Communication and Atypical Language Development

1. Nancy J. Aguinaga, Ph.D. Communication and Atypical Language Development Dr. Ray’s Early Childhood Specialists

2. Session Overview Overview of: - Communication and Language - Impairments in Communication and Language - Social Interaction - Communicative Context of Autism Spectrum Disorder (ASD) - Communication Assessment~ - Communication Interventions

3. Objectives • Identify the attributes of communication and language. • Identify characteristics of atypical language development and communication. • Implement several strategies to foster communication.

4. Communication Speech- neuromuscular act of producing sounds Language- a shared code by a group of people; rule-governed symbol system Communication- a process to exchange information, ideas, needs, wants

5. What are the components needed for successful communication? • A sender of the message • A receiver of the message • A shared intent to communicate • A shared means of communication

6. Impairments in Communication Development of spoken language Initiate or sustain conversation Repetitive use or language or idiosyncratic language~ Lack of age appropriate play

7. Characteristics of language disorder • Impaired comprehension (receptive) and/or use of spoken, written, and/or other symbol system (expressive) • May involve: • The form of language: phonology, morphology, syntax • The content of language: semantics • The function of language in communication (pragmatics) in any combination

8. Language Disorders Impaired comprehension in: • Form • phonology-sound system • Phoneme- smallest linguistic unit of sound that can signal a difference in meaning • e.g. – bill, pill • morphology-words • Morpheme-smallest unit of meaning in a language • e.g. – base, baseball, basement • syntax-rules of phrases, sentences (article, noun, verb) • Content • semantics-meaning of words • Function or Use • pragmatics- use of language for communication • Includes rules of social interaction, conversation

9. Aphasia • Broca’s video • Patients with Expressive aphasia, also known as Broca's aphasia, are individuals who know "what they want to say, they just cannot get it out." They are typically able to understand what is being said to them, but unable to fluently speak. • Wernicke video • Individuals with Receptive aphasia (also known as Wernicke's aphasia ) may speak in long sentences that have no meaning, add unnecessary words, and even create new "words" (neologisms).

10. Language Acquisition Physiological development is a necessary prerequisite for language development • Brain – Central nervous system • Articulation – production of sounds • Lips, teeth, tongue, palate • Resonation – shapes the tone • Mouth, nasal cavity • Phonation – source of noise • Larnyx • Respiration – muscles • Inhalation-thoracic, Exhalation-abdominal

11. Possible relationships between cognition and language Language determines thought - Whorf Language is dependent on cognition – Piaget Language and cognition are interdependent – Vygotsky Language and cognition develop independently – Pinker Explanation?~ Individual differences in development

12. Language Acquisition Children learn language by participating in the linguistic environment all around them~ They are active participants in this process

13. The role that social interaction plays in language acquisition Physical development alone cannot explain the emergence of language Exposure to language during the infant and preschool years is very important (Hart & Risely, 1995) Importance of inclusion • Children learn language by participating in the linguistic environment all around them~ • They are active participants in this process • Need something to talk about • Motivation

14. Impairments in Social Interaction Nonverbal behaviors Peer relationships Seeking interaction with others~ Social or emotional reciprocity

15. Critical Skills for Development of Social Communication • Social Skills • Expressive Language • Receptive Language • Nonverbal Communication • Developmentally Appropriate Tasks/Play • Cognitive Skills • Appropriate Behaviors

16. 3 Considerations for Communication Assessment • Frequency • Form • Function

17. Four assessment principles of persons with communication impairments • All people communicate • Assessment should be a process • Assessment should be functional~ • Assessment should involve more than the person with the exceptionality

18. Communication Intervention • Recommendations: • Intervention should target functional and spontaneous communication • Social skills instruction should occur across settings, specifically those in which the child communicates

19. Communication Questions to Consider Is there a reason for the child to communicate? • Does the child possess the motivation, or intent to communicate. • Children with autism(especially) generally will not engage in communicative interactions unless they are motivated to do so.

20. Communication Questions to Consider, cont…. • Does the child initiate and/or respond to communicative interactions? • Can the individual understand and participate in both roles of the communication process? • Example- a child leads his mom to the refrigerator where he places her hand on the handle. The child then makes facial gestures as to whether he likes or dislikes the food the mother takes out. • Can the child use repair strategies when communication breaks down. • Does child repeat the attempt • Can he show the person what they are trying to communicate • Can he use an alternative way to communicate message

21. After Considering the Previous Questions, Develop an Intervention Program • Develop Communicative Intent • Cause/effect reasoning-this strategy promotes understanding that a specific effort will produce an enjoyable outcome. (ex: stand on stool to get cookie on table) • Joint Activity Routines- highly predictable routines that produce a desired outcome. (ex:play routines with simple toys, food making routines such as making chocolate milk, tickle games.) • Delay responses to anticipated wants/needs- delay the need or want in an effort to give the child an opportunity to communicate the desire in another method.

22. Use Alternative Communication System • Gestural-includes pointing, looking to desired items. • Object Exchange- child gives object to another person to indicate he wants something. Ex: (child gives cup to person to indicate he wants a drink) • Picture Point System- points to various visual representations to indicate what the child wants. Ex: (photos, real drawings, line drawings, written words.) • Picture Exchange system (PECS)-exchanging picture to initiate a request. ex: (child hands a picture of a swing to an adult to let them know they want to swing.) • Electronic/alternative keyboards or computers-child uses a keyboard to communicate through use of reading and writing skills.~ • Voice Output Communication Aids- aids that allow a child to push a button to replay a prerecorded message.

23. Social Stories Social stories were developed by Carol Gray and are very useful for teaching social skills to students on the autism spectrum. They are stories written from the child’s perspective intended to teach social skills to students.~ The social stories are short simple descriptions of social situations explained to the student.

24. To construct a social story, four types of sentences are included. Descriptive sentences describe the behavior steps. They include the who, what, where, andwhy of the behavior. There should be several descriptive sentences. Directive sentences direct the individual to the desired response. This is where the appropriate behavior is positively stated. Keep it brief. Perspective sentencesdescribe the thoughts and feelings of others in the situation. Give an outside account of how the behavior is perceived by others. There may be several perspective sentences. Control sentences are statements where the individual constructs a memory cue or mnemonic to help him or her remember the story and the desired behavior. They are not appropriate for every story or helpful to all individuals or situations. This should also be brief.

25. Social Story Example Recess (pix) After lunch we go to recess. Sometimes recess is on the playground. A lot of the children play on the playground equipment. It is fun to play on the playground equipment. Everyone should play safely. When the whistle blows that means it is time to line up and go inside. I will try to line up as soon as the whistle blows. This will make my teachers happy. After I line up I will try to stay in line. Everyone will be proud of me!

26. Develop the ability to both respond to and initiate communication • Responding to Information: how the child processes information should be considered prior to teaching him to respond to communicate. • If child’s ability to process visual information is strong, use this method. • If child’s ability to process auditory information is poor, find another method. Just choose method where his ability is strong. • Initiating a Communication: Communicative situations should be created using things which are motivating to the child in an established familiar joint attention routine. • Example: Blowing Bubbles, Once activity has been established, close the bubble lid tightly and place in front of child. This creates an incentive for the child to communicate that he wants more bubbles.

27. Develop Strategies to Repair Breakdowns in Receiving Communication • The following strategies can be used to prevent breakdowns, or assist the child in repairing breakdowns in communication when receiving information. • Secure the child’s attention prior to communicating by calling his name or physically prompting the child • Monitor signs of comprehension • Use simple short sentences • Reduce the amount of auditory information given • Give the child time to respond before repeating, due to the possibility of delayed auditory processing • Use of various visual support strategies to ensure that the child understands the messages given

28. Develop Strategies to Repair Breakdowns in Expressive Communication • Children with autism can be taught repair strategies as well. • Strategies include: • Teach child to repeat communicative attempt • Teach child persistence • Teach child to learn to respond to “show me” • Teach child to learn alternative communication systems if appropriate. • Ex, (child vocalizes loudly at a high shelf. Adult encourages child to use his P.E.C.S. communication books to communicate.)

29. The Communicative Context of Autism • Taylor • Range from mutism to higher order social deficits • Gestures – contact with objects or persons • Vocalizations – characterized by infrequent use of consonants • Echolalia – immediate; speech repetitions immediately follow original utterance or delayed - speech repetitions occur after a period of time

30. Communication in Individuals with ASD • Better understanding of nouns vs. other parts of speech (e.g., runner vs. running) • Difficulty understanding ‘bound morphemes’, or tense (e.g., work vs. worked)~ • Impaired understanding and use of pragmatics

31. “Mind the Gap” strategy in Catherine Faherty’s book, “Asperger’s…What Does It Mean To Me?” The period of time during which a child faced with a situation can choose a response or course of action. Modified strategy called “the choice zone”.

32. Show the BIG PICTURE Catherine Faherty, Ashville TEACCH Center • Show the schedule of the day • Use checklists in a variety of settings~ • Answer 4 questions from the work system • What work? • How much work? • How do I know when I am finished? • What comes next

33. Social Thinking I LAUGH Framework Michelle Garcia Winner Social cognition framework which explains the multiple skills and concepts that must be processed and reacted to in order to succeed at social interaction and personal problem solving. • I = Initiation of Communication • L= Listening With Eyes and Brain • A = Abstract and Inferential Language/Communication • U = Understanding Perspective • G= Gestalt Processing/Getting the Big Picture • H= Humor and Human Relatedness

34. Conversational strategies Take turns in the circle: others listen than comment or ask a question Option to say: “I’m open for questions” Visual cue for turn taking “I am interested in talking about_______.” “What are you interested in talking about?” Say three things about a topic~ Do something together, and then talk about it

35. Communication Catherine Faherty, Ashville TEACCH Center Be Clear Be Literal Refrain from double meanings; sarcasm, joking Make no assumptions (facial expressions, body language) Daily “Check-in’s” Say “I need more information.”~ Try multiple choice format to get information

36. Communication • Engage and motivate • Use Special Interests • Incidental teaching – teach through student’s interests

37. “You know one person with autism, you know one person with autism” -Kluth

38. Taylor Morris (people first) What did I learn? Why did I learn it? How can I use it? Presentation available at http://cstl-coe.semo.edu/naguinaga/

39. One thing I learned Please respond to the following items on a sheet of notebook paper and give to me on your way out. • Something new I learned from today’s class was… • I’m still unsure about…

40. THANK YOU! • HAVE A GREAT LAST WEEK!