EPANDING THE CONTENT OF AN OUTLINE using notes.pptx
Communication problems and intervention for children with autism
1. COMMUNICATION PROBLEMS
AND INTERVENTION FOR
CHILDREN WITH AUTISM
Presented by
MS. Fouzia Saleemi
Speech Language Pathologist
M.Phil. Speech Language Pathology,M.A.Sed (Special Education),
PGD(SLT),CD Applied Behavior (USF) CMH,Lahore
2. Allah(GOD) has not sent
down a disease except that
he has also sent down its
cure.
Quoted by
Prophet Muhammad
(P.b.u.h)
3. WORD AUTISM MEANING
A mental condition,
present from early
childhood, characterized
by great difficulty in
communicating and
forming relationships
with other people and in
using language and
abstract concepts.
4. AUTISM
Autism is a lifelong disability
Autism Spectrum Disorders (ASD) are a
collection of developmental disorders that are
characterized by impairments in social
interaction and communication, as well as the
presence of restricted and repetitive behaviors
and interests.it occurs primarily in males. The
ratio is 4:1
5. Autism impairs one’s ability to
Communicate
Receptive Language
Expressive Language
Pragmatic or Social Language abilities
Autism affects socialization.
Autism affects the sensory system.
Autism can impact cognitive skills where
brain is wired differently.
6. COMMUNICATION
Communication is when someone sends a
message to another person and the message is
received and understood.
Everyone Communicates!
• Communication is not just speech.
• Communication may occur through behaviors,
signs, gestures, pictures, pointing, nonverbal
body language, symbols, vocalizations,etc.
• Communication often relies on language.
• Language is a system of symbols and rules that
govern the use of the symbols to convey meaning.
7. DSM- IV CRITERIA
COMMUNICATION IMPAIRMENT
Delay in, or total lack of development of spoken
language
Failure to compensate with non-verbal gestures
Marked impairment in ability to initiate or
sustain conversation in children with speech.
Stereotyped, repetitive use of idiosyncratic
language
Echolalia, scripting, unusual prosody
Lack of spontaneous, varied, spontaneous make
believe play or social imitative play appropriate
to developmental level.
8. DSM-IV CRITERIA
SOCIAL COMMUNICATION IMPAIRMENT
Impairment in use of non-verbal behaviors to
regulate social interaction
Eye contact, facial expressions, gestures
Failure to develop developmentally-appropriate
peer relationships
Lack of spontaneous seeking to share enjoyment
with others
Lack of showing or pointing out objects of interest
Lack of social or emotional reciprocity
18. WHAT COMMUNICATION PROBLEMS ARE
ASSOCIATED WITH ASD
Limited inclination to share enjoyment, interests,
or achievements with other people
Primary purposes for communication to be:
- requests (get someone to do
something)
- protests (get someone/something to stop)
19. GENERAL COMPREHENSION AND
EXPRESSION PROBLEMS
Difficulty with language comprehension
High- pitched, monotonous speech
Echolalia
Sterotypic,meanigful speech
Asocial monologues
Preference for mechanical sounds over human
voice
Reduced interest in communication
Errors in recognizing face.
Poor use of environmental cues.
Poor response to commands.
20. SEMANTIC/PRAGMATIC BEHAVIORS
PROBLEMS
Lack of responsive to others.
Use of only few communication stratgies
Minimal use of gestural communication
Lack of eye contact
Slow acquisition of speech
Word findings difficulties
Poor categorization abilities
Poor understanding of related words
21. COMMUNICATION AND BEHAVIOR
Parents need to understand the behavior – look
deeper to try to understand the communication that is
occurring
Behavior may communicate:
- Frustration
- Fear or other emotional upset
- Discomfort – need to escape noise, light,
sensory,irritation, etc.
- Boredom
- Physical needs – thirst, hunger, bathroom
- Protest
- A request
- Many other things…
23. RECEPTIVE LANGUAGE SAMPLE
Level Of
Functioning Brown
Stages
ICW levels
PEEP
ABLLS
TROG test
Subjective Assessment Objective Assessment
24. EXPRESSIVE LANGUAGE SAMPLE
Pragmatics Checklist
Renfrew Test
Action Picture
Bus Story Test
Word finding
Vocabulary test
CELF 4
PLS 5
SALT
RDLS
Subjective Assessment Objective Assessment
26. The diagnosis of an Autism Spectrum Disorder
presents parents and clinicians with a veritable
maze of programs and therapies.
What is out there?
Which programs are best for my child/student?
29. BIOMEDICS APPROACH
Biomedics approach is commonly known as food
therapy. Gluten is a unique type of protein that is
generally discovered in our day-to-day meals
items. while it is an essential items of our diet,
the body of an Autistic kid responds in a different
way than a normal child. It is vital for the
parents to plan gluten free diet for their child
experiencing Autism.
32. The Assessment of Basic Language and
Learning Skills (ABLLS, often pronounced
“ABLLS") is an educational tool used frequently
to measure the basic linguistic and functional
skills of an individual with developmental delays
or disabilities.
33. OVERVIEW OF ABLLS CURRICULUM
Reinforce
effectiveness
Visual performance
Receptive Language
Imitation
Vocal imitation
Gross Motor Skills
Fine Motor Skills
Requests
Labeling
Intraverbal
Spontaneous
vocalization
Reading Skills
Math skills
Writing Skills
Spelling Skills
Syntax and Grammar
Play and Leisure
Social Interaction
Group Instruction
Classroom Routines
Generalized
Responding
Dressing
Eating
Grooming
Toileting
34. PECS FOR
CHILDREN WITH
AUTISM
Lori Frost, a certified Speech-Language Pathologist,
Andrew Bondy, PhD., at the Delaware Autistic
Program.
35. WHAT IS PECS
PECS was developed by Lori Frost, a certified
Speech-Language Pathologist, and Andrew Bondy,
PhD., at the Delaware Autistic Program.
Using the PECS, with nonverbal ASD children.
Children learns to spontaneously initiate
communicative exchanges. Using PECS, children
learn to gain the attention of the communication
partner in order to make a request.
40. ABA
Applied Behavior Analysis (ABA) is the only
scientifically validated treatment for autism and
is recommended by the U.S. Surgeon General.
Antecedent--Behavior--Consequences
A—B—C
Applied Behavior Analysis (ABA) given in early
then it is called Early intensive behavior analysis
(EIBI)
41. COMPREHENSIVE ABA PROGRAMS
DTT
Natural Environment Training (NET)
Verbal Behavior
Challenging behavior
Fluency based instruction Programme
Programming for generalization
42. VERBAL BEHAVIOR
B.F. Skinner, Verbal Behavior (1957): Applied principles of
behavior analysis to language
Separates language into categories by function
Some incorrectly say that “Verbal behavior is not ABA” or
“We don’t do ABA, we do verbal behavior”
43. COMMON TERMS FOR THE
VERBAL OPERANTS
Echoic
Mand
Tact
Intraverbal
Receptive or Listener Responding
44. Verbal
Operant
Antecedent Behavior Consequence
Mand Motivative
Operation
(wants cookie)
Verbal behavior
(says “cookie”)
Direct reinforcement
(gets cookie)
Tact Sensory Stimuli
(sees or smells
cookie)
Verbal behavior
(says “cookie”)
Non-specific
reinforcement
(gets praised, for
instance)
Intraverbal Verbal stimulus
(someone
says:”What do
you eat?”
Verbal behavior
(says “cookie”)
Non-specific
reinforcement
(gets praised, for
instance)
Echoic Verbal Stimulus
(someone says
“cookie”)
Verbal behavior:
repeats all or part
of antecedent
(says “cookie”)
Non-specific
reinforcement
(gets praised, for
instance)
Receptive
(actually not
a verbal
operant)
Verbal stimulus
(someone says
“touch cooke”)*
Non-verbal
behavior
(child touches
cookie)
Non-specific
reinforcement
(gets praised, for
instance)
45. OTHER TREATMENTS AND COMMUNICATION
METHODS
Sensory Integration Therapy
SIT should be administered by, or need for SIT should be assessed
by, an Occupational Therapist.
Auditory Integration Therapy
AIT generally consists of a prescribed amount of time spent each
day listening to a recording that uses particular combinations of
sound waves to retrain the ear mechanisms.
Music Therapy
Music Therapy can be an excellent addition to a treatment
program, but the therapist should be well-versed in your method of
choice (in other words, if you are running an ABA program, your
music therapist should have some experience working as an ABA
therapist).
47. SCERTS MODEL
SCERTS can be classified as a
combined intervention as it
blends elements of behavioral
and developmental models to
better support children on the
autism spectrum as they
develop.
SCERTS stands for Social-
Communication, Emotional
Regulation, and Transactional
Support. These are seen as the
principal dimensions for
intervention planning.
48. KEY COMPONENTS OF THE SCERTS
MODEL
Communication and language deficits
These are addressed through social-pragmatic language therapy, which
emphasizes the functional use of pre-verbal and verbal communication skills
in natural and semi-structured interactions. The model includes the use of
validated and effective strategies to support the use of non-speech
communication systems such as picture symbols. Social-pragmatic
approaches are now practiced in both contemporary Applied Behavior
Analysis programs as well as developmentally-based programs.
Deficits in social relatedness and social-emotional reciprocity
These are addressed through strategies developed as part of the Floor Time
approach. The basic premise of Floor Time is that children learn skills from
the relationships which they have with their caregivers and other people
significant in their lives.
Sensory processing deficits
These are addressed through sensory integration therapy and environmental
adaptations and supports. Many children with autism also have motor
planning issues affecting daily living skills, which are also addressed.
50. PARENTS-CHILD VERBAL THERAPY
This therapy are based on three stages with
following guidelines
Beginning stage
Middle stage
Advanced stage
51. Sitting
Attending Compliance
Remaining on task
How to Process Feed
Back
Understanding Cause
and effect
Communication skills
Play skills
Self-help
Social skills
Subtle Social Skills
Higher Level Play
Skills
Advanced
communication
&cognitive skills
Integration of skills to
everyday environment
53. LANGUAGE CURRICULUM
0-12 mos.
• Body Parts
• Echoics
• Following
Instructions
• Gestures
• Sound
Discriminati
on
1 - 2 yrs.
• Actions
• Basic Mands
• Categories
• Choices
• Functions
• Negation
• Objects
• People &
Relationships
• Prepositions
• Yes / No
2 - 3 yrs.
• Adverbs
• Attributes
• Features
• Gender
• Manding for
Information
• Opposites
• Pronouns
• Wh-
Discriminatio
n
• Locations
• Plurals
3 - 4 yrs.
• Describe
• Sequences
• Statement -
Statement
4 - 5 yrs.
• Same / Different
5 - 6 yrs.
• Ask & Tell
Discrimination
• Statement –
Question
• Syntax
6 - 7 yrs.
• What Goes With
31 Lessons by Emerging Age and Function:
Language
54. Language Curriculum
BehaviorInstruction
or Setting
Function Consequence
(Reinforcer)
Vocal
Imitation
Someone says
“apple”
“apple” Praise
Praise
Praise
Request Hungry and no
apple present
Labeling
Conversation
“apple”
“apple”
“apple”
Child gets an
apple
Apple is present
“What is your
favorite fruit?”
Language
Matching “Put with same” apple is matched
with apple Praise
“Touch apple” Selects apple PraiseListening
55. PLAY CURRICULUM Play
Electronic Play
Independent Play
Interactive
Play
Pretend
Play
Constructive
Play
Sensorimotor Play
Task Completion Play
Play Stations
Early Social Games
Read-to-Me Books & Nursery Rhyme
Music and Movement
Treasure Hunt
Card and Board Games
Locomotor Play
Peer Play
Functional Pretend Play
Symbolic Play
Imaginary Play
Sociodramatic Play
Block Constructions
Structure Building
and and Water Constructions
Clay Constructions
Arts and Crafts
Audio and Video Play
Computer Play
Video Games
56. ADAPTIVE (SELF
HELP)CURRICULUM
Adaptive
Safety
Safety Awareness
Safety Equipment
Domestic
Pet Care
Setting & Clearing Table
Telephone Skills
Tidying
Meal Preparation
Cleaning
Gardening
Laundry
School Backpack Prep
Making a Bed
Community
Shopping
Restaurant Readiness
Personal
Feeding
Toileting
Undressing
Unfastening
Dressing
Preventing Spread of Germs
Bathing
Fastening
Teeth Care
Hair Care
Nail Care
Health Care
57. Motor Curriculum
Motor
Oral Motor
Ocular Motility
Binocular Vision Skills
Visual Perception
Hand Skills
Coloring
Finger Skills
Drawing
Pre-Handwriting
Cutting with Scissors
Sitting Crawling / Creeping Riding Foot-Propelled Vehicles
Standing Rolling Over Rolling / Throwing / Dribbling
Walking Stairs and Climbing Riding a Tricycle / Bicycle
Running Balance Beam Swinging a Bat / Racquet / Paddle
Jumping Kicking Physical Education Readiness
Hopping Catching
Gross
Fine
Oral
Visual
58. ACADEMIC SKILLS CURRICULUMAcademic
SkillsMath
Shapes
Money
Patterning
Calendar
Addition
Subtraction
Statistics and Data Analysis
Number Concepts:
Numbers
Counting & Quantities
Quantitative Concepts
Ordering Numbers & Groups
Comparisons
Number Patterns
Time:
Time of Day & Daily Activities
Telling Time
Language Arts
Colors
Community Helpers
Handwriting and Penmanship
Writing
Letters
Spelling
Print Concepts
Literary Genres
Decoding & Word Recognition:
Phonics
Sight Reading
Comprehension:
Oral Story Comprehension
Reading Comprehension
Phonological Awareness:
Phoneme Isolation
Phoneme Blending & Segmentation
Phoneme Matching
Phoneme Manipulation
Word Discrimination & Segmentation
Rhyming
Syllables
59. REFERENCES
Perry, A., Condillac, R. A., Freeman N. L., Dunn-Geier, J., &
Belair J. (2005). Mulit-site study of the Childhood Autism
Rating Scale (CARS) in five clinical groups of young children.
Journal of Autism and Developmental Disorders, 35, 625-634.
Rellini, E., Tortolani, D., Trillo, S., Carbone, S., & Montecchi, F.
(2004). Childhood Autism Rating Scale (CARS) and
Autism Behavior Checklist correspondence and conflicts
with DSM-IV criteria in diagnosis of autism. Journal of
Autism and Developmental Disorders, 34, 703-708.
Stella, J., Mundy, P., & Tuchman R. (1999). Social and nonsocial
factors in the Childhood Autism Rating Scale. Journal of
Autism and Developmental Disorders, 29, 307-317.
New York State Department of Health. (1999). Autism/Pervasive
Developmental Disorders. Clinical practice guideline
technical report. New York: Author.