Communication Assessment

2. Communication Assessment Defined as: • An assessment of communication to address the communication characteristics of autism spectrum disorder, including measures of language semantics and pragmatics completed by a speech and language pathologist.

3. Areas to be considered When Assessing Communication: • 1. Ability to use and comprehend nonverbal language • 2. Atypical or delayed nonverbal communicative behaviors • 3. Functional use of expressive language/gestures • 4. Delays in onset of spoken language • 5. Atypical communication patterns characteristic of students with ASD • Hearing evaluation • 6. Functional understanding of spoken language and non-verbal communication • Development of early communication

4. When Assessing Social Interaction and Relationships: • • Social initiation • • Social imitation • • Age-expected reciprocity • • Attachment patterns • • Child’s use of people as tools • • Social interaction with familiar and unfamiliar adults and peers

5. General Characteristics of ASD Communication Profile  • Delay in, or lack of, the development of spoken language • Delays in responding to the verbal instructions, particularly multi-step directions • Avoidant or fleeting eye contact • Unusual speech patterns (speed, volume, tone); speaking in an “adult-like” manner • Reliance on scripted language and/or rote statements, rather than creative language • Misuse of pronouns

6. General Characteristics of ASD Communication Profile  • Uses and interprets language literally •  Difficult understanding gestures and non-verbal communication •  Difficulty with topic maintenance •  Inability to repair communication breakdowns • •Echolalia, or stereotyped and repetitive use of language (language scripts from TV, videos, or people in their environment) •  Impairment in the ability to initiate, terminate, and/or sustain reciprocal conversations with others

7. Assessment should focus on: • 1. Child’s verbal communication skills (ability to use and comprehend), including pragmatic strengths and weaknesses • 2. Nonverbal skills, including atypical or delayed nonverbal communication skills (gestures, eye gaze, body language) • 3. Joint attention • 4. Communicative intent and functionality

8. Assessment should focus on: • 5. Social communication behaviors:     • gaining attention and initiating interaction     • responding to attempts at interaction     • requesting information from communicative partner, askingvariety of questions     • commenting on activity or event     • following routines     • providing or offering information     • understanding expectations for performance, regulating conversation

9. CAUTION! • Children with Asperger Syndrome and high functioning autism often score within the average range on many of these tests that assess articulation, vocabulary, sentence construction, and comprehension.

10. Possible formal speech and language tests EI • PLS-4  Preschool Language Scale • PPVT-4    Peabody Picture Vocabulary Test • EVT-2     Expressive Vocabulary Test • TELD-3   Test of Early Language Development • CELF-P   Clinical Evaluation of Language Functions - Preschool • CSBS-D  Communication and Symbolic Behavior Scale –Developmental Profile

11. Possible formal speech and language tests   School Age: • CCC-2      Children’s Communication Checklist • CELF-4     Clinical Evaluation of Language Functions • EOWPVT   Expressive One Word Picture Vocabulary Test • PPVT-4     Peabody Picture Vocabulary Test • OWLS       Oral and Written Language Scales • TLC-        Expanded Test of Language Competence • TOLD-4    Test of Language Development • CASL       Comprehensive Assessment of Spoken Language • Social Language Development Test • SEE – Social Emotional Evaluation

12. Possible informal assessments: • • Assessment of Social and Communication Skills for Children with Autism (available in the book “Do-Watch-Listen-Say" by Kathleen Quill) • • SCQ – Social Communication questionnaire  (U. of Mich.) • • Conversational Effectiveness Profile (Kowalski) • • Language sample • • Checklists, templates, observation forms, interviews • • Social Cognitive Assessments (from Thinking About You, Thinking about Me – Michelle Garcia Winner) • • SCERTS – SCERTS Assessment Process (SAP)

13. Observation templates & checklists   Typical Receptive Language/Auditory Processing Skills by Sally Eshoo • http://nwresd.k12.or.us/autism/files/sampletemplate-Eschoo.pdf • http://nwresd.k12.or.us/autism/files/SampleTemplate-Eschoo2.pdf Sample  Templates byRobynBean http://nwresd.k12.or.us/autism/files/Sampletemplate-Bean.pdf http://nwresd.k12.or.us/autism/files/SampleTemplate-Bean2.pdf

14. 5. Functional Communication Checklist (Bvtn-adapted from Functional Communication Profile)http://nwresd.k12.or.us/autism/files/FunctionalCommunicationChecklist.pdf6. Conversation Checklist (Kevin Penner)http://nwresd.k12.or.us/autism/files/ConversationChecklist.pdf7. Functional Language Ability Observation(Kevin Penner)http://nwresd.k12.or.us/autism/files/FunctionalLanguageAbilityObservation.pd

15. 8. Conversational Effectiveness Profile (Timothy P. Kowalski) 9. AS/HFA Social Cognitive Assessment*  K-2nd Beaverton ASD Team *Modifiedfrom the assessment description in Thinking About You Thinking About Me (2002) by Michelle Garcia Winner http://nwresd.k12.or.us/autism/files/AS-HFAK-12CognitiveAssessment.pdf

16. 10. AS/HFA Social Cognitive Assessment* 3-12 Beaverton ASD Team     Modified from the assessment description in Thinking About You Thinking About Me (2002)by Michelle Garcia Winnerhttp://nwresd.k12.or.us/autism/files/AS-HFA3-12CogAssessment.pdf11. AS/HFA Social Cognitive Observation – Beaverton ASD teamhttp://nwresd.k12.or.us/autism/files/AS-HFASocialCognitiveObservation.pdf

17. Parent/Teacher Interviews American Speech-Language-Hearing Association (ASHA) • It is recommended as best practice by ASHA that communication assessment for ASD include an interview with parent/caregiver, and teacher.  • This interview may be done by the SLP or autism specialist, and valuable information can be gathered by home/community observations in addition to school.

18. Settings and Contexts for Observations • It is also recommended by ASHA that the individuals should be observed:      • with familiar and unfamiliar adults      • with familiar and unfamiliar peers      • in structured and unstructured settings      • in small and large groups      • at school, community, and home, if possible (Refer to roles and responsibilities of Speech-Language Pathologists in diagnosis, assessment, and treatment of Autism Spectrum Disorders across the life span)

19. Parent/Teacher Interview Forms(for EI/ECSE and School Age) • Fuctional Communication Evaluation http://nwresd.k12.or.us/autism/files/FunctionalCommunicationEvaluation-EI-ECSE.pdf • Functional Communication Assessment – Parent Interview http://nwresd.k12.or.us/autism/files/FCA-ParentInterview.pdf • Speech-Language Checklist -Teachers (Kevin Penner) http://nwresd.k12.or.us/autism/files/Speech-LanguageChecklist.pdf

20. Parent/Teacher Interview Forms(for EI/ECSE and School Age) • 4. Speech and Language Evaluation Summary Report http://nwresd.k12.or.us/autism/files/SpeechandLanguageEvaluationReport-EI-ECSE.pdf • 5. Functional Communication Profile- Beaverton Team http://nwresd.k12.or.us/autism/files/FCProfile-Beaverton.pdf • 6. SCERTS Assessment Process  Report Form for teachers and parents. (There is a different interview for each language level (social partner, language partner, conversational partner)  http://www.scerts.com/docs/SCERTSScoringCriteriaChecklist8-8-06.pdf

21. SCERTS Assessment(Prizant, Wetherby, Rubin, Laurent, & Rydell, 2005) • • Social Communication, Emotional Regulation, and Transactional Support • • Comprehensive, multidisciplinary approach to enhancing communication and social-emotional abilities of individuals with ASD and related disabilities • • The SCERTS assessment process (SAP) is a curriculum based assessment designed to: •              *measure outcome in meaningful and functional contexts •              *pinpoint educational goals to support social and communicative •                competence •              *Identify transactional supports to support child’s progress and •                success •              *Embed goals within natural routines through activity planning • • It is a criterion-referenced or curriculum-based tool, which measures child’s developmental achievements in everyday situations with everyday social partners. • • Focus is on functional use of language and nonverbal communication, socio-emotional abilities rather than on specific forms and milestones of language acquisition. Necessary level of family involvement.

22. Why the SCERTS Process: •Covers all the areas of other checklists and what is recommended by ASHA • Based on research and Best Practice • Includes mutual and self regulation. These affect communication, but a child needs communication skills to help them regulate • Purposefully looks at how transactional supports (interpersonal and learning supports) help the child regulate, engage, and participate • Team works together to prioritize educational objectives that are functional, address family priorities and match developmental areas of need • Completing activity grid allows the team to imbed goals in functional activities and is a very useful way for an SLP to consult in an educational setting • Very effective with task engagement and communication, transitions, and emotional expression

23. Communication Matrix  The Communication Matrix is appropriate for individuals of all ages who are at the earliest stages of communication. It covers the range of communication skills which typically develop between 0 and 24 months of age. The Matrix accommodates any type of communicative behavior, including "augmentative and alternative" (AAC) forms of communication and pre-symbolic communication.  Theprofile shows at a glance what level of communication behaviors a child is using and what kinds of messages he or she expresses. The Communication Skills List shows exactly what behaviors the child uses to express each message.  It is very good for non-verbal communication.

24. http://communicationmatrix.org/

25. Seven Levels of Communication • Level I. Pre-Intentional Behavior • Level II. Intentional Behavior • Level III. Unconventional Communication • Level IV. Conventional Communication • Level V. Concrete Symbols • Level VI. Abstract Symbols • Level VII. Language

26. Level I. Pre-Intentional Behavior Behavior is not under the individual's own control, but it reflects his general state (such as comfortable, uncomfortable, hungry or sleepy). Caregivers interpret the individual's state from behaviors such as body movements, facial expressions and sounds. In typically developing children, this stage occurs between 0 and 3 months of age.

27. Level II. Intentional Behavior   Behavior is under the individual's control, but it is not yet used to communicate intentionally. Caregivers interpret the individual's needs and desires from behaviors such as body movements, facial expressions, vocalizations and eye gaze. In typically developing children, this stage occurs between 3 and 8 months of age.

28. Level III. Unconventional Communication • INTENTIONAL COMMUNICATION BEGINS HERE, AT LEVEL III • Unconventional pre-symbolic behaviors are used intentionally to communicate. • Communicative behaviors are pre-symbolic because they do not involve any sort of symbol; they are unconventional because they are not socially acceptable for us to use as we grow older. • Communicative behaviors include body movements, vocalizations, facial expressions and simple gestures (such as tugging on people). In typically developing children, this stage occurs between 6 and 12 months of age.

29. Level IV. Conventional Communication Conventional pre-symbolic behaviors are used intentionally to communicate. Communicative behaviors are pre-symbolic because they do not involve any sort of symbol; they are conventional because they are socially acceptable and we continue to use them to accompany our language as we mature. The meanings of some gestures may be unique to the culture in which they are used. Communicative behaviors include pointing, nodding or shaking the head, waving, hugging, and looking from a person to a desired object. Note that many of these gestures (and especially pointing) require good visual skills and may not be useful for individuals with severe vision impairment. Some vocal intonations may also be used at this stage. In typically developing children, this stage occurs between 12 and 18 months of age.

30. Level V. Concrete SymbolsSYMBOLIC COMMUNICATION STARTS HERE, AT LEVEL V(symbols represent, or stand for, something else) • Concrete symbols that physically resemble what they represent, are used to communicate. • Concrete symbols look like, feel like, move like or sound like what they represent. Concrete symbols include pictures, objects (such as a shoelace to represent shoe), iconic gestures (such as patting a chair to say sit down) and sounds (such as making a buzzing sound to mean bee). • Most individuals skip this stage and go directly to Level VI. For some individuals concrete symbols may be the only type of symbol that makes sense to them; for others they may serve as a bridge to using abstract symbols. Typically developing children use concrete symbols in conjunction with gestures and words, generally between 12 and 24 months of age, but not as a separate stage.

31. Level VI. Abstract Symbols • Abstract symbols such as speech, manual signs, Brailled or printed words are used to communicate. These symbols are abstract because they are NOT physically similar to what they represent. They are used one at a time. In typically developing children, this stage occurs between 12 and 24 months of age.

32. Level VII. Language • Symbols (concrete or abstract) are combined into two- or three-symbol combinations ('want juice', 'me go out'), according to grammatical rules. • The individual understands that the meaning of symbol combinations may differ depending upon how the symbols are ordered. In typically developing children, this stage begins around 24 months of age.

33. Level VII. Language • Symbols (concrete or abstract) are combined into two- or three-symbol combinations ('want juice', 'me go out'), according to grammatical rules. • The individual understands that the meaning of symbol combinations may differ depending upon how the symbols are ordered. In typically developing children, this stage begins around 24 months of age.