2004 Conference Proceedings

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AAC AND AUTISM: CURRENT PRACTICE AND FUTURE DIRECTIONS

Presenter(s)
Sarah Blackstone, Ph.D.
Augmentative Communication Inc./AAC-RERC
1 Surf Way, #237
Monterey, CA 93940
Phone: 831-649-3050
Fax: 831-646-5428
Website: http://www.augcominc.com 
Email: sarahblack@aol.com 

Emily Rubin, M.S.
Communication Crossroads
656 Jessie Street
Monterey, CA 93940
Phone: 831-333-9070
Email: Emily@CommXRoads.com

Howard Shane, Ph.D.
Children's Hospital Boston/AAC-RERC
300 Longwood Avenue
Boston, MA 02115
Phone: 617 355.6466
Email: howard.shane@tch.harvard.edu

This session will present frameworks for using AAC approaches (e.g., visual supports, low-tech aids, and high-tech devices) in the treatment of the communication disorders with children diagnosed with the autism spectrum disorder (ASD). Presenters will provide a brief overview of current clinical approaches that incorporate the use of assistive technologies (i.e., AAC devices and strategies) and highlight the development of communicative competence and social networks (Blackstone, 2003). They will then briefly introduce the SCERTS model as a framework for prioritizing educational objectives and selecting meaningful social contexts for implementation of supports. Examples will highlight how AAC approaches can be implemented both to support comprehension of spoken language, as well as the ability to express wants and needs and exchange information in social contexts (Shane & Simmons, 2001). Finally, the presenters will introduce an ongoing research project that holds promise in enhancing the communication skills of individuals with ASD.

Background

Persons with autism spectrum disorders (ASD) demonstrate relatively strong skills in responding to visual cues including visual representations and/or written words (Quill, 1997) but they often have significant difficulty processing spoken language. In addition, fifty percent of individuals diagnosed with autism do not speak, but nevertheless are thought to be highly visually oriented (Wetherby & Prizant, 2000). Research has shown that one of the most enigmatic characteristics of ASD is the presence of strong visual-spatial skills with apparent deficits in the area of verbal skills (Grandin, 1995).

Accordingly, more and more educational programs are capitalizing on these visual skills by incorporating visual teaching and learning strategies (Frith & Happe, 1994). This affinity to visual materials underlies the success of the Picture Exchange Communication System (or PECS) as an expressive communication medium, the use of graphics in the form of visual schedules to help organize daily events and activities (Marcus et al., 2000), and the more recent focus on augmented input or visually enhanced / aided language (Romski & Sevcik, 1996). This fervent interest in visual materials extends to characters, events, action and sound that appear on television or movie screens and computer monitors. In fact, individuals with ASD show a high interest in computer programs and children's videotapes - often in a preservative to the point of obsession fashion (Althaus et al., 1996; Shane & Simmons, 2001).

The SCERTS Model

The SCERTS model [Social Communication (SC), Emotional Regulation (ER) and Transactional Support (TS)] is a comprehensive, multidisciplinary approach to enhancing communication and socio-emotional abilities of young children with Autism Spectrum Disorders (ASD) (Prizant, et al., 2002). Emily Rubin will briefly introduce the SCERTS model, which is not exclusionary of other treatment approaches and methodologies, but provides a framework for those who are seeking guidelines for implementing a comprehensive therapeutic and educational plan that is based on our knowledge of the core developmental challenges faced by children with ASD as well as our knowledge of the recommended tenets of practice, as indicated by the National Academy of Sciences (NRC, 2001). The SCERTS Model prioritizes Social Communication, Emotional Regulation, and Transactional Support as the primary developmental dimensions that must be addressed in a comprehensive program designed to support the development of children with ASD. It is derived from a theoretical as well as empirically based foundation and addresses core challenges of children with ASD across various settings. The SCERTS model addresses the primary developmental dimensions to be prioritized in a program designed to support the development of children with ASD and their families. The model recognizes that the most meaningful learning experiences in childhood occur in everyday activities. Therefore, the model supports a child's development with a variety of partners (e.g., parents, brothers and sisters and other children) in everyday routines in a variety of social situations. The collaborators of the SCERTS model are writing a practical, comprehensive manual to help guide the efforts of educators, clinicians and families in supporting the development of children with ASD, from early intervention through the early school years. This manual should be available in 2004 by Paul H. Brookes Publishers. Collaborators on the SCERTS model include: Barry Prizant, Ph.D., Amy Wetherby, Ph.D., Emily Rubin, MS, CCC-SLP, Pat Rydell, Ph.D., and Amy Laurent, OTR/L.

Electronic Media and Intelligent Agents for Persons with ASD

Howard Shane will discuss a model for applying AAC approaches and visual supports to enhance the expression, comprehension and regulate the behaviors of individuals with ASD. Then, he will describe and demonstrate a prototype from a newly funded project that proposes to use Electronic Screen Media (ESM) and computer-based Intelligent Agents (IA) as a way to effect and change behavior and improve the communication skills of persons with ASD. Initially, the project will explore which features (or patterns of features) of visual programs (both video and computer based) are most appealing to persons with ASD and will subsequently use these data to modify and adapt a currently developed prototype ESM research environment to test the effectiveness of using a computer-based Intelligent Agent to support the communication efforts/skills development of individuals with ASD. The goal of the project is to develop an ESM environment, which includes an IA that enables children with autism to communication more effectively.

Conclusion

The purpose of the session is to share information about the ways in which individuals with ASD can benefit from the systematic use of assistive technologies and AAC strategies. Presenters will allow time for questions and discussion at the end of the session. Participants will also receive a 16-page issue of Augmentative Communication News, which covers the topic in more detail.

References

Althaus, M., de Sonneville, L.M., Minderaa, R.B., Hensen, L.G., and Til, R.B. (1996). Information processing and aspects of visual attention in children with the DSM-III-R diagnosis "Pervasive Developmental Disorder Not Otherwise Specified" (PDDNOS): II. sustained attention. Child Neuropsychology, 2(1), 30-38.

Blackstone, S. & Hunt Berg (2003). Social Networks: A Communication Inventory for Persons with Complex Communication Needs and their Communication Partners. Monterey, CA: Augmentative Communication, Inc.

Frith, U. and Happe, F. (1994). Autism: Beyond "theory of mind". Cognition, 50, 115-132.

Grandin, T. (1995). Thinking In Pictures. New York: Vintage Books.

Marcus, L., Schopler, E., and Lord, C. (2000). TEACCH services for preschool children. In Preschool Education Programs for Children with Autism, J.S. Handelman and S.L. Harris (eds.)., Austin, TX: Pro-Ed.

National Research Council (2001). Educating children with autism. Committee on Educational Interventions for Children with Autism. Division of Behavioral and Social Sciences and Education. Washington, DC: National Academy Press.

Prizant, B.M., Wetherby, A.M., Rubin, E., Laurent, A.C., and Rydell, P. (2002). The SCERTS model: Enhancing communication and socioemotional abilities of children with Autism Spectrum Disorders. Jenison Autism Journal, 14, 4, 2-19.

Prizant, B.M., Wetherby, A.M., Rubin, E., and Laurent, A.C. (2003). The SCERTS model: A transactional, family-centered approach to enhancing communication and socioemotional abilities of children with autism spectrum disorder. Infants and Young Children, 16 (4), 296-316.

Romski, M.and Sevcik, R. (1996). Breaking the Speech Barrier: Language Development through Augmented Means. Baltimore, MD: Paul H. Brookes Publishing.

Romski, M.and Sevcik, R. (1996). Breaking the Speech Barrier: Language Development through Augmented Means. Baltimore, MD: Paul H. Brookes Publishing.

Quill, K.A. (1995). Teaching Children With Autism: Strategies to enhance communication and socialization. New York: Delmar Publishers, Inc.

Shane, H.C. and Simmons, M. Supports to Enhance Communication & Improve Problem Behaviors. Paper Presented at the Annual Convention of the American Speech - Language Hearing Association, New Orleans, LA, November 2001.

Wetherby, A.M. and Prizant, B.M. (2000). Autism Spectrum Disorders. Baltimore: Paul H. Brookes Publishing Co., Inc.


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