Functional Communication Intervention for Individuals with Developmental Disabilities

1. Functional Communication Intervention for Individuals with Developmental Disabilities Lillian N. Stiegler, Ph.D., CCC-SLP lstiegler@selu.edu

2. 10 INTERVENTION PREMISES

3. THE SPECTRUM WITHIN THE SPECTRUM

4. INTENSITY! REDUNDANCY!

5. THE NEED FOR VARIABILITY

6. SPIRIT OF EXPECTANCY

7. There is much more to communication than the expression of wants and needs.

8. COGNITIVE DIFFERENCES

9. HUMAN COMMUNICATION IS MULTIFACETED

10. SENSORY DIFFERENCES

11. FEAR AND ANXIETY

12. THE CULTURAL PERSPECTIVE

13. Working with Nonspeaking Individuals

14. NO COOKBOOKS

15. Why do people communicate?

16. Need fulfillment is the most basic reason. To request good things…

17. …And to protest/avoid bad things.

18. What is the most CONVENTIONAL way to perform the functions of requesting and protesting? TALKING!

19. But not talking alone… When people request or protest conventionally, they combine many aspects of communication: Eye gaze gestures Expressions

20. Body language Loudness level Touching Writing Pantomime

21. If TALKING is not an available resource for the multi-modal system, human beings will rely on other components of the system, according to their own ability.

22. What are the factors that eliminate communication resources? Cognitive issues Motor issues Social issues (Or a combination of two or more.)

23. So, it’s our job to help people move up the continuum from less conventional to more conventional.

24. While making this journey up the mountain of conventionality, it’s good to know what each individual already has in his/her “suitcase”…

25. …And then, to figure out what can be added to the “suitcase” through intervention.

26. If there is motor involvement, some communication resources may be diluted or unavailable. Gestures? Speech? Written language? PANTOMIME? Sign language?

27. It is still desirable to exploit every single item in a person’s suitcase to the fullest extent possible. Multi-modal is ALWAYS better than uni-modal.

28. C O N V E N T I O N A L I T Y • Speech • Written Language • Picture board/word board • Echolalia • Sign Language • Familiar cultural gestures • Physical manipulation • Reenactments • Proximity • Idiosyncratic Gestures • Facial Expressions • Screaming • Aggressive Behavior/Tantrums • Self Injurious Behavior

29. INTENSITY in intervention leads to CHANGE

30. FILLING THE CUP

31. By 12 months, the typically-developing baby understands about 50 common words and phrases! And this increases rapidly… 18 months = 100-150 words 24 months = as many as 500 different words

32. During this part of development, the child typically understands about FOUR TIMES as many words as he/she is able to produce!

33. And development happens as a by-product of EXPERIENCE! Someone said, “Experience is the sculptor of the brain.”

34. “Participatory learning activates all the senses and provides immediate feedback. Although a child can learn [the names of] farm animals from a book, a trip to a farm with participation in feeding the animals provides an unforgettable experience. More sensory and motor neurons are activated when the child becomes an active participant, and the connections between this learning experience and previously stored information are increased. When children are physically disabled, it is often more difficult to engage their active participation in [communicative] activities. Frequently, these children become observers rather than participants in learning and life.” (Morris, 1991)

35. Remember that the brain is an amazing structure. New communication skills emerge in response to new skills in other areas

36. A COGNITIVE development results in a communicative development.

37. A SOCIAL development leads to a communicative development.

38. A MOTOR development precipitates a communicative development.

39. As interventionists, we MUST provide experiences…and we must strongly encourage families to do the same.

40. Experiences need not be (a) difficult or (b) expensive. They DO need to happen VERY often.

41. Intensity of experience is what causes brain changes…new pathways…

42. Here’s an example of how to create an experience that can lead to social communication.

43. Start with a theme: SHOES Has this person ever had the opportunity to wear…

44. Tap shoes? Fuzzy slippers? Swim fins? Roller skates?

45. Cowboy boots? Ballet shoes? Cleats? High heels?

46. Trying on shoes, with a peer, perhaps in front of a mirror, is an EXPERIENCE! (Maybe it is an experience that a child has never had.)

47. What else can be done with shoes? • hide items in shoes • Simon Says game with shoes • shoe print painting • choices for self and others • shoes on dolls • kicking balls/balloons wearing differing shoes • visit a shoe store • big shoes/baby shoes

48. Factors that Discourage Active Participation • The reality that some individuals resist the unfamiliar • It is often easier to let a child “be” • It takes more physical and mental energy to insist on at least partial participation

49. A Common Intervention Cycle A new activity is introduced... Child learns to avoid new activities... Child resists... Team member feels bad because child is unhappy... Activity is withdrawn...

50. What obstacles can you think of that would stand in the way of an experience like this? Overcome them with adaptations.