer...
The key to making the iconic or
arbitrary symbol-to-referent
connection may be in the
comprehension skill that the
learner...
Symbol Comprehension
• Without understanding of the
referent, the iconicity of the visual
symbol may not affect his learni...
chips
Thursday, April 3, 14
PECS & Symbol Comprehension
• PECS Phase 3:
Discrimination Training
- Aims to teach icon
discrimination skills given a
lim...
Picture Communication Books
Rely on icon association/
understanding
Thursday, April 3, 14
A Dual Role for Symbols
• Visual-graphic AAC icons themselves play a
role in their acquisition
• The message to represent ...
• Gissette’s icon Recognition?
• How is she going to learn to use
“Put” + “on” to request?
Thursday, April 3, 14
Teaching AAC
• HOW are we teaching this new language?
In AAC:
• Icon recognition?
• Verbal cues?
• Motor patterns?
• Gestu...
So, how do we teach new
movement patterns?
Thursday, April 3, 14
Model + Consequence
$$$ What’s the pay off $$$$
Thursday, April 3, 14
Visual Cues?
Thursday, April 3, 14
Physical Support for the
Correct Movement Pattern
PROMPT TM
Thursday, April 3, 14
Practice! Practice!
Practice!
Daily
Over time
With support
With meaningful consequences
Thursday, April 3, 14
Motor Skills in ASD
• Various altered motor behaviors in autism:
• Slower repetitive hand movements
• Slower and less accu...
Motor Skills in ASD
1. Implicit motor learning processes are
relatively intact in autism
* Gowen, E. & Hamilton, A. (2013)...
Motor Skills in ASD
1. Implicit motor learning processes are
relatively intact in autism
2. Reaction times improve to the ...
Serial Reaction Time Task
Thursday, April 3, 14
Imagine...PECS Phase 1
• Learning the “give”
• Efficiency comes
with practice
Thursday, April 3, 14
Thursday, April 3, 14
Motor Skills in ASD
1. Implicit motor learning processes are
relatively intact in autism
2. Reaction times improve to the ...
Proprioceptive support
Thursday, April 3, 14
• Use motor learning strength to teach the
motor pattern
• Paired with a motivating consequence
Thursday, April 3, 14
• Then reduce the level of visual prompt
Thursday, April 3, 14
Milo - Learning “turn”
Thursday, April 3, 14
Sensory & Movement
Differences
• Starting
• Stopping
• Continuing
• Combining and switching
• Thought
• Memory
• Emotion
•...
Stopping, / Switching
Thursday, April 3, 14
Take from the Right
Thursday, April 3, 14
Motor PlanVS. Icon
Comprehension
• Consistent placement of icons and
meaningful use of them in communication
may be more i...
Motor PlanVS. Icon
Comprehension
• Consistent placement of icons and
meaningful use of them in communication
may be more i...
Why the fuss about
Motor Learning?
EVERY learned physical activity
depends on motor learning
• Walking, driving, climbing/...
Automatic Motor
Patterns
Thursday, April 3, 14
When motor patterns
change...
Automatic
Volitional
Thursday, April 3, 14
Imagine...
Thursday, April 3, 14
Thursday, April 3, 14
Thursday, April 3, 14
When Motor Patterns
Change
• It brings our awareness to our movements
• Requires re-learning
• Ideation - Plan - Execution...
Speaking
• Automatic motor patterns for words and
phrases are established as meaning is
attached (in infancy)
• We don’t t...
AAC Automaticity is
aided when:
1. Consistent motor patterns to access
vocabulary we need
2. There is a unique pattern to ...
Consistent motor patterns are
extremely important when...
• When using multiple pages of vocabulary
• Visual tracking and ...
When Motor Patterns
Change
• By shifting locations of pictures:
• Awareness moves from the message to the execution
• We a...
We can take advantage
of motor learning when:
• Patterns build upon themselves as language
grow
• Plan the end at the begi...
Between activity-based pages...preserve location
Classroom Snack
Thursday, April 3, 14
Consistent Placement -
Pic Card Shadows
Thursday, April 3, 14
Another benefit...
Thursday, April 3, 14
Today Tomorrow
Campus Job - “Here is your schedule”
Thursday, April 3, 14
As language system grows...preserve location
Thursday, April 3, 14
Motor patterns don’t change
Thursday, April 3, 14
NEW! in 2013
Thursday, April 3, 14
Thursday, April 3, 14
Thursday, April 3, 14
When we use motor
learning to our advantage...
• Our lower-functioning students can generate
multi-word phrases...
...acro...
Thank you!
Email: gmeier@villaesperanzaservices.org
Blog: www.scaacn.blogspot.com
Facebook: facebook.com/socalaac.scaacn
T...
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Autism, AAC, and Motor Learning (G. Meier, CSHA 2014)

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Augmentative and alternative communication (AAC) options for children who are nonverbal have exploded in recent years. In this session we will discuss how recent findings related to motor differences in autism relate to student successes and barriers to accessing AAC. Join us in exploring strategies for moving beyond simple requesting and toward additional functions of communication using the power of motor patterns from assessment to language learning.

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Autism, AAC, and Motor Learning (G. Meier, CSHA 2014)

  1. 1. Autism,AAC and Motor Learning Gwendolyn Meier, SLP, MT Villa Esperanza Services gmeier@villaesperanzaservices.org Thursday, April 3, 14
  2. 2. Disclaimer • The speaker has no financial or non- financial interests in the information or products in this presentation Thursday, April 3, 14
  3. 3. Thursday, April 3, 14
  4. 4. The Speech & Language Center Thursday, April 3, 14
  5. 5. Thursday, April 3, 14
  6. 6. Today’s screen shots can be found in the full presentation - link on the CSHA 2014 tab at scaacn.blogspot.com/p/csha-2014.html Thursday, April 3, 14
  7. 7. Agenda Maximizing Motor Skills in: • Autism • AAC Assessment • Teaching • Prompting • Communication displays - high & low tech • Core vocabulary learning & use Thursday, April 3, 14
  8. 8. Slideshow Thursday, April 3, 14
  9. 9. Terminology • Symbol = Icon • Comprehension = Recognition • Device = Any visually-based AAC system • Student = Learner of any age Thursday, April 3, 14
  10. 10. Moving to Budapest! Thursday, April 3, 14
  11. 11. Moving to Budapest! Thursday, April 3, 14
  12. 12. AAC Assessment The snapshot • Test of icon recognition (e.g., TASP) • Present a few systems • Final recommendation The full assessment • Initial impression •System trial/ teaching period • Final recommendation Thursday, April 3, 14
  13. 13. Teaching Hungarian • 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) Where is the toilet?  Hol van a mosdó? (hol vån å MOSH-doa?) Thursday, April 3, 14
  14. 14. Teaching AAC • HOW are we teaching this new language? In AAC: • More likely to learn sequences made meaningful by the reaction they elicit Thursday, April 3, 14
  15. 15. Teaching Hungarian • HOW are we teaching this new language? Hungarian: • Flashcards? • Scripted interaction? • Conversation? Thursday, April 3, 14
  16. 16. How are we teaching this new language? In AAC: • Labeling? • Requesting? • Answering questions? • Scripted interaction? • Conversation? • Icon recognition? • Verbal cues? • Motor patterns? • Gesture cues? • Visual cues? Thursday, April 3, 14
  17. 17. Teaching Language in Autism • Use strengths to shore up weaknesses In autism: (-) Auditory weakness (-) Symbolic weakness (+)Visual strength (?) Motor skills Thursday, April 3, 14
  18. 18. Teaching AAC Language • Modeling and Augmented input highlight the auditory boundaries between words ‣ Human speech alone does not Thursday, April 3, 14
  19. 19. Teaching AAC Language • Neurons that fire together, wire together (Hebb’s rule) In AAC: • Seeing language • Hearing language • Add motor pattern = Multi-sensory stimulation Thursday, April 3, 14
  20. 20. In infancy... • With the motor pattern for speaking words comes increased ability to perceive that word in spoken language* * Halloran & Halloran, 2006. Language Acquisition Through Motor Planning. Center for AAC and Autism. Thursday, April 3, 14
  21. 21. In AAC infancy...? • With the motor pattern for navigating to words comes increased ability to perceive that word in spoken language (?) Thursday, April 3, 14
  22. 22. Multi-Sensory Language Modeling & Augmented Input • See the visual, See the movement, Hear the auditory feedback, Experience the natural consequence Thursday, April 3, 14
  23. 23. Modeling for Milo Thursday, April 3, 14
  24. 24. Language Acquisition... ...requires organization and interpretation of the world through a system of symbols and referents. cat ball bed Thursday, April 3, 14
  25. 25. AAC 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 outsidegowant Thursday, April 3, 14
  26. 26. 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. Symbol Comprehension Thursday, April 3, 14
  27. 27. 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). ExploringVisual-Graphic Symbol Acquisition by Preschool Age Children with Developmental and Language Delays.Augmentative and Alternative Communication,Vol 22(1), 10-20. Thursday, April 3, 14
  28. 28. chips Thursday, April 3, 14
  29. 29. PECS & Symbol Comprehension • PECS Phase 3: Discrimination Training - Aims to teach icon discrimination skills given a limited field of choices TM TM Thursday, April 3, 14
  30. 30. Picture Communication Books Rely on icon association/ understanding Thursday, April 3, 14
  31. 31. 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. Thursday, April 3, 14
  32. 32. • Gissette’s icon Recognition? • How is she going to learn to use “Put” + “on” to request? Thursday, April 3, 14
  33. 33. Teaching AAC • HOW are we teaching this new language? In AAC: • Icon recognition? • Verbal cues? • Motor patterns? • Gesture cues? • Visual cues? • Labeling? • Requesting? • Answering questions? • Scripted interaction? • Conversation? Thursday, April 3, 14
  34. 34. So, how do we teach new movement patterns? Thursday, April 3, 14
  35. 35. Model + Consequence $$$ What’s the pay off $$$$ Thursday, April 3, 14
  36. 36. Visual Cues? Thursday, April 3, 14
  37. 37. Physical Support for the Correct Movement Pattern PROMPT TM Thursday, April 3, 14
  38. 38. Practice! Practice! Practice! Daily Over time With support With meaningful consequences Thursday, April 3, 14
  39. 39. Motor Skills in ASD • Various altered motor behaviors in autism: • Slower repetitive hand movements • Slower and less accurate manual dexterity • Reduced ability for rapidly alternating movements (diadochokinesis) Staples & Reid. (2010). Fundamental movement skills and autism spectrum disorders. Journal of Autism and Developmental Disorders, Vol 40(2), pp. 209-217. Thursday, April 3, 14
  40. 40. 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. Thursday, April 3, 14
  41. 41. 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. Thursday, April 3, 14
  42. 42. Serial Reaction Time Task Thursday, April 3, 14
  43. 43. Imagine...PECS Phase 1 • Learning the “give” • Efficiency comes with practice Thursday, April 3, 14
  44. 44. Thursday, April 3, 14
  45. 45. 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. Thursday, April 3, 14
  46. 46. Proprioceptive support Thursday, April 3, 14
  47. 47. • Use motor learning strength to teach the motor pattern • Paired with a motivating consequence Thursday, April 3, 14
  48. 48. • Then reduce the level of visual prompt Thursday, April 3, 14
  49. 49. Milo - Learning “turn” Thursday, April 3, 14
  50. 50. Sensory & Movement Differences • Starting • Stopping • Continuing • Combining and switching • Thought • Memory • Emotion • Speech Thursday, April 3, 14
  51. 51. Stopping, / Switching Thursday, April 3, 14
  52. 52. Take from the Right Thursday, April 3, 14
  53. 53. Motor PlanVS. 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 Thursday, April 3, 14
  54. 54. Motor PlanVS. 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 Thursday, April 3, 14
  55. 55. 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 Thursday, April 3, 14
  56. 56. Automatic Motor Patterns Thursday, April 3, 14
  57. 57. When motor patterns change... Automatic Volitional Thursday, April 3, 14
  58. 58. Imagine... Thursday, April 3, 14
  59. 59. Thursday, April 3, 14
  60. 60. Thursday, April 3, 14
  61. 61. When Motor Patterns Change • It brings our awareness to our movements • Requires re-learning • Ideation - Plan - Execution - Feedback ✴ Not conducive to communicating! Thursday, April 3, 14
  62. 62. 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. Thursday, April 3, 14
  63. 63. 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. Thursday, April 3, 14
  64. 64. Consistent motor patterns are extremely important when... • When using multiple pages of vocabulary • Visual tracking and scanning are not efficient • When icon recognition is weak • Teaching the use of core vocabulary and use of more abstract vocab/symbols • A visual search is meaningless Thursday, April 3, 14
  65. 65. 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! Thursday, April 3, 14
  66. 66. We can take advantage of motor learning when: • Patterns build upon themselves as language grow • Plan the end at the beginning •Preserve relative location Thursday, April 3, 14
  67. 67. Between activity-based pages...preserve location Classroom Snack Thursday, April 3, 14
  68. 68. Consistent Placement - Pic Card Shadows Thursday, April 3, 14
  69. 69. Another benefit... Thursday, April 3, 14
  70. 70. Today Tomorrow Campus Job - “Here is your schedule” Thursday, April 3, 14
  71. 71. As language system grows...preserve location Thursday, April 3, 14
  72. 72. Motor patterns don’t change Thursday, April 3, 14
  73. 73. NEW! in 2013 Thursday, April 3, 14
  74. 74. Thursday, April 3, 14
  75. 75. Thursday, April 3, 14
  76. 76. 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! Thursday, April 3, 14
  77. 77. Thank you! Email: gmeier@villaesperanzaservices.org Blog: www.scaacn.blogspot.com Facebook: facebook.com/socalaac.scaacn Twitter: @scaacn Thursday, April 3, 14

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