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

Autism,AAC
and Motor Learning
Gwendolyn Meier, SLP, MT
Villa Esperanza Services
gmeier@villaesperanzaservices.org
Thursday, April 3, 14

Disclaimer
• The speaker has no ﬁnancial or non-
ﬁnancial interests in the information or
products in this presentation

The Speech & Language Center

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

Agenda
Maximizing Motor Skills in:
• Autism
• AAC Assessment
• Teaching
• Prompting
• Communication displays - high & low tech
• Core vocabulary learning & use

Slideshow

Terminology
• Symbol = Icon
• Comprehension = Recognition
• Device = Any visually-based AAC
system
• Student = Learner of any age

Moving to Budapest!

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

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?)

Teaching AAC
In AAC:
• More likely to learn sequences made
meaningful by the reaction they elicit

Teaching Hungarian
Hungarian:
• Flashcards?
• Scripted interaction?
• Conversation?

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?

Teaching Language in
Autism
• Use strengths to shore up weaknesses
In autism:
(-) Auditory weakness
(-) Symbolic weakness
(+)Visual strength
(?) Motor skills

Teaching AAC Language
• Modeling and Augmented input highlight the
auditory boundaries between words
‣ Human speech alone does not

Teaching AAC Language
• Neurons that ﬁre together, wire together
(Hebb’s rule)
In AAC:
• Seeing language
• Hearing language
• Add motor pattern
= Multi-sensory stimulation

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.

In AAC infancy...?
• With the motor pattern for navigating to
words comes increased ability to perceive
that word in spoken language (?)

Multi-Sensory Language
Modeling & Augmented Input
• See the visual, See the movement, Hear the
auditory feedback, Experience the natural
consequence

Modeling for Milo

Language Acquisition...
...requires organization and interpretation of the
world through a system of symbols and
referents.
cat
ball
bed

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

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

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.

PECS & Symbol Comprehension
• PECS Phase 3:
Discrimination Training
- Aims to teach icon
discrimination skills given a
limited ﬁeld of choices
TM
TM

Picture Communication Books
Rely on icon association/
understanding

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.

• Gissette’s icon Recognition?
• How is she going to learn to use
“Put” + “on” to request?

Teaching AAC
In AAC:
• Icon recognition?
• Verbal cues?
• Motor patterns?
• Gesture cues?
• Visual cues?
• Labeling?
• Requesting?
• Answering questions?
• Scripted interaction?
• Conversation?

So, how do we teach new
movement patterns?

Model + Consequence
$$$ What’s the pay off $$$$

Visual Cues?

Physical Support for the
Correct Movement Pattern
PROMPT TM

Practice! Practice!
Practice!
Daily
Over time
With support
With meaningful consequences

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.

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.

Motor Skills in ASD
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.

Serial Reaction Time Task

Imagine...PECS Phase 1
• Learning the “give”
• Efﬁciency comes
with practice

Motor Skills in ASD
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.

Proprioceptive support

• Use motor learning strength to teach the
motor pattern
• Paired with a motivating consequence

• Then reduce the level of visual prompt

Milo - Learning “turn”

Sensory & Movement
Differences
• Starting
• Stopping
• Continuing
• Combining and switching
• Thought
• Memory
• Emotion
• Speech

Stopping, / Switching

Take from the Right

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

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

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

Automatic Motor
Patterns

When motor patterns
change...
Automatic
Volitional

Imagine...

When Motor Patterns
Change
• It brings our awareness to our movements
• Requires re-learning
• Ideation - Plan - Execution - Feedback
✴ Not conducive to communicating!

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.

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.

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

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!

We can take advantage
of motor learning when:
• Patterns build upon themselves as language
grow
• Plan the end at the beginning
•Preserve relative location

Between activity-based pages...preserve location
Classroom Snack

Consistent Placement -
Pic Card Shadows

Another beneﬁt...

Today Tomorrow
Campus Job - “Here is your schedule”

As language system grows...preserve location

Motor patterns don’t change

NEW! in 2013

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!

Thank you!
Email: gmeier@villaesperanzaservices.org
Blog: www.scaacn.blogspot.com
Facebook: facebook.com/socalaac.scaacn
Twitter: @scaacn

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