AAC & Facilitated Communication in Individuals with Autism

1. AAC & Facilitated Communication in Individuals with Autism Sarah Choss & Sara Cook CSD 823X

2. Autism Spectrum Disorders (ASD) • Autism and Autism spectrum disorder are terms to describe a group of disorders that affect brain development. • Range from incredible severe to a very high functioning form where it is very difficult to tell if someone has ASD. Typically, it is those with more severe forms of ASD who use alternative communication. • At this time, there are no known cases of autism • 1 in 88 children are diagnosed with autism

3. Characteristics of ASD • Impairments in social interaction • Impairments in Communication • Restricted and repetitive patterns of behaviors, communication, activities, and interests • Attention and motor difficulties • Physical and health problems Each type of ASD contains some combination of these characteristics.

4. Types of ASD ASD includes the following disorders: • Autistic disorder • Asperger syndrome • Pervasive developmental disorder-not otherwise specified (PDD-NOS) • Childhood disintegrative disorder • Rett syndrome

5. Augmentative & Alternative Communication (AAC)

6. Definition Augmentative and Alternative communication is defined as the use of other communication modalities to support or replace verbal communication.

7. Examples of AAC Devices Low Tech: (Non-SGDs) • Picture Exchange Communication System (PECS) • Word/Letter Boards High Tech: (SGD or VOCA) • The Tango • The Xpress • iPad or iPod with Proloquo2go

8. Benefits • Provides independence for the individual • Does not require a facilitator or assistant at all times. • Functionality • For individuals who are nonverbal, AAC devices can provide a way to communicate his or her wants and needs. In some cases, these alternative devices will help foster oral speech and language development. • Social Skills • Allows the individual to engage in meaningful communicative exchanges with others in his or her environment.

9. Facilitated Communication (FC)

10. What is Facilitated Communication? Facilitated Communication involves another person, called a facilitator. The facilitator holds a person with autism's hand while he looks for letters and moves his hand around a keyboard or letter board. The facilitator does not type or guide the person's hand, but provides physical support for the person's forearm, wrist, or fingers and providing positive feedback for correct responses. Eventually, the person will learn to move his hand on his own and will no longer need feedback of support.

12. FC Controversy • Many believe the facilitator is controlling the person with autism's hand and speaking for him. • Studies have proven this to be the case • Wendrow case • Oftentimes, FC is done in lab and persons with autism do not adjust well to this setting.

13. Benefits of FC for Individuals with Autism • Many people have learned to speak independently • With autism specifically, it helps individuals to gain motor control • Provides supports to produce meaningful and complex messages • The facilitator provides physical and emotional support

14. AAC and FC in Therapy

15. Assessment for Alternative Communication 1) Identify communication needs through interviews, surveys, and observation 2) Assess skills (ex: receptive or expressive language, verbal speech, cognitive skills, literacy, sensory skills, motivation, family support etc.) 3) Identify if have other people to facilitate communication and environmental barriers 4) Determine appropriate type of alternative communication & how to teach the necessary skills 5) Teach the user and facilitators how to use the system

16. Considerations Specifically for Autism • Individuals with Autism tend to have problems with fine motor control and may have problems with AAC device • Respond better to pictures than words. • AAC helps teach social interaction & planning • Computer-based devices do not send confusing social messages and provide a consistent way to communicate

17. AAC Uses for ASD in Therapy Examples: • Picture Exchange Communication System a.k.a. PECS • Using visual representation to teach children to communicate their wants and needs. 2. DynaVox • Reading development for children with ASD

18. Video: AAC in Therapy http://www.youtube.com/watch?v=hoF1UJ9YBUY

19. Examples & Case Studies for AAC & FC

20. AAC: Josh • 6 years old at the time of assessment for AAC, diagnosed with Autism at 3;6 • Main form of communication before using an AAC device was natural speech and pointing. • Josh's natural speech usually consisted of one to two word utterances to express wants or needs that were difficult to understand • He uses the Powerbook made by Apple Inc. • When assessed, Josh needed a device that would allow him to expand his expressive vocabulary, create more complex sentences, and initiate communication at home and at school to name a few.

21. FC: Jamie • 19 year-old, Jamie, has autism. • He types on a keyboard while his mom holds the keyboard, providing physical and emotional support • He has since learned to speak, but needs to type out his thoughts first • FC has worked for Jamie as he can now communicate with others without anxiety

22. Video: FC & AAC in Real Life http://www.youtube.com/watch?v=CzYIidZvfjA

23. When living with a neurological condition (or with a loved one who has one), it can be very easy to focus on the challenges and limitations. But in my life, I have found that focusing on abilities, finding new ways to adapt, have been crucial to my successes in life. Seeking those solutions can even be seen as a form of creativity. -Individual with Autism

24. References Beukelman, David & Mirenda, Pat (2005). Augmentative & Alternative Communication. Pittsburgh: Paul H. Brooks Publishing Wallis, C. (2006, May 10)."Helping" Autistic People to Speak." Time.Retrieved from http://www.time.com Wisely, J. & Brasier, L.L (2011, June 15). Sex abuse claims in Wendrow case fall apart in court. Detroit Free Press, Retrieved from http://www.freep.com Center for Disease Control and Prevention (n.d.). Facts About ASD. Center for Disease Control and Prevention. Retrieved from http://www.cdc.gov Light, J., Roberts, B., Dimarco, R., & Greiner, N. (1998). Augmentative and alternative communication to support receptive and expressive communication for people with autism. Journal of Communication Disorders, 31(2), 153-180.

25. References Cont. Carr, Deborah, and Janet Felce. "The Effects of PECS Teaching to Phase III on the Communicative Interactions between Children with Autism and their Teachers." Journal of Autism and Developmental Disorders 37.4 (2007): 724-37. ProQuest Psychology Journals; ProQuest Research Library. Web. Light, Janice C., et al. "Augmentative and Alternative Communication to Support Receptive and Expressive Communication for People with Autism." Journal of communication disorders 31.2 (1998): 153-80. ERIC. Light, Janice C., et al. "Augmentative and Alternative Communication to Support Receptive and Expressive Communication for People with Autism." Journal of communication disorders 31.2 (1998): 153-80. ERIC Zangari, C.; Lloyd, L.; Vicker, B. (1994). "Augmentative and alternative communication: An historic perspective". Augmentative and Alternative Communication10 (1): 27–59.