1. Augmentative
Communication and Literacy
Chapter 14
By Pat Mirenda and Karen A. Erickson

2. Autism and Augmentative
Communication
 1988 summary article stated no firm
conclusion on the efficacy of AAC
interventions with ASD population
 No current summary article completed
between 1988- the 2000 printing of this book
 This chapter examines the 1990’s as an up-to-
date summary of AAC and Autism

3. Function vs. Form
 In typical development early forms of
communication are gradually improved upon
by new forms and result in an integrated
multimodal system
 In intervention, promoting the use of early
forms of communication in natural contexts is
a good starting point for those who are
“preintentional”

4. Function vs. Form
 The goal is the development of natural speech
and language,
 However, if this does not occur, a foundation
for later AAC intervention has been
developed.
 Comprehensive intervention supports
concurrent development of both form and
function of language

5. Function vs. Form
Initial communication goals:
1. Building intentionality, turn-taking, joint
attention, and initiation skills using unaided
AAC techniques (gestures, vocalizations, and
speech)
2. Expanding the individual’s repertoire of
communicative functions beyond
instrumental

6. Brief History of Symbol Use in Autism
 Symbol- something
that stands for
something else
Two types:
1. Unaided symbols
2. Aided symbols
 Referent- the
“something else”

7. Symbols
 Unaided
*gestures
*vocalizations
*facial expressions
*body language
Used by beginning
communicators often
thought of as
“preintentional”
 Aided
*requires some type of
external device for
production
(communication book,
board, or computer)

8. Chimps, Chips, Signs, and Lexigrams
 Premack & Premack (1974 book chapter)
taught chimp to associate plastic shapes with
words and she used them to communicate
 Gardner & Gardner (1969, 1975) taught
chimp to use sign language
 Rumbaugh, Savage-Rumbaugh, & Boysen
(1977, 1978) taught chimps to communicate
using abstract lexigrams

9. Letters and Words
 Operant conditioning interventions
demonstrated that some individuals with
autism could learn to associate words with
their referents (1970’s)
 Hyperlexia spurred interest in using
orthographic symbols to help those with
autism communicate (1980’s)

10. Visuospatial Symbols
 A natural match for the visuospatial strengths
demonstrated in autistic individuals
-line drawings
-photographs
 Widespread utilization of this approach by the
late 1980’s

11. Manual Signs and Visual-Graphic
Symbol Research
 All people, regardless of the apparent extent
of their disability, can learn to communicate
 Both manual signs and visual-graphic
symbols hold particular promise for
individuals with autism (Fay & Schuler,
1980)
 Shift from use of manual signs to visual-
graphic symbols occurred as a result of
research in imitation, iconicity, and
intelligibility

12. Imitation
 Research shows that the development of
expressive speech in children with autism is
dependent on the mastery of imitation at the
time of intervention (using manual signs)
 Generalized imitation deficit in autism
 Motor coordination difficulties (apraxia)
correlated to the acquisition and use of signs
by autistic individuals

13. Iconicity
 “Symbols having strong resemblance (visual
relationship)to referents are easier to learn”
hypothesis (Fuller & Stratton, 1991)
 Support in the literature
 Many of the most basic need and functional signs
fail the iconicity test
 Visual-graphic symbols capitalize on the
visuospatial strengths commonly seen in people with
autism

14. Intelligibility
 Research supports the use of visual-graphic
symbols as opposed to manual signs
 Untrained communication partners are more
likely to be able to interpret meaning from
pictures than from manual signs

15. Relationship between AAC and Speech
Development
 Research shows communication transfers
from sign to spoken language when individual
has mastered approximately 200 signs and
begins chaining them together
 Research also shows that some individuals
remain mute and acquire only a few signs
 There is potential for speech development in
conjunction with manual signing ( it does not
inhibit speech production)

16. Continued…
 Research on Picture Exchange
Communication System
 Research on VOCAs/System for Augmenting
Language
 Together results suggest that aided symbol
use does not inhibit development of speech in
individuals with autism

17. The Role of Voice-Output
Communication Aids and Computers
 Single level devices- deliver a limited number of
messages and are simple to operate
 Multi-level devices- deliver more than 20 messages
on two or more levels and are more difficult to
program
 Comprehensive devices-deliver multiple messages
and have additional features including printers,
calculators, large memory capacity, and the ability to
interface with computers

18. Computer Software
 Used to support communication and literacy
development
 Research showed computer use also has a
positive effect on peer interactions and
verbalizations (Panyan, 1984), problem-
solving strategies (Jordan & Powell, 1990),
motivation and behavior (Chen & Bernard-
Opitz, 1993) and reading individual words
(Hiemann, Neslon, Tjus, & Gillberg, 1995)

19. AAC interventions for Challenging
Behavior
 Many empirical studies that show providing
receptive/expressive communication supports
decreases occurrence of challenging behavior
in individuals with autism

20. Augmentative Input Strategies
Used to either communicate more effectively
with others or to understand communication
from others.
1. Pictorial or written schedule
*within-task
*between-task
*rules

21. Functional Communication Training
Using AAC
 Functional Communication Training- teaching
individuals to use manual signs or other AAC
techniques as “substitutes” for the “messages”
underlying challenging behaviors
 Research shows 3 basic messages:
1. Attention (Pay attention to me)
2. Tangibles ( I want _____)
3. Escape (I don’t want to do this)
 FCT teaches use of more functional messages and
provides a positive alternative to challenging
behaviors

22. Clinical and Educational Implications:
AAC Interventions and Autism
 Complex task considering not only form but
function of language
 Careful assessment of types of symbols
 Instructional and facilitator supports
 May use electronic devices
 Communication opportunities must be
provided

23. Directions for Future Research:
 What strategies are most successful for developing natural
gestures and vocalizations for preintentional communicators?
 How much incidental modeling is needed for efficient symbol
learning?
 What are comparative outcomes of PECS and SAL
approaches with young children with autism
 How does use of augmented input strategies for behavioral
support affect communication and social development
 How much does availability of voice output technology
contribute to symbol learning, speech development, and
receptive language development as compared with visual-
graphic symbol use without

24. Autism and Literacy
 Facilitated communication created renewed
interest in the literacy learning potential of
people with autism

25. Hyperlexia
 Appears most often in children with autism as
compared to other disability groups
 Specific characteristics:
1. Word reading skills that exceed what is predicted or
expected
2. Compulsive or indiscriminate reading of words
3. Onset of ability between 2 and 5 years of age
4. Onset of ability in the absence of direct instruction

26. Hyperlexia
 Evidence supports that hyperlexia stems
from a problem with general receptive
language comprehension coupled with strong
word recognition skills
 Children with autism and hyperlexia do not
differ dramatically from readers without
disabilities: they both require background
knowledge and language understanding to
comprehend text

27. What is Literacy?
 Skill usually acquired through numerous
opportunities to interact with print in meaningful
ways and receive appropriate instruction
 Involves the interaction of several processes
 Defined as the combination of reading and writing
 Reading- silent reading comprehension
 Writing- translation of thoughts and words into
written text

28. Emergent Literacy and Readiness
Perspectives
 Emergent Literacy Perspective-the ability to read
and write is acquired in much the same way as
spoken language
 Readiness Perspective-a within child characteristic;
they are ready for reading and writing instruction
when they have mastered the following set of skills:
1. shape, number, and color recognition
2. Letter identification
3. Pincer grasp

29. Children with Autism
 Research shows they can learn readiness skills
 They can learn to recognize and use isolated words
 No research regarding ability to comprehend
paragraph-length or longer text
 Research provides evidence that an intervention can
be used effectively to increase clause length, phrase
length, and frequency of adjective and gerund use in
both students without disabilities and those with
autism

30. Center for Literacy and Disability
Studies Preschool Project
 Comprehensive example of the potential for
Emergent Literacy Perspective
 Intervention in two phases: writing and
reading as focus
 Results suggest that children with autism
develop emergent reading and writing skills
in much the same way as their typically
developing peers

31. Sociocultural Model of Literacy
Learning
 Multiple contexts influence literacy learning
 Individual’s abilities and disabilities are only one of
the contributing factors
 Attitudes and expectations of people in child’s
environment a factor
 Availability of accessible reading and writing
materials a factor
 Nature of the interactions between individual and
his/her literacy instructor a factor

32. Clinical and Educational Implications:
Autism and Literacy
 What we do know is that we really don’t
know what type of intervention is best
 Should incorporate many aspects of
interventions that are known to work for
literacy learning (Four Block Model)

33. Directions for Future Research
 How does Early literacy development according to
emergent literacy model apply to individuals with
autism
 Relationship between literacy learning and
communication development?
 To what extent can recommended practices in
literacy instruction apply to autism?
 Can people with autism be taught using a
comprehensive approach?
 How does the use of AAC graphic symbols impact
literacy learning in people with autism?

34. Conclusion
 Social context is important both for communication
and learning
 Instruction must be embedded in relevant,
motivating social contexts
 AAC intervention should provide both receptive and
expressive supports
 Literacy supports should incorporate both decoding
and comprehension skills that are developmentally
appropriate